艾滋病合并乙型肝炎患者CD4+T淋巴细胞及血浆病毒载量与肝功能的相关性分析

Correlation between CD4+T lymphocytes, plasma viral load and liver function of AIDS patients complicated with hepatitis B

目的分析艾滋病合并乙型肝炎患者CD4+T淋巴细胞水平及血浆病毒载量与肝功能的相关性。方法选取2013年5月-2018年6月遂宁市中心医院收治的艾滋病合并乙型肝炎患者84例为研究组,未合并乙型肝炎的单纯艾滋病患者100例为对照组,分析患者CD4+T淋巴细胞水平、HIV RNA载量、肝功能指标:谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)水平,分析CD4+T淋巴细胞、病毒载量与肝功能的相关性。结果研究组CD4+T淋巴细胞数、ALB水平低于对照组,而HIV RNA载量、ALT、AST、TBIL水平高于对照组(P<0.05);随着CD4+T淋巴细胞数增加,HBV DNA载量、HIV RNA载量及ALT、AST、TBIL水平逐渐下降,ALB逐渐升高,差异均有统计学意义(P<0.05);随着HBV DNA拷贝数增加,CD4+T淋巴细胞数、ALB逐渐降低,而HIV RNA载量、ALT、AST、TBIL逐渐升高,差异有统计学意义(P<0.05);艾滋病合并乙型肝炎患者CD4+T淋巴细胞数与ALB呈正相关,与HBV DNA载量、HIV RNA载量、ALT、AST、TBIL呈负相关(P<0.05),HBV DNA载量与HIV RNA载量呈正相关(P<0.05)。结论艾滋病合并乙型感染患者CD4+T淋巴细胞、血浆病毒载量及肝功能存在明显相关性,随CD4+T淋巴细胞数减少,病毒载量上升,肝功能受损更严重,同时两种病毒可能有相互促进作用,加重患者肝损伤与免疫缺陷。

OBJECTIVE To analyze the correlation between CD4+T lymphocytes,plasma viral load and liver function of AIDS patients complicated with hepatitis B.METHODS Totally 84 AIDS patients complicated with hepatitis B who were treated in suining central hospital from May 2013 to Jun 2018 were chosen as the study group,and 100 AIDS patients who were not complicated with hepatitis B were set as the control group.The levels of CD4+T lymphocytes,HIV RNA load and the liver function indexes,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and albumin(ALB),were observed,and the correlation between CD4+T lymphocytes,viral load and liver function was analyzed.RESULTS The levels of CD4+T lymphocytes and ALB of the study group were significantly lower than those of the control group,however,the levels of HIV RNA load,ALT,AST and TBIL of the study group were significantly higher than those of the control group(P<0.05).With the increase of CD4+T lymphocytes counts,the HBV DNA load,HIV RNA load and levels of ALT,AST and TBIL were reduced,the ALB level was elevated,and there were significant differences(P<0.05).With the increase of HBV DNA copies,the CD4+T lymphocytes counts and ALB level were gradually reduced,while the levels of HIV RNA,ALT,AST and TBIL were gradually elevated,and there were significant differences(P<0.05).The CD4+T lymphocytes counts of the AIDS patients complicated with hepatitis B were positively correlated with ALB and negatively correlated with the HBV DNA load,HIV RNA load,ALT,AST and TBIL(P<0.05),and the HBV DNA load was positively correlated with the HIV RNA load(P<0.05).CONCLUSION There is an obvious correlation between the CD4+T lymphocytes,plasma viral load and liver function of the AIDS patients complicated with hepatitis B,the patients may have more severe liver function damage with the decrease of CD4+T lymphocytes counts and the increase of viral load.The two types of viruses may interact each other,which could aggravate the liver damage and immune deficiency.