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目的探讨人免疫缺陷病毒-1(HIV-1)/AIDS患者合并乙型肝炎病毒(HBV)/丙型肝炎病毒(HCV)感染情况及发病特点。方法分析国家“十一五重大专项”课题中河南某获得性免疫缺陷综合征(Acquired immu-nodeficiency syndrome,AIDS)示范区中187例经血液途径感染HIV-1者的血浆,采用酶联免疫吸附试验(ELISA)检测乙型肝炎表面抗原与抗体(HBsAg与抗HBs)、乙型肝炎e抗原与抗体(HBeAg与抗Hbe)、乙型肝炎核心抗体(抗HBc)及丙型肝炎抗体(抗HCV);采用流式细胞仪计数CD4+T淋巴细胞;采用制备膜选择性吸附DNA的方法抽提HBV DNA,并采用巢式PCR法检测HBV DNA。结果 187例HIV-1感染者中,HBsAg阳性9例(4.81%),HBsAg阴性178例(95.19%);抗-HCV阳性143例(76.47%),抗-HCV阴性44例(23.53%);HIV-1/HBV/HCV三重感染者6例(3.21%)。178例HBsAg阴性的HIV感染者中,合并隐匿性HBV感染53例(29.78%)。抗-HCV阳性者合并隐匿性HBV感染42例(29.37%),抗-HCV阴性者合并隐匿性HBV感染11例(25.00%),差异均无统计学意义(P>0.05)。抗-HCV阳性/抗-HCV阴性患者的HbsAg阳性例数、抗-HBs阳性例数、CD4+T淋巴细胞数、单独抗-HBc阳性例数比较差异均无统计学意义(P>0.05)。结论经血传播感染HIV患者中HBsAg阳性率低于普通人群,HCV感染率显著高于普通人群;经输血传播感染HIV患者中存在隐匿性HBV感染,对HBsAg阴性的HIV感染者进行HBV DNA检测是有必要;HIV合并HCV感染不能增加隐匿性HBV感染率。
Objective To investigate the prevalence and incidence of hepatitis B virus (HBV) / hepatitis C virus (HCV) infection in human immunodeficiency virus-1 (HIV-1) / AIDS patients. Methods A total of 187 plasma samples of HIV-1 infected by bloodstream in one Acquired Immu-nodeficiency syndrome (AIDS) demonstration area in the national “Eleven-Five major projects” Immunoabsorbent assay (ELISA) was used to detect hepatitis B surface antigen and antibody (HBsAg and anti HBs), hepatitis B e antigen and antibody (HBeAg and anti Hbe), hepatitis B core antibody (anti HBc) and hepatitis C antibody Anti-HCV). CD4 + T lymphocytes were counted by flow cytometry. HBV DNA was extracted by selective membrane DNA preparation and HBV DNA was detected by nested PCR. Results Among 187 HIV-1 infected patients, HBsAg was positive in 9 cases (4.81%), HBsAg negative in 178 cases (95.19%), anti-HCV positive in 143 cases (76.47%) and anti-HCV negative in 44 cases (23.53% HIV-1 / HBV / HCV triple infection in 6 patients (3.21%). Of the 178 HBsAg-negative HIV-infected patients, 53 were complicated with occult HBV infection (29.78%). There were 42 cases (29.37%) with occult HBV infection and 11 cases (25.00%) with anti-HCV negative and occult HBV infection, the difference was not statistically significant (P> 0.05). The number of HBsAg positive cases, anti-HBs positive cases, CD4 + T lymphocytes and anti-HBc positive cases in anti-HCV positive / anti-HCV negative patients were no significant difference (P> 0.05). Conclusions The positive rate of HBsAg in HIV-infected persons with blood transfusion is lower than that in the general population, and the HCV infection rate is significantly higher than that in the general population. Occult HBV infection exists in transfusion-infected HIV patients and HBV DNA in HBsAg-negative HIV infected patients is Necessary; HIV co-infection with HCV can not increase the occult HBV infection rate.