摘要
目的探讨HIV／HBV合并感染的流行病学及临床特征。方法选择广州市第八人民医院2009年9月至2011年8月确诊为HIV感染并接受HAART的患者为研究对象，筛出HIV／HBV合并感染者和HIV单纯感染者，收集两组患者抗病毒治疗前的资料，比较两组患者ALT、AST、CD4^＋T淋巴细胞计数和HIVRNA水平。HIV／HBV合并感染患者根据HBeAg状态、HBVDNA水平和CD4^＋T淋巴细胞分组，比较组间差异。统计学分析采用卡方检验和秩和检验。结果l218例患者中HBsAg阳性165例（13．5％），筛选出HIV／HBV合并感染者121例，HIV单纯感染者510例。HIV单纯感染者ALT和AST水平分别为29和34U／L，均较HIV／HBV合并感染者高（22和25U／L，Z值分别为-4．270和-5．780，均P=0．000）。HIV／HBV合并感染者的CD4^＋T淋巴细胞计数较HIV单纯感染者明显减少，差异有统计学意义（Z=-2．980，P=0．003）。HBeAg阳性的HIV／HBV合并感染者CD4’T淋巴细胞计数较HBeAg阴性者低（Z=-2．660，P=0．008）。HBVDNA≥5’lg拷贝／mL患者的CD4^＋T淋巴细胞计数明显低于HBVDNA〈51g拷贝／mL患者（Z=-2．311，P=0．021）。54例CD4^＋T淋巴细胞〈50／μL的患者，HBVDNA阳性比例为81．5％、HBVDNA≥5lg拷贝／mL的比例为66．7％、ALT、AST异常比例为44．4％和53．7％，均高于CD4^＋T淋巴细胞≥50／μL的患者，差异均有统计学意义（x^2值分别为6．159、6．618、7．144和9．586，均P〈0．05）。结论本研究中HIV／HBV合并感染率较高，合并感染者CD4^＋T淋巴细胞计数较低，尤其HBeAg阳性和高HBVDNA的患者。CD4^＋T淋巴细胞与HBVDNA复制水平有关。
Objective To investigate the epidemiologic and clinical features of human immunodeficiency virus （HIV）/hepatitis B virus （HBV） co-infected patients. Methods Patients who confirmed with HIV infection and received highly active anti-retroviral therapy （HAART） at Guangzhou Eighth People＇s Hospital were enrolled. HIV/HBV co-infected patients and HIV mono-infected patients were screened and their epidemiological and clinical features were analyzed before HAART. Comparison of the levels of alanine transaminase （ALT）, aspartate transaminase （AST）, CD4^＋ T lymphocyte and HIV RNA between the two groups were conducted. The data were statistically analyzed by chi-square test and nonparametric test. Results One hundred and sixty-five out of 1 218（13.5%） patients were hepatitis B surface antigen positive. The median ALT and AST levels of HIV mono-infected patients were 29 U/L and 34 U/L respectively, which were both higher than HIV/HBV co-infected patients （22 U/L and 25 U/L, respectively） （Z=- 4. 270 and Z= - 5. 780, respectively, both P= 0. 000）. The median CD4^＋ T lymphocyte count of HIV/HBV co-infected patients was significantly lower than that of HIV monoinfected patients （Z= -2. 980, P=0. 003）. The CD4^＋T lymphocyte count was lower in hepatitis B e antigen （HBeAg） positive patients than HBeAg negative patients （Z=-2. 660, P=0. 008）. The median CD4^＋T lymphocyte count in patients with HBV DNA≥5 lg copy/mL was signifi.cantly lower than those with HBV DNA〈5 lg copy/mL （Z=- 2. 311, P=0. 021）. The proportions of positive HBV DNA, HBV DNA≥5 lg copy/mL, abnormal ALT and AST in 54 patiens with CD4^＋ T lymphocyte counts% 50//LL were 81. 5%, 66. 7%, 44. 4% and 53. 7%, respectively. All were significantly higher than patients withCD4^＋Tlymphocytecount≥50/μL（x^2=6.159, P=0.046 x^2 =6. 618, P=0.037 ;x^2= 7. 144, P=0. 028 and Z =9. 586, P=0. 008, respectively）. Conclusions The prevalence of HBV/HIV co-infection is high in this study. The CD4^＋ T lymphocyte c
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2015年第7期391-395,共5页
Chinese Journal of Infectious Diseases
基金
十二五国家科技重大专项基金资助项目（2012ZX10001003）
