摘要
目的探讨艾滋病病毒/艾滋病(HIV/AIDS)患者的肝脏损害情况。方法检测230例住院的HIV/AIDS患者乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)感染标志,分为单纯HIV感染、HIV/HCV、HIV/HBV、HIV/HCV/HBV合并感染4组,对这4组患者的肝脏病理、CD4+淋巴细胞计数、肝功能、凝血酶原时间及活动度进行回顾性分析。结果HIV合并HCV感染的患者住院时的CD4+计数216±195/mm3,与单纯HIV感染者及合并HBV感染者比较有显著性差异;单纯HIV感染者的肝脏病理呈非特异性改变,丙氨酸转氨酶(ALT)、天冬酸转氨酶(AST)呈轻度升高,白蛋白(ALB)降低;HIV/HCV、HIV/HBV合并感染者的肝脏损害表现为肝脏病理的炎症分级和纤维化程度比单纯HIV感染者高,ALT、AST呈轻度升高,ALB降低,以HIV/HBV合并感染者为明显,达27.7±7.5g/L;HIV/HCV/HBV合并感染者的肝脏损害最严重,表现为总胆红素(TB)明显增高,达61.0±100.6μmol/mm3,ALT、AST呈轻至中度升高,ALB降低,胆碱脂酶明显降低,凝血酶原时间明显延长,除ALB外,与单纯HIV感染者比较差异有显著性意义。结论单纯HIV感染患者的肝脏损害呈非特异性,HIV合并HCV或/和HBV感染,可加重患者的肝脏损害,以同时合并HCV、HBV感染者为明显。
Objective To study the status of liver damages in people with HIV/AIDS. Method Two hundred and thirty hospitalized cases of HIV/AIDS were detected for infection markers of HBV and HCV, and were divided into four groups as follows： simple HIV infection, HIV co-infection with HCV, HIV co-infection with HBV, HIV co-infection with HCV and HBV. All these cases of four groups were retrospectively analyzed for their liver pathological parameters, CD4^＋ counts,liver functions,prothrombin time and activity. Result The CD4^＋ count of HIV/HCV in the study subjects were 216± 195/mm^3, which was apparently different from that in cases of simple HIV infection. There were non-specific changes in liver pathological examinations and mild increasing of ALT,AST and descending of ALB among cases of simple infection. There were higher inflammations and liver fibrosis in eases of co-infection with HCV and HBVr than in eases of simple HIV infection, including mild increasing of ALT, AST and descending of ALB. ALB changes were more apparent in cases of HIV/HBV co-infection than in eases of HIV/HCV co-infection, which was as high as 27.7 ± 7.5g/L. It was found that liver damages in eases of HIV/HCV/HBV co-infection was most severe, manifesting the significant increasing of total bilirubin（TB）up to 61.0 ± 100.6umol/mm^3 and mild increasing of ALT,AST,descending of ALB,significant descending of cholinesterase（Che）and significant prolongation of FTA. Except for ALB, all the other markers were significantly different from those in eases of simple infection. Conclusion Liver damages were non-specific in cases of simple HIV infection, whereas HIV/HCV or HIV/HBV co-infection would aggravate the damage of the liver, especially in cases of HIV/HCV/HBV co-infection.
出处
《中国艾滋病性病》
CAS
2006年第5期406-408,共3页
Chinese Journal of Aids & STD
关键词
艾滋病病毒/艾滋病
肝脏损害
合并感染
Human immunodeficiency virus
Acquired immune deficiency syndrome
Liver functions
Co-infection
