HAART对AIDS合并HBV/HCV感染患儿CD4~+T细胞、病毒载量的影响
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摘要
目的探讨高效抗逆转录病毒治疗(HAART)对AIDS合并HBV/HCV感染患儿CD4~+T细胞、病毒载量和肝功能的影响。方法选取2014年4月至2015年4月在该院接受治疗的单纯HIV感染患儿88例,分为A组;HIV合并HBV感染的患儿8例,分为B组;然后将HIV合并HCV感染的23例患儿分为C组。3组患儿全部接受HAART治疗,治疗时间为两年,比较3组患儿治疗前后肝功能、病毒载量以及CD4~+T细胞变化情况。结果治疗前,3组肝功能异常的患儿共计29例(24.79%),3组组间比较差异无统计学意义(P>0.05);治疗后,3组肝功能异常的患儿共计82例(70.09%),3组治疗前后比较差异有统计意义(P<0.05)。治疗前,3组患者的AIT、AST及TBIL水平比较差异无统计学意义(P>0.05);治疗后,3组患儿的AIT、AST及TBIL水平均明显升高,差异有统计学意义(P<0.05);且A组的ALT水平明显低于B组和C组,差异有统计学意义(P<0.05)。3组AST、TBIL水平比较无统计学意义(P>0.05)。治疗前,3组患儿的CD4~+T细胞及HIV RNA水平比较,差异有统计学意义(P<0.05);治疗后,3组患者的CD4~+T细胞水平均明显增高,HIV RNA水平均明显降低,,差异有统计学意义(P<0.05)。但3组患者组间比较差异无统计学意义(P>0.05)。结论高效抗逆转录病毒治疗AIDS合并HBV/HCV感染患儿,对患儿的肝功能存在不同差异,治疗后能明显升高CD4~+T细胞水平,降低病毒载量,对于AIDS合并HBV/HCV感染患儿均存在不同差异,在临床应用过程中应密切关注患儿的肝功能状况。
Objective To investigate the effect of high performance antiretroviral therapy on CD4~+T cells,viral load and liver function in children with AIDS combined with HBV/HCV infection.Methods The simple HIV from April 2014 to April 2015 in our hospital infection in 88 cases were divided into group A,8 cases of HIV patients with HBV infection was divided into B group,and 23 cases of HIV patients with HCV infection was divided into C group,three groups were all treated with HAART,after about two years treatment time,before and after treatment of liver function,viral load and CD4~+T cell changes between the three groups were compared.Results Before treatment,the total of three groups of children with abnormal liver function was 29 cases(24.79%),and the three groups were not statistically significant(P>0.05).After treatment,the total of three groups of children with abnormal liver function were 82(70.09%),and the difference between the three groups was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of AIT,AST and TBIL between the three groups(P>0.05).After treatment,the levels of AIT,AST and TBIL in the three groups increased significantly(P<0.05).The data between the three groups were not statistically significant(P>0.05).Before treatment,there was no significant difference between the three groups of children with CD4~+T cells and viral load(P>0.05);after treatment,the three groups of patients with CD4~+T(P<0.05)cells increased,HIVRNA decreased significantly(P<0.05),the three groups had no statistically significant difference between the two groups of patients(P>0.05).Conclusion High-efficiency antiretroviral treatment in children with AIDS complicated with HBV/HCV infection,there are different differences in liver function of patients,after treatment can significantly increase the level of CD4~+T cells,reduce viral load,AIDS combined with HBV/HCV infected children have different differences,the liver function should be paid close attention in clinical application.
Objective To investigate the effect of high performance antiretroviral therapy on CD4~+T cells,viral load and liver function in children with AIDS combined with HBV/HCV infection.Methods The simple HIV from April 2014 to April 2015 in our hospital infection in 88 cases were divided into group A,8 cases of HIV patients with HBV infection was divided into B group,and 23 cases of HIV patients with HCV infection was divided into C group,three groups were all treated with HAART,after about two years treatment time,before and after treatment of liver function,viral load and CD4~+T cell changes between the three groups were compared.Results Before treatment,the total of three groups of children with abnormal liver function was 29 cases(24.79%),and the three groups were not statistically significant(P>0.05).After treatment,the total of three groups of children with abnormal liver function were 82(70.09%),and the difference between the three groups was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of AIT,AST and TBIL between the three groups(P>0.05).After treatment,the levels of AIT,AST and TBIL in the three groups increased significantly(P<0.05).The data between the three groups were not statistically significant(P>0.05).Before treatment,there was no significant difference between the three groups of children with CD4~+T cells and viral load(P>0.05);after treatment,the three groups of patients with CD4~+T(P<0.05)cells increased,HIVRNA decreased significantly(P<0.05),the three groups had no statistically significant difference between the two groups of patients(P>0.05).Conclusion High-efficiency antiretroviral treatment in children with AIDS complicated with HBV/HCV infection,there are different differences in liver function of patients,after treatment can significantly increase the level of CD4~+T cells,reduce viral load,AIDS combined with HBV/HCV infected children have different differences,the liver function should be paid close attention in clinical application.
