Relation between HIV-1 and hepatitis C viral load in patients with hemophilia
Relation between HIV-1 and hepatitis C viral load in patients with hemophilia
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DOI：
10.1097/00126334-200104150-00011
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发表时间：
2001-04-15
期刊：
影响因子：
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通讯作者：
Winkler, CA
中科院分区：
文献类型：
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作者：
Daar, ES;Lynn, H;Winkler, CA
丙型肝炎病毒（HCV）和HIV-1的合并感染在血友病患者和静脉吸毒者中很常见。然而，很少有人知道HIV-1和HCV共感染之间的关系和对HCV清除和发病机制的影响。我们检查了207例HIV-1感染和126例HIV-1未感染的血友病患者的数据，这些患者参加了多中心血友病生长和发育研究。在大约7年的前瞻性随访期间观察参与者，每年测量丙氨酸氨基转移酶（ALT）、CD 4（+）细胞、HCV和HIV-1 RNA水平。未感染HIV-1的患者更有可能清除HCV（14.3% vs 2.5%;比值比[OR] 4.79：95%置信区间[CI]，1.63-14.08）。p = 0.005），并且随着年龄的降低而更常见（OR，1.23; 95% CI，1.04-1.47; p = 0.017）。在7年的随访中，HIV-1感染者的HCV RNA水平较高（p <0.001）。在HIV-1感染的受试者中，基线CD 4（+）细胞与HCV RNA呈负相关，每增加100个细胞，HCV RNA就减少0.19 log（10）拷贝/ml（p = .002），HIV-1和HCV RNA水平直接相关（p = .008）。无论HIV-1感染状态如何，HCV RNA水平的升高也与ALT水平显著升高相关。这些结果表明，HIV-1/HCV合并感染与HCV清除的可能性降低相关，并且更高水平的HCV RNA与肝脏炎症增加相关。
Coinfection with hepatitis C virus (HCV) and HIV-1 is common in patients with hemophilia and in intravenous drug users. Little, however, is known about the relation between HIV-1 and HCV coinfection and the effects on HCV clearance and pathogenesis. We examined data from 207 HIV-1-infected and 126 HIV-1-uninfected patients with hemophilia enrolled in the multicenter Hemophilia Growth and Development Study. Participants were observed during prospective follow-up for approximately 7 years with annual measurements of alanine aminotransferase (ALT), CD4(+) cells, and HCV and HIV-1 RNA levels. Clearance of HCV was more likely to occur in those uninfected with HIV-1 (14.3 versus 2.5%; odds ratio [OR] 4.79: 95% confidence interval [CI], 1.63-14.08. p = .005) and was more common with decreasing age (OR, 1.23; 95% CI, 1.04-1.47; p = .017). HCV RNA levels were higher throughout the 7 years of follow-up in those HIV-1-infected (p < .001). In the HIV-1-infected participants, baseline CD4(+) cells were inversely related to HCV RNA with every 100-cell increase associated with a 0.19 log(10) copy/ml decrease in HCV RNA (p = .002), and HIV-1 and HCV RNA levels were directly related (p = .008). Increasing HCV RNA levels were also associated with significantly higher ALT levels regardless of HIV-1 infection status. These results demonstrate that HIV-1/HCV coinfection is associated with a reduced likelihood of HCV clearance and that higher levels of HCV RNA are associated with increased hepatic inflammation.