人类免疫缺陷病毒/乙型肝炎病毒共感染者CD4/CD8比值与肝功能及乙型肝炎病毒载量的关系研究

Study on the relationship between CD4/CD8 ratio and liver function as well as HBV load in HIV/HBV coinfected patients

目的探讨长期抗病毒治疗治疗(antiretroviral therapy,ART)的人类免疫缺陷病毒(human immunodeficiency virus,HIV)/乙型肝炎病毒(hepatitis B virus,HBV)共感染者CD4/CD8比值与肝功能及HBV脱氧核糖核酸(HBV deoxyribonucleic acid,HBV DNA)的关系。方法以重庆市第五人民医院2021年10月至2023年6月收治的51例HIV/HBV共感染者作为HIV/HBV共感染组,另选取同期该院收治的51例单纯HBV感染者作为单纯HBV感染组。采用流式细胞分析法检测2组患者免疫功能指标(CD4^(+)T细胞计数、CD8^(+)T细胞计数、CD4/CD8比值)水平,采用全自动生化分析仪检测血清肝功能指标[天冬氨酸氨基转移酶(aspartate transaminase,AST)、丙氨酸氨基转移酶(alanine transaminase,ALT)、血清白蛋白(albumin,ALB)]水平,采用实时荧光定量PCR法检测HBV DNA水平;用Pearson相关分析法分析HIV/HBV共感染者CD4/CD8比值与肝功能指标及HBV DNA的关系。结果HIV/HBV共感染组CD4^(+)T细胞计数、CD4/CD8比值均低于单纯HBV感染组,CD8^(+)T细胞计数高于单纯HBV感染组(P均<0.05)。HIV/HBV共感染组ALB水平低于单纯HBV感染组,AST、ALT、HBV DNA水平均高于单纯HBV感染组(P均<0.05)。Pearson相关分析结果显示,HIV/HBV共感染者CD4/CD8比值与肝功能指标AST、ALT水平均呈负相关(r=-0.435、-0.413),与ALB水平呈正相关(r=0.455),与HBV DNA水平呈负相关(r=-0.397)。结论HIV感染者合并HBV感染后机体免疫功能进一步受损,CD4/CD8比值下降,使HBV DNA复制更加活跃,导致肝脏损伤增强。

Objective study the relationship between CD4/CD8 and liver function as well as HBV viral load(hepatitis B virus DNA,HBV)in patients with co-infection of human immunodeficiency virus(HIV)/hepatitis B virus(HBV)DNA.Methods Fifty one patients with HIV/HBV co-infection admitted to the Fifth Peoples Hospital of Chongqing from October 2021 to June 2023 were selected as the HIV/HBV co-infection group,and 51 patients with only HBV infection admitted to our hospital during the same period were selected as the pure HBV infection group.Flow cytometry analysis was used to detect the immune function indicators including CD4^(+)T cell count,CD8^(+)T cell count and CD4/CD8;A fully automatic biochemical analyzer was used to detect serum liver function indicators including aspartate transaminase(AST),alanine transaminase(ALT),and albumin(ALB);Real-time fluorescence quantitative PCR method was used to detect HBV DNA levels;Pearson correlation analysis was used to evaluate the relationship between CD4/CD8 and liver function as well as HBV NDA.Results The CD4^(+)T cell count and CD4/CD8 ratio in the HIV/HBV coinfection group were lower than those in the pure HBV infection group,and the CD8^(+)T cell count was higher than that in the pure HBV infection group(P<0.05).The ALB level of the HIV/HBV coinfection group was lower than that of the pure HBV infection group,and the levels of AST,ALT,and HBV DNA were higher than those of the pure HBV infection group(P<0.05).The results of Pearson correlation analysis showed that CD4/CD8 ratio in patients with HIV/HBV coinfection was negatively correlated with AST and ALT(r=-0.435,-0.413),positively correlated with ALB(r=0.455),and negatively correlated with HBV DNA(r=-0.397).Conclusion The CD4/CD8 ratio decreases with HIV and HBV coinfection,which makes HBV DNA replication more active and lead to increased liver damage.