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目的观察AIDS患者合并HBV和HCV感染的临床特征及其对患者肝功能、T淋巴细胞亚群的影响。方法回顾性分析2012年3月—2014年3月收治的285例AIDS患者,对其HBV、HCV感染情况进行检测,并分析其肝功能和T淋巴细胞亚群变化。结果 285例AIDS患者中,单纯HBV感染者5例,占1.8%,单纯HCV感染者231例,占81.1%,合并HBV和HCV感染者18例,占6.3%;HIV合并HBV或(和)HCV者共254例,感染率为89.1%;单纯HIV感染者谷丙转氨酶(ALT)、谷草转氨酶(AST)水平显著低于,HIV合并HBV或(和)HCV患者肝功能(P<0.05),后者ALT、AST水平略高于正常值;单纯HIV感染者CD4、CD8及CD4/CD8水平显著低于HIV合并HBV或(和)HCV患者(P<0.05);单纯HIV感染者B超检测未见明显异常,HIV合并HBV或(和)HCV患者可见为弥漫性肝病、胆囊炎或脾肿大表现,其中4例(1.6%)患者发现肝硬化。结论 AIDS患者合并HBV、HCV感染的风险较高,且上述感染会导致其AIDS病程进展和肝脏病变的加速,是导致其死亡的重要原因,应早期预防筛查AIDS患者HBV、HCV感染情况并进行相应的治疗,以尽可能降低其HBV、HCV感染率,延长患者生命。
Objective To observe the clinical characteristics of AIDS patients with HBV and HCV infection and their effects on liver function and T lymphocyte subsets. Methods A retrospective analysis of 285 AIDS patients admitted to our hospital from March 2012 to March 2014 was performed to detect HBV and HCV infection and analyze the changes of liver function and T lymphocyte subsets. Results Among 285 AIDS patients, HBV infection was found in 5 cases (1.8%), HCV infection in 231 cases (81.1%) and HBV infection (HCV / HCV infection) in 18 cases (6.3%). (N = 254). The infection rate was 89.1%. The levels of ALT and AST in HIV-infected patients were significantly lower than those in HIV-infected patients with or without HCV (P <0.05) The levels of ALT and AST in patients with HIV infection were slightly higher than those in normal controls. The levels of CD4, CD8 and CD4 / CD8 in HIV-infected patients were significantly lower than those in patients with HIV or HCV infection (P <0.05) Obvious abnormalities were found in HIV-infected patients with HBV or (and) HCV, diffuse liver disease, cholecystitis, or splenomegaly. Cirrhosis was found in 4 (1.6%) patients. Conclusions AIDS patients with high risk of HBV and HCV infection, and the infection will lead to AIDS progression and liver disease is accelerated, is the leading cause of death, should be early detection of HIV infection in patients with HCV and HCV infection and carried out The corresponding treatment, in order to minimize its HBV, HCV infection rate, prolong the life of patients.