HCV/HIV重叠感染患者不同时期丙肝抗病毒疗效的比较
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摘要
目的探讨HCV/HIV重叠感染患者,根据CD4淋巴细胞水平不同,予不同时期应用聚乙二醇干扰素α-2a联合利巴韦林抗丙肝病毒的疗效进行比较。方法选取徐州市传染病医院2014年12月至2016年12月门诊收治的20例HCV/HIV重叠感染患者进行研究,根据CD4淋巴细胞水平不同,分为下面两组:CD4>200,根据肝功能情况先进行抗HCV-RNA治疗,后进行高效抗逆转录病毒疗法(HAART)治疗,总共10例,记为实验组;CD4<200,先进行HAART治疗后再进行抗HCV-RNA治疗,共10例,记为对照组。结果实验组的抗丙肝病毒病毒学应答率(70.0%)明显高于对照组(40.0%),具有统计学意义(P<0.05);经过检测发现,治疗3月后实验组患者抗丙肝病毒治疗后的ALT、 AST、 TBIL、HCV-RNA水平均明显低于对照组患者的各项指标水平,ALB水平明显升高,差异具有统计学意义(P <0. 05);实验组发生不良反应(10.0%)明显少于对照组(40.0%),具有统计学意义(P<0.05)。结论根据抗丙肝病毒时期不同,可看出CD4细胞水平越高,抗丙肝病毒治疗后HCV-RNA下降明显,抑制了丙肝病毒的复制,改善了患者肝脏功能为进行抗高效抗逆转录病毒治疗提供较好的基础,从而更好的控制HCV/HIV重叠感染患者的病情。
Objective To investigate the efficacy of peginterferon alfa-2 a combined with ribavirin againsthepatitis C virus in different periods of HCV/HIV overlap infection according to different CD4 lymphocyte levels.Methods Twenty patients with HCV/HIV overlap infection who were admitted to the outpatient department ofXuzhou Infectious Disease Hospital from December 2014 to December 2016 were enrolled. According to differentCD4 lymphocyte levels, they were divided into the following two groups: CD4>200, according to the liver. Functionalstatus was first treated with anti-HCV-RNA, followed by highly active antiretroviral therapy (HAART), a total of 10 cases, recorded as the experimental group. CD4 <200, first HAART treatment followed by anti-HCV-RNA treatment,a total of 10 cases were recorded as a control group. Results The virological response rate of anti-hepatitis C virus inthe experimental group (70.0%) was significantly higher than that in the control group (40.0%), which was statisticallysignificant (P< 0.05). After the test, the anti-hepatitis C virus treatment in the experimental group was observed after 3 months of treatment. The levels of ALT, AST, TBIL and HCV-RNA were significantly lower than those of the controlgroup, and the ALB level was significantly increased (P< 0.05). The adverse reactions occurred in the experimentalgroup ( 10.0%) was significantly less than the control group (40.0%), with statistical significance (P< 0.05). ConclusionAccording to the anti-hepatitis C virus period, it can be seen that the higher the level of CD4 cells, the lowering of HCV-RNA after anti-hepatitis C virus treatment, inhibiting the replication of hepatitis C virus, improving the liver functionof patients, and anti-high-efficiency antiretroviral therapy, providing a better basis to better control the condition ofpatients with HCV/HIV overlap infection.
Objective To investigate the efficacy of peginterferon alfa-2 a combined with ribavirin againsthepatitis C virus in different periods of HCV/HIV overlap infection according to different CD4 lymphocyte levels.Methods Twenty patients with HCV/HIV overlap infection who were admitted to the outpatient department ofXuzhou Infectious Disease Hospital from December 2014 to December 2016 were enrolled. According to differentCD4 lymphocyte levels, they were divided into the following two groups: CD4>200, according to the liver. Functionalstatus was first treated with anti-HCV-RNA, followed by highly active antiretroviral therapy (HAART), a total of 10 cases, recorded as the experimental group. CD4 <200, first HAART treatment followed by anti-HCV-RNA treatment,a total of 10 cases were recorded as a control group. Results The virological response rate of anti-hepatitis C virus inthe experimental group (70.0%) was significantly higher than that in the control group (40.0%), which was statisticallysignificant (P< 0.05). After the test, the anti-hepatitis C virus treatment in the experimental group was observed after 3 months of treatment. The levels of ALT, AST, TBIL and HCV-RNA were significantly lower than those of the controlgroup, and the ALB level was significantly increased (P< 0.05). The adverse reactions occurred in the experimentalgroup ( 10.0%) was significantly less than the control group (40.0%), with statistical significance (P< 0.05). ConclusionAccording to the anti-hepatitis C virus period, it can be seen that the higher the level of CD4 cells, the lowering of HCV-RNA after anti-hepatitis C virus treatment, inhibiting the replication of hepatitis C virus, improving the liver functionof patients, and anti-high-efficiency antiretroviral therapy, providing a better basis to better control the condition ofpatients with HCV/HIV overlap infection.
