HIV/AIDS合并感染乙型/丙型肝炎病毒患者肝功能损伤情况分析

Analysis of liver function injury in patients with HIV/AIDS combined with HBV/HCV

目的分析人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者和艾滋病即获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者同时合并感染乙型肝炎病毒(hepatitis B virus,HBV)和/或丙型肝炎病毒(hepatitis C virus,HCV)病例的肝功能受损情况。方法回顾性分析2016年1月至2019年1月首都医科大学附属北京佑安医院收治的HIV确诊患者100例,分为单纯HIV感染组、HIV/HBV组、HIV/HCV组、HIV/HBV/HCV组,对各组患者的肝功能、凝血功能及肝脏病理等指标进行对比分析。结果 HIV/HBV组和HIV/HCV组患者肝脏病理的炎症分级和纤维化程度均比单纯HIV感染组高,丙氨酸氨基转移酶(alanine aminotransfease,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)呈轻度升高,血清白蛋白(albumin,ALB)降低,其中HIV/HBV组ALB降低更为明显;HIV/HBV/HCV混合感染组肝损伤最为严重,与其他三组比较,AST、血清总蛋白(total protein,TB)均明显升高,凝血酶原时间(prothrombin,PT)明显延长,凝血酶原活动度(prothrombin activity,PTA)明显降低,差异有显著性。结论当HIV合并感染HBV和/或HCV可加重患者的肝脏损伤,同时合并感染HBV/HCV者肝脏损伤更为严重。

Objective To analyze the impairment of liver function in patients infected with human immunodeficiency virus(HIV) and acquired immunodeficiency syndrome(AIDS) combined with hepatitis B virus(HBV) and/or hepatitis C virus(HCV).Methods Retrospective analysis of 100 confirmed cases of HIV from January 2016 to January2019 were performed.The 100 patients were divided into four groups:simple HIV infection,HIV/HBV,HIV/HCV,HIV/HBV/HCV.The liver function,coagulation function and liver pathology of each group of patients were compared and analyzed.Results The degree of inflammation and fibrosis in the liver pathology of HIV/HBV and HIV/HCV group was higher than that of simple HIV infection.ALT and AST were slightly increased and ALB was reduced,among which ALB in HIV/HBV group was more obvious.The most serious liver damage was in the HIV/HBV/HCV co-infection group.Compared with the other three groups,AST and TB were significantly increased,PT was significantly prolonged,and PTA was significantly reduced,and the differences were statistically significant.Conclusion When HIV combined with HBV and/or HCV can aggravate the liver damage in patients,and the liver damage in patients with HIV/HBV/HCV co-infection is the most serious.