替诺福韦联合拉米夫定治疗乙型肝炎病毒/人类免疫缺陷病毒共感染患者的效果

Effect of Tenofovir combined with Lamivudine in the treatment of patients with Hepatitis B virus/Human immunodeficiency virus co-infection

目的探讨应用替诺福韦联合拉米夫定治疗乙型肝炎病毒(HBV)/人类免疫缺陷病毒(HIV)共感染患者的临床效果。方法选取2014年1月~2016年12月我院收治的60例HIV合并HBV患者作为研究对象,按照随机数字表法将其分为对照组(n=30)和研究组(n=30),对照组患者予以拉米夫定治疗,研究组患者在对照组基础上予以替诺福韦联合治疗。比较两组患者治疗后的HIV-RNA载量、HBV-DNA载量、CD4+T淋巴细胞水平、免疫球蛋白水平、肝功能相关指标以及不良反应发生情况。结果研究组患者的HIV-RNA低于下限率、HBV-DNA低于下限率显著高于对照组,差异有统计学意义(P<0.05)。研究组患者的CD4+T淋巴细胞水平为(238.46±26.48)个/μl,显著高于对照组的(164.32±12.44)个/μl,差异有统计学意义(t=7.452,P<0.05)。研究组患者的免疫球蛋白水平显著高于对照组,差异有统计学意义(P<0.05)。研究组患者的丙氨酸转氨酶(ALT)、谷草转氨酶(AST)水平均显著低于对照组,差异有统计学意义(P<0.05),两组患者的总胆红素(TBil)水平比较,差异无统计学意义(P>0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论采用替诺福韦联合拉米夫定治疗HIV合并HBV患者,可显著降低体内病毒载量,提高患者免疫功能,改善患者肝功能,临床应用安全有效。

Objective To investigate the clinical effect of Tenofovir combined with Lamivudine in the treatment of coinfection of Hepatitis B virus（HBV） and Human immunodeficiency virus（HIV）. Methods Sixty patients with HIV/HBV admitted to our hospital from January 2014 to December 2016 were selected as subjects and divided into the control group（n=30） and the study group（n=30） according to the random number table method. The control group was treated with Lamivudine, while the study group was treated with Tenofovir on the basis of the control group. The HIV-RNA load, HBV-DNA load, CD4＋T lymphocyte level, immunoglobulin level, liver function related indicators and adverse reactions were compared between the two groups after treatment. Results The rate of HIV-RNA below the lower limit and HBV-DNA below the lower limit in the study group were significantly higher than those in the control group, and the differences were statistically significant（P〈0.05）. The CD4＋T lymphocytes of the study group was（238.46±26.48）per 1 μl, which was significantly higher than that of the control group（[164.32 ±12.44] per 1 μl）, and the difference was statistically significant（t =7.452, P〈0.05）. The immunoglobulin level of the study group was significantly higher than that of the control group, and the difference was statistically significant（P〈0.05）. The levels of alanine transaminase（ALT） and aspartate aminotransferase（AST） in the study group were significantly lower than those in the control group, and the differences were statistically significant（P〈0.05）. There were no significant differences in levels of total bilirubin（TBIL） between two groups（P〈0.05）. There was no significant difference in the total incidence of adverse reactions between two groups（P〈0.05）. Conclusion Tenofovir combined with Lamivudine in the treatment of patients with HIV and HBV can significantly reduce the viral load in the body and improve the immune function and liver function,with safe and effective clinical application.