贵州省383例HIV/HCV共感染者HCV基因分型及临床特征

王梅; 熊华刚; 杨智刚; 龙海; 王艺; 谭丽

doi:10.3969/j.issn.1001-5256.2020.10.009

贵州省383例HIV/HCV共感染者HCV基因分型及临床特征

DOI: 10.3969/j.issn.1001-5256.2020.10.009

1. 贵阳市公共卫生救治中心肝病科
2. 贵阳市公共卫生救治中心艾滋病科
3. 贵阳市公共卫生救治中心检验科

基金项目:

贵阳市科技计划项目(筑科合同〔2018〕1-46号)；

详细信息

中图分类号: R512.63
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出版历程
- 收稿日期: 2020-04-15
- 出版日期: 2020-10-20

HCV genotype and clinical features of patients with HIV/HCV coinfection in Guizhou,China: An analysis of 383 cases

Department of Hepatology,Guiyang Public Health Clinical Center
Department of AIDS,Guiyang Public Health Clinical Center
Department of Clinical Laboratory,Guiyang Public Health Clinical Center

Research funding:

摘要

摘要: 目的探讨贵州省383例HIV/HCV共感染者HCV基因型分布特征及共感染对HIV病毒载量、CD4+T淋巴细胞和PLT计数的影响,为HIV合并HCV感染者的个体化治疗提供依据。方法收集2015年3月-2019年12月贵阳市公共卫生救治中心383例HIV/HCV共感染者临床资料,检测HCV基因型、HIV病毒载量、CD4+T淋巴细胞、PLT计数,并以1068例单纯HIV患者为对照。多组间比较采用Kruskall-Wallis H检验,两组间比较采用Wilcoxon秩和检验,进一步两两比较采用Bonferroni法校正;计数资料组间比较采用卡方检验或Fisher确切概率法。结果 4664例HIV感染者中,HCV共感染率为8.21%（383/4664）,HCV基因型以6a型（35.51%）、3b型（27.42%）、1b型（21.41%）为主,其次3a（13.32%）、1a（1.31%）、2a（0.52%）、6n（0.26%）、6xa（0.26%）型占比较少。感染途径以静脉药瘾为主（72.59%）,其次为性接触（24.80%）。与单纯HIV感染者相比,H...
- HIV /
- 肝炎病毒属 /
- 同时感染 /
- 基因型 /
- 体征和症状
Abstract: Objective To investigate the distribution of HCV genotypes in 383 patients with HIV/HCV coinfection in Guizhou,China and the effect of coinfection on HIV viral load,CD4+T lymphocytes,and platelet count( PLT),and to provide a basis for individualized treatment of patients with HIV/HCV coinfection. Methods Related clinical data were collected from 383 patients with HIV/HCV coinfection who were treated in Guiyang Public Health Clinical Center from March 2015 to December 2019,and HCV genotype,HIV viral load,CD4+T lymphocytes,and PLT were determined. A total of 1068 patients with HIV alone were enrolled as control. The Kruskal-Wallis H test was used for comparison between multiple groups,the Wilcoxon rank-sum test was used for comparison between two groups,and the Bonferroni method was used for further comparison between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results Among the 4664 patients with HIV infection,383( 8. 21%) had HCV coinfection,and the main HCV genotypes were genotype 6 a( 35. 51%), genotype 3 b( 27. 42%), and genotype 1 b( 21. 41%), followed by genotypes3 a( 13. 32%),1 a( 1. 31%),2 a( 0. 52%),6 n( 0. 26%),and 6 xa( 0. 26%). The most common route of infection was intravenous drug addiction( 72. 59%),followed by sexual contact( 24. 80%). Compared with the patients with HIV infection alone,the patients with HIV/HCV coinfection had a significantly higher HIV RNA load and significantly lower CD4+T lymphocytes and PLT( Z = 6. 716,11. 813,and9. 192,all P < 0. 05). Among the patients with coinfection,the patients with HCV genotype 3 b had the highest HIV RNA load and the lowest CD4+T lymphocytes and PLT,while the patients with HCV genotype 1 a had the lowest HIV RNA load and the highest CD4+T lymphocytes( all P < 0. 05). Among the patients with different clinical stages,the patients with compensated cirrhosis had the highest HIV RNA load,the patients with chronic hepatitis C had the lowest HIV RNA load,the patients with end-stage liver disease had the lowest count of CD4+T lymphocytes,and the patients with chronic hepatitis C had the highest PLT( all P < 0. 05). Conclusion The distribution of HCV genotypes is diverse in the patients with HIV/HCV coinfection in Guizhou,and HCV strains with genotypes 6 a,3 b,and 1 b are the main epidemic strains. Intravenous drug addiction is the main route of infection. Coinfection may affect HIV replication and immune status,with a significantly marked effect on HCV genotype 3 b and liver cirrhosis or end-stage liver disease.
- HIV /
- hepacivirus /
- coinfection /
- genotype /
- signs and symptoms

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