【摘要】 目的:探讨HBV(乙肝病毒)重叠HIV(人类免疫缺陷病毒)感染患者的临床特征,以及细胞免疫功能损害情况。方法:回顾性分析我院2004-2007年收治的HBV重叠HIV感染的AIDS(获得性免疫缺陷综合征)患者30例的临床资料、免疫状态和转归,分析30例HBV重叠HIV感染者、50例单纯AIDS患者以及20例正常对照者的CD3、CD4、CD8细胞百分比以及CD4/CD8比值。结果:在30例HBV重叠HIV感染者中,6例死亡,均死于肝功能衰竭或肝硬化并发症。实验检查发现其肝功能以低蛋白血症为主要表现,转氨酶、胆红素轻度升高,透明质酸(HA)升高明显,HBV复制异常高拷贝。CD4、CD3的检测值,在3组之间两两比较差异有统计学意义,CD3及CD4细胞计数表现为HBV/HIV重叠感染组<AIDS组<正常对照组(P<0.01),CD8细胞计数3组间两两比较差异无统计学意义。CD4/CD8比值降低,HBV/HIV重叠感染组、AIDS感染组均<正常对照组(P<0.01)。B超均显示肝回声增粗,弥漫性肝损害6例、腹水5例、肝肿大10例、脾大10例。结论:HBV重叠HIV感染者临床表现肝脏炎症反应较轻,但全身情况差,并发症多,增强了与HBV感染相关的终末期肝病风险,病死率也明显升高,同时CD4淋巴细胞衰减明显,细胞免疫损害明显。更多还原

【Abstract】 Objective:To study the clinical feature and function lesion of cellular immunity in patients coinfected with HBV and HIV.Methods:Retrospective analysis was performed in 30 cases AIDS coinfected with HBV and HIV patients hospitalized from 2004 to 2007,which include clinical datas,immune state and prognosis.Fifty patients infected with HIV,30 patients coinfected with HBV and HIV and 20 normaI controls were measured CD3,CD4,CD8 cell percentage and CD4/CD8 ratio.Results:In 30 cases AIDS coinfected with HBV and HIV patients,6 cases died from liver function exhaustion or complication of hepatic cirrhosis.Liver function lesion was mainly showed in hypoproteinemia,lightly raised in transaminase and bilirubin.HA and HBV DNA replica was both abnormally high.HBV/HIV coinfection group,AIDS group and normal control group had statistic difference with each other.Quantity of CD3 cells showed that HBV/HIVgroup<AIDS group<normal control(P<0.01),quantity of CD4 cells was HBV/HIVgroup<AIDS group<normal control(P<0.01),while quantity of CD8 cells didn’t have statistic difference in the groups.CD4/CD8 ratio was invert,HBV/HIV,AIDS group<normal control(P<0.01).Type-B ultrasonic was used to show that 30 cases liver echo were all thickening,including 6 cases diffuse liver lesion,5 cases ascits,10 cases hepatomegaly,10 cases splenomegaly.Conclusion:The clinical situation showed liver inflammatory reaction was slight and liver lesion severe in patients coinfected with HBV and HIV,which raised up final stage liver disease ralated with HBV and case fatality.Besides,CD4 lymph cells extincted and cellular immunity damaged more markedly in patients coinfected with HBV and HIV,compared with patients infected with HIV.更多还原