高效抗逆转录病毒疗法对艾滋病合并 HCV感染儿童肝功能与病毒载量的影响

摘要

目的：观察艾滋病合并HCV感染患儿高效抗逆转录病毒疗法（ HAART）治疗后肝功能、病毒载量、CD4＋T细胞变化特点，探讨艾滋病患儿合并HCV感染对HAART治疗效果的影响。方法选择艾滋病患儿合并HCV感染者19例为研究组，单纯艾滋病患儿64例为对照组，患儿均接受HAART治疗，采用酶法检测治疗前、后两组肝功能，采用PCR法检测病毒载量，采用流式细胞术检测CD4＋T细胞，并进行比较。结果研究组治疗后，ALT、CD4＋T细胞均显著升高，HIV-RNA降低（P均＜0．01）。对照组治疗后，ALT、TBIL、CD4＋T细胞均显著升高，HIV-RNA降低（P均＜0．01）。研究组治疗后ALT高于对照组（P＜0．05）。 HAART治疗后，研究组2级以上肝毒性发生率明显高于对照组（χ2＝7．07，P＜0．01）。结论 HAART增加了艾滋病患儿合并HCV感染者肝毒性的发生率，但合并HCV感染对HAART治疗效果的影响较小。%Objective To observe the change of the liver function, viral load, and CD4+T of the children co-infected with AIDS and HCV after being treated with HAART and to discuss the effect of HAART on children with both AIDS and HCV.Methods Nineteen children co-infected with AIDS and HCV were treated as the study group and 64 children with only AIDS were treated as the control group.All children were given HAART.The changes of the liver function, viral load, and CD4+T were observed by successive-enzymatic analysis, PCR and flow cytometry respectively.Results After the treatment, the levels of ALT and CD4+T of the study group increased significantly and the HIV-RNA level decreased (all P<0.01).The levels of ALT, TBIL, CD4+T highly active antiretrairal therapy in the control group increased significantly and the HIV-RNA level decreased, compared with those before treatment(all P<0.01).The ALT level of the study group was higher than that of the control group (P<0.05).After HAART, the incidence rate of level-2 or higher hepatotoxicity in the study group was higher than that of the control group (χ2 =7.07, P<0.01).Conclusion The HAART for the children co-infected with AIDS and HCV raises the incidence of the hepatotoxicity but the effect of the therapy is not affect-ed despite the co-infection of HCV and AIDS.