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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (1): 60-66.doi: 10.6040/j.issn.1671-7554.0.2019.1166

• • 上一篇    

山东省单纯艾滋病病毒感染与合并乙型肝炎病毒感染者抗病毒治疗效果及相关因素

刘翠晓1, 朱晓艳2, 张娜2, 黄鹏翔2, 王国永2, 康殿民1,2,3   

  1. 1.山东大学公共卫生学院流行病学系, 山东 济南 250012;2.山东省疾病预防控制中心艾滋病防制所, 山东 济南 250014;3.山东省传染病预防控制重点实验室, 山东 济南 250014
  • 发布日期:2022-09-27
  • 通讯作者: 康殿民. E-mail:dmkang66@163.com
  • 基金资助:
    “十二五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2014ZX10001002-001-003)

Antiretrovial treatment effect and related factors of patients with human immunodeficiency virus infection and hepatitis B virus co-infection in Shandong Province

LIU Cuixiao1, ZHU Xiaoyan2, ZHANG Na2, HUANG Pengxiang2, WANG Guoyong2, KANG Dianmin1,2,3   

  1. 1. Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Division of AIDS Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China;
    3. Key Laboratory of Prevention and Control of Infections Diseases in Shandong Province, Jinan 250014, Shandong, China
  • Published:2022-09-27

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摘要： 目的 了解山东省合并乙型肝炎病毒(HBV)感染与单纯感染艾滋病(AIDS)病毒(HIV)患者的抗病毒治疗效果及相关影响因素。 方法 从2015~2017年山东省艾滋病抗病毒治疗数据库中筛选符合条件的HIV/AIDS患者500例,分为HIV单纯感染组(n=168)和HIV/HBV合并感染组(n=332),年龄分别为(35.41±10.24)岁和(34.75±9.22)岁,分析比较两组患者基本情况、抗病毒治疗12个月后相关指标变化情况,使用Logistic回归模型进行治疗效果的相关因素分析。 结果 两组均以男性、未婚、性途径感染为主。抗病毒治疗12个月后,HIV单纯感染组CD4+T淋巴细胞中位数从315.5个/μL上升至439.0个/μL,HIV/HBV合并感染组从349.5个/μL增加至491.0个/μL。HIV单纯感染组与HIV/HBV合并感染组患者出现免疫学失败的比例分别为16.3%和44.6%;病毒学失败比例分别为7.5%和13.1%。两组患者治疗效果多因素Logistic分析显示,出现免疫学失败与合并HBV感染(OR=1.619,95%CI:1.061~2.469)、年龄35~44岁(OR=2.695,95%CI:1.145~6.345)和≥45岁(OR=3.101,95%CI:1.291~7.450)有关;病毒学失败的发生则与合并HBV感染(OR=2.156,95%CI:1.142~4.070)、临床分期Ⅲ/Ⅳ期(OR=2.443,95%CI:1.102~5.416)有关。 结论 合并HBV感染者治疗效果不如单纯感染者理想,应加强HIV/AIDS患者乙型病毒性肝炎的筛查及有效管理,针对不同人群选择合适的治疗方案,提高抗病毒治疗的有效性。

关键词: 乙型肝炎病毒, 艾滋病病毒, 合并感染, 抗病毒治疗

Abstract: Objective To investigate the treatment effect and its related factors among human immunodeficiency virus(HIV)/ acquired immunodeficiency syndrome(AIDS)patients with or without HBV co-infection in Shandong Province. Methods Data of 500 HIV/AIDS patients were collected from the Shandong AIDS Antiviral Treatment Database during 2015 and 2017. The patients were divided into the HIV infection group(n=168)and the HIV/HBV co-infection group(n=332), aged(35.41±10.24)and(34.75±9.22)years, respectively. The basic situation of patients were analyzed, and the changes of related indicators after treatment for 12 months were compared. Logistic regression model was used to analyze the related factors of the antiretroviral therapy effect. Results Most of patients were male, unmarried, 山 东 大 学 学 报 (医 学 版)58卷1期 -刘翠晓,等.山东省单纯艾滋病病毒感染与合并乙型肝炎病毒感染者抗病毒治疗效果及相关因素 \=-and infected by sexual transmission. After treatment for 12 months, the median of CD4+ T lymphocyte increased from 315.5/μL to 439.0/μL in HIV infection group, and from 349.5/μL to 491.0/μL in HIV/HBV co-infection group. The proportion of immunological failure was 16.3% in the HIV infection group and 44.6% in the HIV/HBV co-infection group. The proportion of virological failure was 7.5% in the HIV infection group and 13.1% in the HIV/HBV co-infection group. Multivariate Logistic analysis of treatment outcomes showed that immunological failure was associated with HBV co-infection(OR=1.619, 95%CI: 1.061-2.469), 35-44 years old (OR=2.695, 95%CI: 1.145-6.345)and older than 45 years old (OR=3.101, 95%CI: 1.291-7.450). The occurrence of virological failure was associated with HBV co-infection(OR=2.156, 95%CI: 1.142-4.070)and clinical stage III or IV (OR=2.443, 95%CI: 1.102-5.416). Conclusion The treatment effect of patients with HIV/HBV co-infection is not as good as that with HIV simple infection. Screening and effective management of HBV in HIV/AIDS patients should be strengthened. Choosing the suitable treatment drug for different people is crucial and can improve the effectiveness of antiviral treatment.

Key words: Hepatitis B virus, Human immunodeficiency virus, Co-infection, Antiretroviral therapy

中图分类号: 

  • R512.91
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