不同抗HIV治疗方案对HCV与HIV合并感染者丙型肝炎疾病进展的影响

孙洪清; 黄琴; 沈芳; 邬敏; 周晓明; 蔡卫平; 胡芸文

doi:10.3969/j.issn.1001-5256.2013.11.009

不同抗HIV治疗方案对HCV与HIV合并感染者丙型肝炎疾病进展的影响

DOI: 10.3969/j.issn.1001-5256.2013.11.009

1. 上海市公共卫生临床中心感染科
2. 上海市公共卫生临床中心检验科
3. 复旦大学上海医学院流行病学教研室
4. 广州市第八人民医院感染科

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中图分类号: R512.91
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出版历程
- 收稿日期: 2012-11-28
- 出版日期: 2013-11-20

Effects of different anti- HIV therapies on progression of hepatitis C in HCV / HIV- coinfected patients

Department of Infectious Diseases, Shanghai Public Health Clinical Center

摘要

摘要: 目的探讨以蛋白酶抑制剂（PIs）或非核苷类反转录酶抑制剂（NNRTIs）为主方案治疗HCV/HIV合并感染者,对患者丙型肝炎疾病进展的影响。方法收集初次就诊的273例HCV/HIV合并感染者为研究对象。分别用PIs（PIs组,135例）或NNRTIs（NNRTIs组,138例）为主的方案治疗1年。实验室检查治疗前、后HCV RNA、AST、ALT、TBil、白蛋白（Alb）、层粘连蛋白（LN）、甘胆酸（CG）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CⅣ）、凝血酶原活动度（PTA）、胆碱酯酶（ChE）等指标。计量资料经Kolmogorov-Smirnov检验,非正态分布数据采用Mann Whitney U检验。结果治疗后NNRTIs组PTA、ChE、TBil、Alb、ALT、AST、CG、LN显著高于PIs组。PTA分别是77%（67%,109%）和68%（56%,91%）;ChE分别是6717.00（5951.00,7622.00）和5862.00（4392.00,8539.25）U/L;TBil分别是10.95（8.10,14.32）和8.60（8.00,9.50）μmol/L;Alb分别...
- 肝炎,丙型,慢性 /
- 肝炎病毒属 /
- HIV /
- 蛋白酶抑制药 /
- 抗逆转录病毒治疗,高效
Abstract: Objective To investigate the effect of protease inhibitors ( PIs) - or non- nucleoside reverse transcriptase inhibitors ( NNRTIs) - based therapy on the progression of hepatitis C in patients with hepatitis C virus ( HCV) / human immunodeficiency virus ( HIV) coinfection. Methods A total of 273 patients initially diagnosed with HCV / HIV coinfection were enrolled and divided into PIs group ( n = 135) and NNRTIs group ( n = 138) to receive PIs- based therapy and NNRTIs- based therapy, respectively, for one year. Laboratory indices, such as HCV RNA, aspartate aminotransferase ( AST) , alanine aminotransferase ( ALT) , total bilirubin ( TBil) , albumin ( Alb) , laminin ( LN) , cholyglycine ( CG) , type III procollagen ( PCIII) , type IV collagen ( CIV) , prothrombin activity ( PTA) , and cholinesterase ( CHE) , were quantified before and after treatment. The obtained data were analyzed using SPSS 11. 5 software; enumeration data were analyzed using the Kolmogorov- Smirnov test, and non- normal data were analyzed using the Mann- Whitney U test. Results After the end of treatment, PTA, CHE, TBil, Alb, ALT, AST, CG, and LN levels were significantly higher in NNRTIs group than in PIs [PTA: 77% ( 67%-109%) vs 68% ( 56%-91%) ; CHE: 6717. 00 U/L ( 5951. 00-7622. 00 U/L) vs 5862. 00 U/L ( 4392. 00- 8539. 25 U/L) ;TBil: 10. 95 μmol / L ( 8. 10- 14. 32 μmol / L) vs 8. 60 μmol / L ( 8. 00- 9. 50 μmol / L) ; Alb: 43. 90 mmol / L ( 39. 65- 48. 20 mmol / L) vs 38. 90 mmol / L ( 36. 00- 45. 00 mmol / L) ; ALT: 52. 50 U / L ( 30. 00- 93. 50 U / L) vs 36. 20 U / L ( 30. 30- 40. 40 U / L) ; AST: 49. 00U /L ( 33. 00- 80. 00 U / L) vs 31. 30 U / L ( 29. 70- 38. 70 U / L) ; CG: 16. 78 μg / ml ( 3. 26- 29. 32 μg / ml) vs 3. 26 μg / ml ( 1. 02-6. 88 μg / ml) ; LN: 34. 40 ng / ml ( 16. 71- 46. 54 ng / ml) vs 34. 05 ng / ml ( 33. 42- 64. 33 ng / ml) ; P < 0. 01 or P < 0. 05]. Conclusion NNRTIs- based therapy can accelerate the progression of hepatitis C in HCV / HIV- coinfected patients.
- hepatitis C, chronic /
- hepacivirus /
- HIV /
- protease inhibitors /
- antiretroviral therapy, highly active

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参考文献(1)

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