首页|云南省昆明地区HIV合并感染不同基因型HCV患者血液检测指标分析

云南省昆明地区HIV合并感染不同基因型HCV患者血液检测指标分析

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目的 了解云南省人类免疫缺陷病毒(human immunodeficiency virus type,HIV)合并感染丙型肝炎病毒(hep-atitis C virus,HCV)患者基因型分型及其不同基因型间病毒载量、生化指标和血常规指标的差异,为HIV/HCV合并感染患者的疾病诊治提供实验室依据.方法 2022年11月—2023年6月在云南省传染病医院抗病毒门诊收集诊断为HIV/HCV合并感染患者血清标本及基本信息,采用一步法实时荧光定量聚合酶链反应(real-time fluorescence quantification polymerase chain reaction,qRT-PCR)扩增检测HCV病毒载量,并对检测阳性样本进行测序,基于NS5基因序列进行基因分型.分析HIV/HCV合并感染HCV不同基因型和低、高病毒载量患者生化和血常规指标间差异.结果 共收集到HIV/HCV合并感染患者126例,其中HCV基因1型20例(15.9%),基因3型91例(72.2%)和基因6型15例(11.9%).HCV 3种基因型的病毒载量最大值和最小值分别为:1型(1.0×108、4.8×104 IU/mL)、3型(2.2×108、2.9×102 IU/mL)和6型(8.1×107、6.8×104 IU/mL).HIV合并感染不同基因型HCV以及核苷类逆转录酶抑制剂+整合酶链转移抑制剂、核苷类逆转录酶抑制剂+非核苷类逆转录酶抑制剂、核苷类逆转录酶抑制剂+蛋白酶抑制剂3种HIV治疗方案和治疗时间长短与患者病毒载量的差异均无统计学意义(P>0.05).总胆红素(total Bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、肌酐(creatinine,CREA)等生化指标和白细胞(white blood cell,WBC)、红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,HGB)、血小板(platelet,PLT)、平均血红蛋白量(mean corpuscular hemoglobin,MCH)、平均血红蛋白浓度(mean corpuscu-lar hemoglobin concentration,MCHC)等血常规指标在不同HCV基因型和低、高病毒载量间的分析结果显示:HIV合并感染HCV患者的生化指标和血常规指标在低、高病毒载量间的差异均无统计学意义(P>0.05);HIV/HCV合并感染患者的TBIL、IBIL和MCHC指标在基因3型HCV感染患者与基因1型感染患者之间差异有统计学意义(P<0.05),其余生化和血常规指标在不同HCV基因型间差异均无统计学意义(P>0.05).结论 在云南省昆明地区HIV患者中存在基因1、3、6型3个基因型6个基因亚型HCV合并感染,其中基因3型HCV为HIV合并感染人群主要流行的基因型病毒;HIV合并感染3型HCV患者的TBIL、IBIL和MCHC值与1型HCV感染患者存在差异.
Analysis of blood testing indicators in HIV patients co-infected with different genotypes of HCV in Kunming area of Yunnan Province
Objective To understand the genotyping of human immunodeficiency virus(HIV)co-infected hepatitis C virus(HCV)patients in Yunnan Province,and to analyze the differences in viral load,biochemical indicators,and blood routine indicators among different genotypes,in order to provide a laboratory basis for the diagnosis and clinical treatment of HIV/HCV co-infected patients.Methods From November 2022 to June 2023,the serum samples and basic information of patients diagnosed with HIV/HCV co-infection were collected in the antiviral outpatient clinic of Yunnan Provincial Hospital of Infectious Diseases.The HCV viral load was detected by one-step qRT-PCR amplification,the positive samples were sequenced,and genotyping was determined based on NS5 gene sequence.The differences in biochemical and blood routine indexes between HIV patients co-infected with different HCV genotypes and low/high viral loads were analyzed.Results A total of 126 HIV/HCV co-infected patients were collected,including 20 HCV genotype 1(15.9%),91 HCV genotype 3(72.2%),and 15 HCV genotype 6(11.9%).The maximum and minimum viral load of the three HCV genotypes were as follows:HCV type 1(1.0×108,4.8×104 IU/mL),HCV type 3(2.2×108,2.9×102 IU/mL),and HCV type 6(8.1×107,6.8×104 IU/mL).The results showed that there was no significant difference between HIV co-infection with different genotypes of HCV and three HIV treatment schemes,including nucleoside reverse transcriptase inhibitors+integrase strand transfer inhibitors(NRTIs+INSTIs),nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors(NRTIs+NNRTIs)and nucleoside reverse transcriptase inhibitors+protease inhibitor(NRTIs+PLs),and the viral load of patients(P>0.05).The analysis of biochemical indexes such as total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(CREA),and blood routine indexes such as white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),platelet(PLT),mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin concentration(MCHC)among different HCV genotypes and low/high viral loads showed that there was no significant difference in biochemical indexes and blood routine indexes between low/high viral loads of HIV co-infected HCV patients(P>0.05);however,the biochemical indicators TBIL,IBIL and MCHC were significantly different statistically between patients with genotype 3 HCV infection and those with genotype 1 HCV infection(P<0.05),while other biochemical and blood routine indexes were not statistically different among different HCV genotypes(P>0.05).Conclusions There are six subtypes of HCV co-infection in HIV patients in Kunming,Yunnan Province,including three genes of genotype 1,3,and 6.Among them,genotype 3 HCV is the main prevalent genetic virus among HIV co-infected populations.The TBIL,IBIL and MCHC values of HIV patients co-infected with HCV type 3 are different from those infected with HCV type 1.

HIV/HCV co-infectionHCV genotype or subtypeviral loadbiochemical indicatorsblood routine indicators

刘俊仪、亢丽娟、王诗敏、朱燕涛、张米、张念、谢祺、刘仕芳、杨剑陶、李肖、何全英、王佳丽

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云南省传染病医院,云南昆明 650301

昆明医科大学公共卫生学院,云南昆明 650224

大理大学公共卫生学院,云南大理 671003

香港理工大学,香港 999077

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HIV/HCV合并感染 HCV基因型或基因亚型 病毒载量 生化指标 血常规指标

国家自然科学基金云南省教育厅项目云南省科技厅-昆明医科大学应用基础研究联合专项面上项目云南省科技厅-昆明医科大学应用基础研究联合专项面上项目云南省科技厅重大专项昆明医科大学艾滋病合并感染传染性疾病诊疗科技创新团队项目云南省高层次卫生技术人才培养经费项目

819606052019J1305202101AY070001-223202201AY070001-208202102AA310005CXTD202111H-2018050

2024

中国热带医学
中华预防医学会,海南疾病预防控制中心

中国热带医学

CSTPCD北大核心
影响因子:0.722
ISSN:1009-9727
年,卷(期):2024.24(3)
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