Souza A R, Tovo C V, Mattos A A, Chaves S
Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, RS, Brasil.
Braz J Med Biol Res. 2008 Mar;41(3):223-8. doi: 10.1590/s0100-879x2006005000200. Epub 2007 Dec 20.
Some studies have suggested that human immunodeficiency virus (HIV) infection modifies the natural history of hepatitis C virus (HCV) infection, accelerating the progression of fibrosis and the development of cirrhosis. Our objective was to evaluate the fibrosis progression rate (FPR) in HCV/HIV-co-infected patients, and to identify factors that may influence it. HCV-mono-infected and HCV/HIV-co-infected patients with a known date of HCV infection (transfusion or injection drug use) and a liver biopsy were included. The FPR was defined as the ratio between the fibrosis stage (Metavir score) and the estimated length of infection in years and the result was reported as fibrosis units per year. The factors studied were gender, age at infection, consumption of alcohol, aminotransferase levels, histological activity grade, HCV genotype and viral load, CD4 cell count, HIV viral load, and the use of antiretroviral therapy. Sixty-five HCV-infected (group 1) and 53 HCV/HIV-co-infected (group 2) patients were evaluated over a period of 19 months. The mean FPR of groups 1 and 2 was 0.086 +/- 0.074 and 0.109 +/- 0.098 fibrosis units per year, respectively (P = 0.276). There was a correlation between length of HCV infection and stage of fibrosis in both groups. The age at infection, the aspartate aminotransferase level (r = 0.36) and the inflammatory activity grade were correlated with the FPR (P < 0.001). No difference in FPR was found between HCV-mono-infected and HCV/HIV-co-infected patients.
一些研究表明，人类免疫缺陷病毒（HIV）感染会改变丙型肝炎病毒（HCV）感染的自然病程，加速纤维化进程和肝硬化的发展。我们的目的是评估HCV/HIV合并感染患者的纤维化进展率（FPR），并确定可能影响该进展率的因素。纳入了已知HCV感染日期（输血或注射吸毒）且进行过肝活检的HCV单一感染和HCV/HIV合并感染患者。FPR定义为纤维化阶段（梅塔维分级）与估计感染年限的比值，结果以每年纤维化单位表示。研究的因素包括性别、感染时年龄、酒精摄入量、转氨酶水平、组织学活动度分级、HCV基因型和病毒载量、CD4细胞计数、HIV病毒载量以及抗逆转录病毒治疗的使用情况。在19个月的时间里对65例HCV感染患者（第1组）和53例HCV/HIV合并感染患者（第2组）进行了评估。第1组和第2组的平均FPR分别为每年0.086±0.074和0.109±0.098纤维化单位（P = 0.276）。两组中HCV感染时长与纤维化阶段均存在相关性。感染时年龄、天冬氨酸转氨酶水平（r = 0.36）和炎症活动度分级与FPR相关（P < 0.001）。HCV单一感染和HCV/HIV合并感染患者之间的FPR未发现差异。