引文
[1]饶和平,王炜,姚水洪,等.高效抗逆转录病毒疗法对艾滋病合并HCV感染儿童肝功能与病毒载量的影响[J].山东医药,2014,12(41):6-7.
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[9]朱晓艳,陶小润,王国永,等.山东省HIV感染及艾滋病儿童抗病毒治疗结果分析[J].中华预防医学杂志,2014,16(11):959-963.
[10]GOWDA C,COPPOCK D,BRICKMAN C,et al.DETERMINANTS OF HIV TRANSMISSION RISK AMONG HIV-INFECTED PERSONS ENGAGED IN CARE[J].AIDS Educ Prev,2016,28(5):440-452.
[11]朱晓华,尹宁,唐政,等.112例艾滋病感染者中男男性行为人群高危行为及心理状况分析[J/CD].中华实验和临床感染病杂志(电子版),2014,30(3):340-344.
[12]雷卫勇,杨芳,张云霞.基于“马斯洛需要层次理论”的互动式信息支持在减轻HIV感染孕产妇焦虑水平的应用研究[J].中华实验和临床病毒学杂志,2014,28(4):309-312.
[2] TAIEB F,TRAM T H,HO H T,et al.Evaluation of two techniques for viral load monitoring using dried blood spot in routine practice in Vietnam(French National agency for AIDS and hepatitis research 12338)[J].Open Forum Infect Dis,2016,3(3):142.
[3]饶和平,方美新,王炜,等.艾滋病合并HBV/HCV感染患儿HAART治疗后肝功能及病毒载量变化[J].中国免疫学杂志,2015,45(10):1385-1388.
[4]王其亮,林明华,王宗立.122例艾滋病患者合并乙肝病毒丙肝病毒感染的临床流行病学研究[J].安徽医学,2015,36(5):583-586.
[5]郭永红,周云,张颖,等.慢加急性乙型肝炎肝衰竭患者Th1/Th2细胞的细胞因子变化及与肝功能指标的关系[J].检验医学,2014,21(3):274-278.
[6]谭友文,叶云,姜林仙,等.血浆置换联合持续血液滤过对肝功能衰竭患者短期生存期的影响[J].中华传染病杂志,2014,32(4):243-246.
[7] HATAYAMA Y,HASHIMOTO Y,HARA A,et al.Construction and evaluation of cytomegalovirus DNA quantification system with Real-Time detection polymerase chain reaction[J].Yonago Acta Med,2016,59(3):217-222.
[8]黄丹,丛喆,徐珮,等.游离SIVmac239病毒与T细胞介导两种方式感染内皮细胞的效果比较[J].中国比较医学杂志,2016,26(6):1-5.
[9]朱晓艳,陶小润,王国永,等.山东省HIV感染及艾滋病儿童抗病毒治疗结果分析[J].中华预防医学杂志,2014,16(11):959-963.
[10]GOWDA C,COPPOCK D,BRICKMAN C,et al.DETERMINANTS OF HIV TRANSMISSION RISK AMONG HIV-INFECTED PERSONS ENGAGED IN CARE[J].AIDS Educ Prev,2016,28(5):440-452.
[11]朱晓华,尹宁,唐政,等.112例艾滋病感染者中男男性行为人群高危行为及心理状况分析[J/CD].中华实验和临床感染病杂志(电子版),2014,30(3):340-344.
[12]雷卫勇,杨芳,张云霞.基于“马斯洛需要层次理论”的互动式信息支持在减轻HIV感染孕产妇焦虑水平的应用研究[J].中华实验和临床病毒学杂志,2014,28(4):309-312.