HIV/HCV感染者合并脂肪肝的临床特征及独立预测因素研究

摘要

目的 探讨HIV/HCV共同感染者脂肪肝的发生率和独立危险因素分析.方法 选取102例HIV/HCV共同感染者,通过彩超检查是否存在脂肪肝,分析所有患者的性别、感染途径、体质指数(BMI)、高效抗反转录病毒治疗(HAART)方案和持续时间、CD4+T淋巴细胞计数、空腹血糖、血脂、肝肾功能、HCV-RNA定量值和HCV-RNA阳性率,采用Logistic回归分析HIV/HCV共同感染者脂肪肝的独立危险因素.结果 在102例HIV/HCV共同感染者中,21例(20.6%)存在脂肪肝.Logistic回归多变量分析发现脂肪肝的独立危险因素包括:高总胆固醇(TG)血症(OR=1.76,P=0.010)、低高密度脂蛋白(HDL)血症(OR=0.14,P=0.049)和HAART持续时间(OR=1.03,P=0.006);未发现患者的性别、感染途径、BMI、肝肾功能、HAART方案、CD4+T淋巴细胞计数、HCV-RNA定量值和HCV-RNA阳性率与脂肪肝的发生相关.结论 HIV/HCV共同感染者中脂肪肝的发生率为20.6%;高TG血症、低HDL血症和HAART治疗持续时间是脂肪肝发生的独立预测因素.%Objective To explore the prevalence and independent risk factors of hepatic steatosis in HIV/HCV co - infected patients. Methods We performed a retrospective study. The prevalence of hepatic steatosis in HIV/HCV co - infected patients was evaluated by ultrasound examination. Risk factors including gender, BMI, duration of HAART, HAART regimen, CD4 cell count, fasting plasma glucose, metabolic syndromes, hyperlipemia, HCV - RNA and liver functions were evaluated by logistic regression analysis. Results We retrospectively studied the clinical data of HIV/HCV co - infected patients and find that 21 ( 20. 6% ) of them were diagnosed as hepatic steatosis. Multivariate logistic regression analyses revealed that the following risk factors were associated with hepatic steatosis: high triglycerides ( OR = 1. 76, P = 0. 010 ), low HDL ( OR = 0. 14, P =0. 049 ) and durations of HAART ( OR = 1. 03 , P = 0. 006 ) . The following factors, including gender, BMI, ART regimen, CD4 cell count, fasting plasma glucose, HCV - RNA and liver functions were not associated with hepatic steatosis. Conclusion Prevalence of hepatic steatosis in HIV/HCV co - infected patients is 20. 6% . High triglycerides levels, low HDL levels and HAART durations are independent risk factors of hepatic steatosis in HIV/HCV co - infected patients.