Trimoulet P, Neau D, Le Bail B, Rullier A, Winnock M, Galperine T, Legrand E, Schvoerer E, Dupon M, Ragnaud J M, Bioulac-Sage P, Chêne G, Fleury H, Lafon M E
Laboratoire de Virologie, Centre Hospitalo-Universitaire, Bordeaux, France.
J Med Virol. 2002 Jun;67(2):143-51. doi: 10.1002/jmv.2203.
Serum and intrahepatic hepatitis C virus (HCV) RNA were measured in 37 HIV-HCV co-infected patients with controlled human immunodeficiency virus (HIV) infection and correlated with clinical, biological, and histological parameters. Thirty-seven interferon-naive patients underwent liver biopsy. HCV-induced activity (A) and fibrosis (F) were evaluated with METAVIR score. The 37 patients included had HIV plasma loads < 10,000 copies/ml, CD4(+) count > 250/microl. All the patients but two were receiving antiretroviral treatment. Liver tissue and sera were used for measurement of HCV RNA by the Cobas Amplicor HCV Monitor. All patients had serum and liver HCV RNA, and both levels were correlated (r = 0.47; P = 0.003). Intrahepatic HCV load did not depend on age, sex, duration of HCV infection, CD4(+), HCV genotype, or fibrosis. AST levels correlated with intrahepatic HCV load (r = 0.52; P = 0.001). Patients with METAVIR A1/A2 had significantly lower levels of liver HCV-RNA than were found in patients with METAVIR A3 (P = 0.026). Highly active antiretroviral therapy (HAART) including protease inhibitors(PI)-treated patients had significantly lower intrahepatic HCV load (P = 0.04). A weak but significant correlation between serum and liver HCV RNA was found. The amount of hepatic HCV RNA was correlated with AST levels, histological activity, but not with HCV genotype or fibrosis. The immune improvement associated with PI regimens could help reduce HCV load, supporting a protective effect of PI-induced immune restoration.
对37例人类免疫缺陷病毒（HIV）感染得到控制的HIV-HCV合并感染患者测定了血清和肝内丙型肝炎病毒（HCV）RNA，并将其与临床、生物学和组织学参数进行关联分析。37例未接受过干扰素治疗的患者接受了肝活检。采用METAVIR评分评估HCV诱导的活性（A）和纤维化（F）。纳入的37例患者HIV血浆载量<10,000拷贝/ml，CD4(+)细胞计数>250/μl。除2例患者外，所有患者均接受抗逆转录病毒治疗。采用Cobas Amplicor HCV Monitor检测肝组织和血清中的HCV RNA。所有患者血清和肝内均有HCV RNA，且两者水平具有相关性（r = 0.47；P = 0.003）。肝内HCV载量不取决于年龄、性别、HCV感染持续时间、CD4(+)细胞、HCV基因型或纤维化程度。天冬氨酸转氨酶（AST）水平与肝内HCV载量相关（r = 0.52；P = 0.001）。METAVIR A1/A2级患者的肝内HCV-RNA水平显著低于METAVIR A3级患者（P = 0.026）。接受包括蛋白酶抑制剂（PI）在内的高效抗逆转录病毒治疗（HAART）的患者肝内HCV载量显著较低（P = 0.04）。血清和肝内HCV RNA之间存在微弱但显著的相关性。肝内HCV RNA量与AST水平、组织学活性相关，但与HCV基因型或纤维化无关。与PI方案相关的免疫改善有助于降低HCV载量，支持PI诱导的免疫恢复具有保护作用。
