摘要
目的探讨高效抗逆转录病毒药物联合聚乙二醇化干扰素α-2a（PEG-IFNα-2a）治疗HIV合并HCV感染者的疗效和不良反应。方法22例HCV/HIV合并感染者,先予高效抗逆转录病毒药物治疗;待所有患者CD4^＋ T淋巴细胞上升至0.20×10^9/L以上,将患者分成CD4^＋T淋巴细胞≥0.35×10^9/L和〈0.35×10^9/L两组,给予PEG-IFNα-2a,180μg,每周肌肉注射1次,检测两组患者的HCV RNA和HIV RNA水平、肝功能和血常规,并做CD4^＋T淋巴细胞计数。结果CD4^＋T淋巴细胞≥0.35×10^9/L组13例,在治疗12、24、48周后,与治疗前比较,HCV RNA平均分别下降2.0650 log10拷贝/ml（t=3.8733,P〈0.01）、2.9146 log10拷贝/ml（t= 7.6741,P〈0.01）、2.4315 log10拷贝/ml（t=5.8202,P〈0.01）。CD4^＋T淋巴细胞〈0.35×10^9/L组9例,分别下降1.1522 log10拷贝/ml（t=2.8937,P〈0.05）、1.4189 log10拷贝/ml（t= 2.4422,P〈0.05）、1.1167 log10拷贝/ml（t=1.1261,P〉0.05）。两组患者HCV RNA早期应答率和治疗结束应答率比较,P值均〉0.05。CD4^＋T淋巴细胞〈0.35×10^9/L组,在治疗24周时白细胞较治疗前下降（t=2.4700,P〈0.05）。CD4^＋T淋巴细胞≥0.35×10^9/L组,治疗24周和48周血小板均较治疗前下降（t=2.3273,P〈0.05;t=3.6149,P〈0.01）。结论PEG-IFNα-2a治疗HIV/HCV患者,能有效降低HCV病毒载量,CD4^＋T淋巴细胞≥0.35×10^9/L组疗效更显著,但两组患者的HCV RNA早期应答率和治疗结束应答率差异无统计学意义。PEG-IFNα-2a可降低外周血白细胞和血小板。
Objective To evaluate the clinical effect and side-effect of peg-interferon alfa-2a （PEG- IFN alfa-2a） and highly active antiretroviral therapy （HAART） for patients infected with hepatitis C virus （HCV） and co-infected with human immunodeficiency virus （HIV）. Methods Twenty-two patients with HCV/HIV co-infection received highly active antiretroviral therapy initially; after their CD4 lymphocyte counts rose to over 0.20 ×10^9/L, they were separated into two groups： one group with CD4 lymphocytes over 0.35 ×10^9/L （high group） and one group with CD4 lymphocytes below 0.35 ×10^9/L （low group）. Both groups were given 180 μg of PEG-IFN alfa-2a every week intramuscularly. HCV RNA and HIV RNA loads, blood cell and CD4 lymphocyte counts, and liver functions were routinely exaimined. Results After 12, 24 and 48 weeks of PEG-IFN alfa-2a therapy, mean HCV RNA loads reduced 2.0650 log10copies/ml （t = 3.8733, P 〈 0.01）, 2.9146 log10 copies/ml （t = 7.6741, P 〈 0.01） and 2.4315 log10copies/ml （t = 5.8202, P 〈 0.01） from the baseline at week 0 in the 13 patients in the high group, and reduced 1.1522 log10 copies/ml （t = 2.8937, P 〈 0.05）, 1.4189 log10 copies/ml （t = 2.4422, P 〈 0.05） and 1.1167 log10 （t = 1.1261, P 〉 0.05） in the 8 patients of the low group. However, there was no significant difference between the early viral response rate （EVR） and the end of treatment viral response rate （ETVR） of the two groups （P 〉 0.05）. In the high group, the white blood cell count was lower at 24 weeks than the base line （t = 2.4700, P 〈 0.05）, and the blood platelet count was lower both at 24 and 48 weeks than the base line （t = 2.3273, P 〈 0.05 and t = 3.6149, P 〈 0.01）. Conclusions PEG-IFN alfa-2a can effectively reduce HCV RNA loads in patients with HCV-/HIV coinfection, and the inhibition rate in patients with higher CD4 lymphocyte counts is better. The EVR and ETVR of the two groups of patients show similar results after the treatment. PEG-IFN alfa-2a can reduce the white blood cell counts and the blood platelet counts in the peripheral blood.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第10期734-737,共4页
Chinese Journal of Hepatology
