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

摘要

Objective To study the clinical epidemiology of HIV-infected patients with HBV and /or HCV receiving highly active anti retroviral therapy and the characteristics of serum biochemistry and virology related to HBV and HCV. Methods A total of 122 HIV-in-fected patients were included. Microparticle enzyme immunoassay ( MEIA) was used to detect HBV serological markers ( HBsAg, Anti-HBs, HBeAg, Anti-HBe, Anti-HBc) and liver function. Enzyme linked immunosorbent assay( ELISA) was used to detect HCV antibody. The posi-tion of HCV-Ab, HBsAg and anti-HBC further was detected by RT-PCR assay. As comparison, 43 patients with mono-infected HCV were studied. Results Among 122 patients infected HIV, 3 patients (2. 46％) were HBsAg positive, 97 patients'HBV serological markers were negative, the cumulative 19 patients'anti-HBs positive, 3 patients' anti-HBc positive. 84 patients were HCV-Ab positive, and 58 of those HCV-RNA were positive;the prevalence rate of HIV/HBV/HCV was 0. There were no significant differences in HCV-RNA and liver function between patients with HIV/HCV co-infection and patients with mono-infected HCV. Likewise, no significant difference was found in HCV-RNA between different levels of CD4 +cell number in patients with HIV/HCV co-infection. Conclusion In patients with HIV/HBV and/or HCV co-infection, the HBsAg positive rate is lower than that in common population, and the HCV antibody positive rate is higher than that in common population. HIV/HCV co-infection shows similar change in serum biochemistry and the level of HCV-RNA compared to HCV mono-infection.%目的 研究在抗逆转录病毒药物治疗(HAART)状态下HIV/AIDS患者合并乙肝病毒(HBV)、丙肝病毒(HCV)的流行状况以及相关血清生化和病毒学特征.方法 对122例正在接受HAART治疗的HIV/AIDS患者采集血标本,使用酶免法(ME-IA)检测乙肝五项指标(HBs Ag、抗-HBs、HBe Ag、抗-HBe、抗-HBc)、肝功能,应用酶联免疫吸附法(ELISA)检测丙型肝炎病毒抗体,运用RT-PCR法对丙肝病毒抗体阳性标本以及表面抗原和/或核心抗体阳性标本分别进行HCV-RNA以及HBV-DNA测定.以43名单纯HCV感染者作为对照组进行研究.结果 122名 HIV/AIDS患者,乙肝五项指标全阴性97例(78.86％),表面抗原阳性3例(2.46％),表面抗体阳性者总计19例(15.57％),单纯核心抗体阳性者3例(2.46％).HCV 抗体阳性84例(68.85％),84例HCV抗体阳性标本中HCV-RNA 阳性58例(69.05％),HIV/HCV/HBV合并感染者为0.HIV/HCV合并感染组 HCV-RNA 水平与感染者性别,CD4 +细胞数水平无明显差异(P＞0.05);HIV/HCV合并感染组与单纯HCV感染组 HCV-RNA水平、肝功能异常率无明显差异(P＞0.05).结论 HIV感染者HBsAg阳性率低于普通人群,HIV/HCV合并感染的比例显著高于普通人群.HIV/HCV合并感染与单纯HCV感染者血清生化及病毒学改变相似.