摘要
目的了解有偿献血者中丙型肝炎病毒(HCV)感染者肝脏纤维化状况和丙肝纤维化危险因素。方法选取河南省王营村有有偿献血史的单纯HCV感染者149例和丙型肝炎病毒/人类免疫缺陷病毒(HCV/HIV)混合感染者106例,进行回顾性队列研究和现场调查,采集血样进行HCV、HIV抗体、CD4、CD8T细胞检测,B超检查肝脏纤维化;采用COX回归分析比较HCV感染者肝脏纤维化的危险因素。结果 255例患者中,肝脏纤维化发生率为25.88%(66/255),不同性别、是否接受高效抗逆转录病毒治疗、CD4T和CD8T细胞计数、病毒感染类型的肝脏纤维化发生率差异均有统计学意义(P<0.05);以肝脏纤维化为结局,HCV混合感染组的中位生存时间比单纯HCV感染者早5.74年进入肝脏纤维化阶段,差异有统计学意义(χ2=47.41,P<0.01)。HCV/HIV混合感染是影响肝脏纤维化的风险因子(χ2=10.453,P<0.01)。结论与单纯HCV感染者比较,HCV/HIV混合感染能够增加肝脏纤维化发生危险性并加快其病程进程。
Objective To investigate the liver fibrosis progression in hepatitis C virus （HCV） infected patients and its risk factors among paid blood donors in Wangying village of Henan province. Methods Totally 149 HCV monoinfected and 106 HCV/human immunodeficiency virus（HIV） coinfected paid blood donors were enrolled into a cohort and followed- up. The blood samples were collected for HCV or HIV antibody test and CD4T,CDST cell counts ,and B ultrasonic exami- nation was performed for liver fibrosis detection. Cox regression analysis was used to explore the risk factors of liver fibrosis in HCV patients. Results Among the subjects,25.88% （66/255） were diagnosed as liver fibrosis and the incidence of liver fibrosis was different between the patients of different gender, with and without highly active anti-retrovirai therapy, different counts of CD4T and CD8T cell,and types of virus infection（χ2 = 10. 453 ,P 〈0. 01 ）. Considering liver fibrosis as the end point, the median survive time of coinfected group was 5.74 years earlier than the monoinfected group, with a significant difference（ P 〈0. 05 ）. Cox regression analysis indicated that the only risk factor of liver fibrosis was types of virus infected （ χ2 = 10. 453, P 〈 0. 01 ）. Conclusion Compared with the HCV monoinfected, HCV/HIV coinfected could increase the risk of hepatic fibrosis and accelerate the progression of liver fibrosis.
出处
《中国公共卫生》
CAS
CSCD
北大核心
2012年第1期12-14,共3页
Chinese Journal of Public Health
基金
国家"十一五"科技重大专项课题(2008ZX10002-013)
