HIV合并HBV感染者T淋巴细胞亚群血浆病毒载量与肝脏功能的关系

Relationship between T lymphocyte subsets,plasma viral load and liver function in HIV patients with HBV infection

目的探讨HIV合并HBV感染者T淋巴细胞亚群、血浆病毒载量与肝脏功能的关系。方法选取宁德师范学院附属宁德市医院2018年9月至2020年11月收治的103例HIV合并HBV感染者(研究组)及98例单纯HIV感染者(对照组)为研究对象,测定CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞(简称CD3细胞、CD4细胞、CD8细胞)、血浆病毒载量、肝脏功能情况。结果研究组与对照组CD3细胞、CD8细胞计数差异均无统计学意义(P>0.05),研究组CD4细胞计数显著低于对照组(P<0.05)。研究组HIV RNA(6.42±0.54)lg拷贝/mL显著高于对照组(4.29±0.38)lg拷贝/mL(P<0.05)。研究组HBV DNA为(6.15±0.61)lg拷贝/mL。研究组血清中ALT、AST、总胆红素(TBIL)、血清白蛋白(ALB)水平均显著高于对照组(P<0.05),ALB水平显著低于对照组(P<0.05)。研究组CD4细胞计数与ALT、AST、TBIL水平呈负相关(P<0.05),与ALB呈正相关(P<0.05),与HBV DNA载量呈负相关(P<0.05)。研究组HIV RNA载量与HBV DNA载量呈正相关(P<0.05)。结论HIV合并HBV感染者CD4细胞计数与肝脏功能存在明显相关性,建议临床尽早筛查,及时制订干预措施。

Objective To explore the relationship between T lymphocyte subsets,plasma viral load,and liver function in HIV patients with HBV infection.Methods We selected 103 patients with HIV co-infected with HBV infection(Study Group)and 98 patients with HIV infection only(control group)who were treated in Ningde Hospital Affiliated to Ningde Normal University from September 2018 to November 2020 as the research objects.CD3^(+),CD4^(+),CD8^(+)T lymphocytes(referred to as CD3 cells,CD4 cells and CD8 cells),plasma viral load and liver function were measured.Results There was no significant difference in the counts of CD3 cells and CD8 cells between the study group and the control group(P>0.05),and the count of CD4 cells in the study group was significantly lower than that in the control group(P<0.05).The HIV RNA(6.42±0.54)LG copy/ml in the study group was significantly higher than that(4.29±0.38)lg copy/ml in the control group(P<0.05).HBV DNA in the study group was(6.15±0.61)lg copy/ml.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),and serum albumin(ALB)in the study group were significantly higher than those in the control group(P<0.05),and the level of serum albumin(ALB)was significantly lower than those in the control group(P<0.05).In the study group,CD4 cell count was negatively correlated with ALT,AST,and TBIL levels(P<0.05),positively correlated with ALB(P<0.05),and negatively correlated with HBV DNA load(P<0.05).There was a positive correlation between HIV RNA load and HBV DNA load in the study group(P<0.05).Conclusion here was a significant correlation between CD4 cell count and liver function in HIV patients with HBV infection.It was suggested that clinical screening should be carried out as soon as possible and intervention measures should be formulated in time.