引文
[1]邓莉平,桂希恩.HIV/HCV合并感染者联合抗反转录病毒治疗后死亡原因及危险因素分析[J].中华临床感染病杂志,2012,6(5):153-154.
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[4]姜枫.中医药治疗艾滋病免疫指标疗效评价标准探讨[J].中华中医药杂志,2012,20(1):234-236.
[5]陈莉华,郭会军,蒋自强,等.艾滋病合并肝损伤的研究现状及分析[A].中华中医药学会防治艾滋病分会2014年学术会议论文集,2014.
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[7]吕黄先.丙型肝炎感染患者血清脂代谢指标检测的临床意义[J].浙江临床医学,2013(10):1655-1658.
[8]张晓红,洪春霞,许镇,等.聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎患者效果的影响因素[J].中华传染病杂志,2012,30(7):416-420.
[9]周友乾,尹凤鸣,冯经华.慢性丙型肝炎患者混合或重叠感染其他病原体状况分析[J].实用肝脏病杂志,2012,20(5):58-62.
[10]李婷,包剑锋.艾滋病合并丙型肝炎HIVRNA水平及CD4+细胞损害研究[J].浙江预防医学,2015,28(6):358-362.
[11]李娅,陈斌,易富,等.994例HIV感染者的临床分布及HIV和HCV合并感染的统计分析[J].国际检验医学杂志,2013,25(18):1022-1026.
[12]王建生,韩志启,程琰,等.HIV合并HCV感染者抗丙型肝炎病毒治疗疗效观察[J].实用肝脏病杂志,2013,20(5):254-256.
[13]曹婉娴,姚晖,杨静.合肥市158例艾滋病流行病学及临床特征分析[J].安徽医学,2012,20(6):2547-2549.
[14]王艳春,彭勃,李雁,等.艾滋病与非艾滋病发热的流行病学对照调查研究[J].中华中医药杂志,2012,20(4):248-251.
[15]刘晓,孙丽萍,王寰,等.慢性丙肝患者血清中HCV RNA与HCV-Ab的相关性分析[J].中外健康文摘,2014,25(5):125-129.
[2]周友乾,尹凤鸣,冯经华.慢性丙型肝炎患者混合或重叠感染其他病原体状况分析[J].实用肝脏病杂志,2012,20(5):58-62.
[3]邓莉平,桂希恩.抗反转录病毒治疗人类免疫缺陷病毒/丙型肝炎病毒合并感染者终末期肝病的发生率及危险因素[J].中华传染病杂志,2012,8(30):488-489.
[4]姜枫.中医药治疗艾滋病免疫指标疗效评价标准探讨[J].中华中医药杂志,2012,20(1):234-236.
[5]陈莉华,郭会军,蒋自强,等.艾滋病合并肝损伤的研究现状及分析[A].中华中医药学会防治艾滋病分会2014年学术会议论文集,2014.
[6]Potter M,Odueyungbo A,Yang H,et a1.Impact of hepatitis C viral replication on CD4+T-lymphocyte progression in HIV-HCV coinfection before and after antiretroviral therapy[J].AIDS,2015,24(12):1857-1865.
[7]吕黄先.丙型肝炎感染患者血清脂代谢指标检测的临床意义[J].浙江临床医学,2013(10):1655-1658.
[8]张晓红,洪春霞,许镇,等.聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎患者效果的影响因素[J].中华传染病杂志,2012,30(7):416-420.
[9]周友乾,尹凤鸣,冯经华.慢性丙型肝炎患者混合或重叠感染其他病原体状况分析[J].实用肝脏病杂志,2012,20(5):58-62.
[10]李婷,包剑锋.艾滋病合并丙型肝炎HIVRNA水平及CD4+细胞损害研究[J].浙江预防医学,2015,28(6):358-362.
[11]李娅,陈斌,易富,等.994例HIV感染者的临床分布及HIV和HCV合并感染的统计分析[J].国际检验医学杂志,2013,25(18):1022-1026.
[12]王建生,韩志启,程琰,等.HIV合并HCV感染者抗丙型肝炎病毒治疗疗效观察[J].实用肝脏病杂志,2013,20(5):254-256.
[13]曹婉娴,姚晖,杨静.合肥市158例艾滋病流行病学及临床特征分析[J].安徽医学,2012,20(6):2547-2549.
[14]王艳春,彭勃,李雁,等.艾滋病与非艾滋病发热的流行病学对照调查研究[J].中华中医药杂志,2012,20(4):248-251.
[15]刘晓,孙丽萍,王寰,等.慢性丙肝患者血清中HCV RNA与HCV-Ab的相关性分析[J].中外健康文摘,2014,25(5):125-129.