慢性乙型重型肝炎患者HIV感染情况调查及其对预后的影响分析

Investigation of HIV infection in patients with chronic severe hepatitis B and analysis of its influence on prognosis

目的调查慢性乙型重型肝炎患者人类免疫缺陷病毒(HIV)感染情况,并分析其对患者预后的影响。方法回顾性分析该院2019年1-10月收治的379例慢性乙型重型肝炎患者临床资料,统计患者HIV感染情况,并分析慢性乙型重型肝炎合并HIV感染的相关因素。随访3年,观察所有患者预后情况。结果379例患者中,合并HIV感染的有29例,发生率为7.65%,将这29例HIV感染患者纳入感染组,另350例患者纳入非感染组,感染组男性、>40岁、初中及以下文化程度患者比例高于非感染组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,男性、>40岁、初中及以下文化程度患者均为慢性乙型重型肝炎合并HIV感染的危险因素(P<0.05)。感染组不良结局发生率高于非感染组,差异有统计学意义(P<0.05)。感染组天门冬氨酸氨基转移酶、丙氨酸氨基转移酶及总胆红素水平均高于非感染组,CD3^(+)、CD4^(+)、CD8^(+)水平均低于非感染组,差异有统计学意义(P<0.05)。结论部分乙型重型肝炎患者伴有HIV感染,以男性、>40岁、初中及以下文化程度患者最为多见,合并HIV感染慢性乙型重型肝炎患者肝功能损伤更为严重、免疫功能更为低下,更易出现不良预后。

Objective To investigate the infection status of human immunodeficiency virus(HIV)in patients with chronic severe hepatitis B,and to analyze its influence on the prognosis of patients.Methods The clinical data of 379 patients with chronic severe hepatitis B admitted to the Ninth Hospital of Nanchang from January to October 2019 were analyzed retrospectively in patients with chronic severe hepatitis B.The HIV infection status of the patients was statistically analyzed,and the related factors of HIV infection in patients with chronic severe hepatitis B were analyzed.After 3 years of follow-up,the prognosis of patients was observed.Results Among the 379 patients,29 cases were infected with HIV,with an incidence rate of 7.65%.The 29 HIV-infected patients were included in infected group and the other 350 patients were enrolled as non-infected group.The proportions of males,patients with age>40 years old and patients with education level of junior high school and below in infected group were higher than those in non-infected group(P<0.05).Multivariate Logistic regression analysis showed that male,>40 years old and education level of junior high school and below were risk factors of chronic severe hepatitis B complicated with HIV infection(P<0.05).The incidence rate of adverse outcomes in infected group was higher than that in non-infected group(P<0.05).The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin in infected group were higher than those in non-infected group,while the levels of CD3^(+),CD4^(+)and CD8^(+)were lower than those in non-infected group(P<0.05).Conclusion Some patients with severe hepatitis B are complicated with HIV infection,and most of them are males,with age>40 years old and education level of junior high school and below.Patients with chronic severe hepatitis B complicated with HIV infection have more serious liver function injury and lower immune function,and are more likely to have poor prognosis.