在HIV/HCV合并感染患者中，聚乙二醇干扰素α-2b治疗期间丙型肝炎病毒动力学与基线CD4+ T细胞计数的关系。
Hepatitis C viral kinetics during treatment with peg IFN-alpha-2b in HIV/HCV coinfected patients as a function of baseline CD4+ T-cell counts.
作者信息
Avidan Neumann U, Goldstein Deborah, Rozenberg Lynn, McLaughlin Mary, Ferenci Peter, Masur Henry, Buti Maria, Fauci Anthony S, Polis Michael A, Kottilil Shyam
机构信息
Bar-Ilan University, Ramat-Gan, Israel.
出版信息
J Acquir Immune Defic Syndr. 2009 Dec 1;52(4):452-8. doi: 10.1097/QAI.0b013e3181be7249.
BACKGROUND
HIV/hepatitis C virus (HCV) coinfected patients are known to have lower sustained viral response (SVR) rates than HCV monoinfected patients. However, the role of CD4+ T-cell counts on viral kinetics and outcome is not fully understood.
METHODS
HCV RNA kinetics (bDNA v3, lower limit of detection [LD] = 615 IU/mL) was analyzed in 32 HIV/HCV coinfected persons treated with Pegylated-interferon-alpha2b (1.5 microg/kg weekly) and ribavirin (1-1.2 g daily) for 48 weeks and compared with results obtained from 12 HCV monoinfected patients treated with the same regimen.
RESULTS
Baseline CD4+ T-cell counts > or =450 cells/mm3 were significantly (P < 0.002) associated with SVR in coinfected genotype 1 patients. First phase decline was significantly lower among patients with low as compared with high CD4 counts (P < 0.03) and among coinfected compared with monoinfected patients (P < 0.002). Second phase decline slope showed a similar trend for coinfected patients.
CONCLUSIONS
Low baseline CD4+ T-cell count is associated with slower HCV viral kinetics and worse response to treatment among HIV coinfected patients, suggesting HCV treatment response depends on immune status. HCV genotype 1 coinfected patients have slower first phase viral kinetics than HCV monoinfected patients. First phase viral decline (>1.0 log) and second phase viral decline slope (>0.3 log/wk) are excellent predictors of SVR for coinfected patients.
背景
已知人类免疫缺陷病毒（HIV）/丙型肝炎病毒（HCV）合并感染患者的持续病毒学应答（SVR）率低于单纯HCV感染患者。然而，CD4 + T细胞计数对病毒动力学和治疗结果的作用尚未完全明确。
方法
对32例接受聚乙二醇化干扰素α-2b（每周1.5μg/kg）和利巴韦林（每日1 - 1.2g）治疗48周的HIV/HCV合并感染患者的HCV RNA动力学（分支DNA v3，检测下限[LD]=615 IU/mL）进行分析，并与12例接受相同治疗方案的单纯HCV感染患者的结果进行比较。
结果
在合并感染基因1型的患者中，基线CD4 + T细胞计数≥450个细胞/mm3与SVR显著相关（P < 0.002）。低CD4计数患者的第一阶段病毒下降幅度显著低于高CD4计数患者（P < 0.03），且合并感染患者低于单纯感染患者（P < 0.002）。合并感染患者的第二阶段病毒下降斜率呈现相似趋势。
结论
基线CD4 + T细胞计数低与HIV合并感染患者的HCV病毒动力学较慢及治疗反应较差相关，提示HCV治疗反应取决于免疫状态。合并感染基因1型的患者第一阶段病毒动力学比单纯HCV感染患者慢。第一阶段病毒下降幅度（>1.0 log）和第二阶段病毒下降斜率（>0.3 log/周）是合并感染患者SVR的良好预测指标。
Zotero 插件