Impact of viral hepatitis co-infection on response to antiretroviral therapy and HIV disease progression in the HIV-NAT cohort
Impact of viral hepatitis co-infection on response to antiretroviral therapy and HIV disease progression in the HIV-NAT cohort
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DOI：
10.1097/00002030-200405210-00010
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发表时间：
2004-05-21
期刊：
影响因子：
3.8
通讯作者：
Dore, GJ
中科院分区：
文献类型：
--
作者：
Law, WP;Duncombe, CJ;Dore, GJ
目的：为了研究病毒性肝炎合并感染对HIV疾病的影响后，开始联合抗逆转录病毒治疗在一个发展中国家setting.Methods：HIV RNA抑制，CD 4细胞计数恢复，和HIV疾病的进展进行了检查，在一个队列的泰国HIV感染者参加了8个HIV-NAT抗逆转录病毒治疗的随机对照试验（n = 692）。B型肝炎病毒（HBV）和丙型肝炎病毒（HCV）检测进行储存serum.Results：平均年龄为32.3岁，52%为男性，11%的CDC C类HIV疾病在基线，和22%接受过抗逆转录病毒治疗。HBV、HCV和HBV/HCV合并感染的患病率分别为8.7%、7.2%和0.4%。从第4周至第48周，HIV、HIV-HBV、HIV-HCV亚组的中位HIV RNA降低（log（10）拷贝/ml）约为1.5。第4周时，HIV-HBV和HIV-HCV亚组中CD 4细胞计数的平均增加显著较低（HIV，62 × 10（6）个细胞/l; HIV-HBV，29 × 10（6）个细胞/l; HIV-HCV，33 × 10（6）个细胞/l），然而，到第48周，CD 4细胞增加相似（HIV，115 x 10（6）个细胞/l; HIV-HBV，113 x 10（6）个细胞/l; HIV-HCV，97 x 10（6）个细胞/l）。考克斯回归分析显示，HIV-HBV或HIV-HCV合并感染与48周内CD 4细胞计数增加100 x 10（6）个细胞/l无关。估计第48周进展为AIDS事件或死亡的比例为3.3%（95%置信区间，2.0-5.1%），艾滋病毒，6.7%（2.5-14.6%）为艾滋病毒-乙型肝炎病毒感染者，（2.2-20.5%），HIV-HCV亚组结论：HIV/病毒性肝炎合并感染患者CD 4计数恢复延迟并不持久，且与HIV疾病进展增加无关。(C)2004年利平科特威廉姆斯威尔金斯。
Objective: To examine the impact of viral hepatitis co-infection on HIV disease outcomes following commencement of combination antiretroviral therapy in a developing country setting.Methods: HIV RNA suppression, CD4 cell count recovery, and HIV disease progression were examined within a cohort of Thai HIV-infected patients enrolled in eight HIV-NAT randomized controlled trials of antiretroviral therapy (n = 692). Hepatitis B virus (HBV) and hepatitis C virus (HCV) testing was performed on stored serum.Results: Mean age was 32.3 years, 52% were male, 11% had CDC category C HIV disease at baseline, and 22% had received prior antiretroviral therapy. Prevalence of HBV, HCV and HBV/HCV co-infection was 8.7, 7.2 and 0.4%, respectively. Median HIV RNA reductions (log(10) copies/ml) were approximately 1.5 for HIV, HIV-HBV, HIV-HCV subgroups from week 4 up to week 48. Mean increases in CD4 cell count were significantly lower among HIV-HBV and HIV-HCV subgroups at week 4 (HIV, 62 x 10(6) cells/l; HIV-HBV, 29 x 10(6) cells/l; HIV-HCV, 33 x 10(6) cells/l), however, by week 48 CD4 cell increases were similar (HIV, 115 x 10(6) cells/l; HIV-HBV, 113 x 10(6) cells/l; HIV-HCV, 97 x 10(6) cells/l). Cox regression analyses showed that HIV-HBV or HIV-HCV co-infection were not associated with a CD4 cell count increase of 100 x 10(6) cells/l over 48 weeks. Estimated progression to AIDS event or death at week 48 was 3.3% (95% confidence interval, 2.0-5.1%) for HIV, 6.7% (2.5-14.6%) for HIV-HBV, and 8.0% (2.2-20.5%) for HIV-HCV subgroups (P > 0.05).Conclusions: An early delayed CD4 count recovery among HIV/viral hepatitis co-infected patients was not sustained, and was not associated with increased HIV disease progression. (C) 2004 Lippincott Williams Wilkins.