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可溶性 Fas 和 Fas 配体在 HIV/HCV 合并感染患者中的变化及其对 HCV 治疗的影响。

Soluble Fas and Fas ligand in HIV/HCV coinfected patients and impact of HCV therapy.

机构信息

Laboratory of Molecular Epidemiology of Infectious Diseases, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

出版信息

Eur J Clin Microbiol Infect Dis. 2011 Oct;30(10):1213-21. doi: 10.1007/s10096-011-1215-0. Epub 2011 Mar 26.

Abstract

The aim of this study was to evaluate the influence of clinical and epidemiological characteristics of 183 HIV/HCV coinfected patients and HCV clearance after antiviral treatment on serum sFas and sFasL levels. Thirty out of 183 patients underwent HCV antiviral therapy with IFN-α + RBV for a duration of 48 weeks. HCV genotype 1 and homeostasis model assessment for insulin resistance (HOMA-IR) had a significant positive relationship, and CD4+/μL had a significant negative relationship with sFas (R-square = 0.582; p < 0.001) and sFasL (R-square = 0.216; p < 0.001) in multivariate linear regression analysis. HCV genotype 1 was the only significant variable associated with the sFas/sFasL ratio (R-square = 0.201; p < 0.001). sFas and sFasL levels had positive significant correlations with serum sICAM-1, sVCAM-1, and HOMA levels (p < 0.05). Among patients on IFN-α + RBV therapy, 15 patients showed a sustained virologic response (SVR), while 15 patients were non-responders (NR). Patients with SVR had significant decreases in sFas (p = 0.008) and sFas/sFasL ratio (p = 0.002), while non-responders had a significant increase in sFasL values (p = 0.013). In conclusion, HCV genotype 1, high HOMA, and low CD4+/μL were associated with high serum levels of sFas and sFasL, which indicate higher levels of inflammation and, possibly, increased cardiovascular risk. Moreover, response to HCV antiviral therapy is known to reduce inflammation.

摘要

本研究旨在评估 183 例 HIV/HCV 合并感染患者的临床和流行病学特征以及抗病毒治疗后 HCV 清除对血清 sFas 和 sFasL 水平的影响。其中 30 例患者接受 IFN-α+RBV 抗病毒治疗,疗程为 48 周。多因素线性回归分析显示,HCV 基因型 1 与稳态模型评估的胰岛素抵抗(HOMA-IR)呈显著正相关,CD4+/μL 与 sFas(R 平方=0.582;p<0.001)和 sFasL(R 平方=0.216;p<0.001)呈显著负相关。HCV 基因型 1 是唯一与 sFas/sFasL 比值显著相关的变量(R 平方=0.201;p<0.001)。sFas 和 sFasL 水平与血清 sICAM-1、sVCAM-1 和 HOMA 水平呈显著正相关(p<0.05)。在接受 IFN-α+RBV 治疗的患者中,15 例患者获得持续病毒学应答(SVR),15 例患者无应答(NR)。SVR 患者的 sFas(p=0.008)和 sFas/sFasL 比值(p=0.002)显著降低,而 NR 患者的 sFasL 值显著升高(p=0.013)。综上所述,HCV 基因型 1、高 HOMA 和低 CD4+/μL 与血清 sFas 和 sFasL 水平升高相关,表明炎症水平升高,可能增加心血管风险。此外,HCV 抗病毒治疗的反应可降低炎症水平。

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