CD4^+T淋巴细胞水平对HCV/HIV合并感染自然进程的影响

The influence of CD4^+T lymphocyte counts in the natural processes of HCV/HIV co-infection

目的探讨CD4^+T淋巴细胞水平对丙型肝炎病毒(HCV)/人类免疫缺陷病毒(HIV)合并感染自然进程的影响。方法比较初次就诊高效抗反转录病毒治疗(HAART)前HCV/HIV合并感染(HCV/HIV组)、HCV单纯感染(HCV组)、HIV单纯感染(HIV组)患者的CD4^+T淋巴细胞水平与HCV RNA、HIV RNA、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、透明质酸酶(HA)、层粘连蛋白(LN)、甘胆酸(CG)、Ⅲ型胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、年龄等危险因素的相关性。结果 HCV/HIV组CD4^+T淋巴细胞明显低于HCV组和HIV组(P<0.01);HIV RNA高于HIV组(P<0.01);发病年龄低于HCV组(P<0.01);HCV RNA、CⅣ、CG、PCⅢ、ALT高于HCV组(P<0.05);HCV/HIV组CD4^+T淋巴细胞与CG和PCⅢ呈负相关(r=-0.504、r=-0.232,P<0.05)。结论低水平的CD4^+T淋巴细胞加快和加重HCV/HIV合并感染的自然进程。

Objective To investigate the influence of the level of CD4 ^＋ T lymphocyte in the natural processes of HCV/HIV co-infection. Methods The relationship between the level of CD4^＋ T lymphocyte and HCV RNA was com- pared, HIV RNA, aspartate aminotransferase （AST）, total bilirubin （TBIL） , hyaluronidase （HA）, laminin （LN）, eholyglycine （CG） , Ⅲ collagen （PCⅢ） , Ⅳ collagen （CⅣ） and age were compared among untreated HCV infection, HIV infection and HCV/HIV co-infection patients. Results The level of CD4 ^＋ T lymphocyte in HCV/HIV co-infection group was obviously lower than that in HCV group or H1V group （P 〈 0.01）. The level of HIV RNA in HCV/HIV group was higher than that in HIV group （P 〈0.01 ）. The age of onset in HCV/HIV group was lower than that in HCV group （P 〈0.01 ）. The levels of HCV RNA, CIV, CG, PC III , ALT of HCV/HIV group were higher than those in HCV group （P 〈 0.05）. There was a negative correlation between the level of CD44^＋ T lymphocyte and the level of CG and PC Ⅲ （r = -0. 504, r = - 0. 232, P 〈 0.05）. Conclusion The low level of CD44^＋ T lymphocyte may accelerate the natural processes of HCV/HIV co-lnfection patients.