摘要
目的探讨乙型肝炎病毒(HBV)与丙型肝炎病毒(HCV)合并感染患者抗HCV治疗后HBV复制激活相关影响因素。方法选取收治的HBV/HCV合并感染患者36例为研究组,24例单纯HBV感染患者及22例单纯HCV感染患者为对照组。比较2组患者在抗HCV治疗过程中HBV再激活情况,分析2组患者抗HCV治疗前后肝功能指标即丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil),采用多因素Logistic回归分析法分析HBV复制激活的影响因素。结果研究组患者出现HBV复制激活8例,对照组患者未有HBV复制激活;抗HCV治疗后研究组与对照组患者ALT、AST、TBil均显著高于治疗前(P<0.05),且研究组Ⅱ度、Ⅲ度肝损伤程度患者例数显著高于对照组(P<0.05);Logistic分析显示糖皮质激素、索非布韦(SOF)、西咪匹韦(SMV)均为影响HBV复制激活的独立危险因素。结论HBV/HCV合并感染患者抗HCV治疗过程中出现不同程度的肝功能损伤,且存在HBV复制激活风险,使用糖皮质激素、SOF药物及SMV药物是HBV复制激活的高危因素。
Objective To investigate the factors influencing the activation of HBV replication after anti-HCV treatment in patients with hepatitis B virus(HBV)and hepatitis C virus(HCV)coinfection.Methods Thirty-six patients with HBV/HCV coinfection who were admitted and treated in our hospital from March 2017 to February 2018 were enrolled as research group,and 24 patients with HBV infection and 22 patients with HCV infection were enrolled as control group.The HBV reactivation in the anti-HCV treatment was compared between the two groups.The liver function indexes of the two groups before and after anti-HCV treatment were analyzed,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil).Multivariate logistic regression analysis was used to analyze the influencing factors of HBV replication activation.Results In the research group,8 patients had HBV replication activation,which,however,which was not observed in control group.After anti-HCV treatment,the ALT,AST,and TBil in research group and control group were significantly higher than those before treatment(P<0.05),and the number of patients with degreeⅡandⅢliver injury in research group was significantly higher than that in control group(P<0.05).Logistic analysis showed that glucocorticoid,sofosbuvir(SOF)and cimetipide(SMV)capsules were independent risk factors affecting HBV replication activation.Conclusion HBV/HCV co-infected patients have different degrees of liver function injury during anti-HCV treatment,and there is a risk of HBV replication activation.Glucocorticoids,SOF drugs and SMV drugs are high risk factors for HBV replication activation.
作者
娄仲雷
LOU Zhonglei(Department of Infectious Diseases,Affiliated Hospital of Qinghai University, Qinghai, Xi’ning 810000,China)
出处
《河北医药》
CAS
2020年第2期220-223,共4页
Hebei Medical Journal
