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艾滋病毒与丙型肝炎病毒合并感染。如今这位患者情况如何?

HIV AND HEPATITIS C VIRUS COINFECTION. WHO IS THIS PATIENT TODAY?

作者信息

Antonello Vicente Sperb, Antonello Ivan Carlos Ferreira, Zaltron Rosana Ferrazza, Tovo Cristiane Valle

机构信息

Serviço de Atendimento Especializado em AIDS/DSTs IAPI, Prefeitura de Porto Alegre, RS, Brasil.

Departamento de Prevenção e Controle de Infecção, Hospital Fêmina, Porto Alegre, RS, Brasil.

出版信息

Arq Gastroenterol. 2016 Jul-Sep;53(3):180-4. doi: 10.1590/S0004-28032016000300011.

DOI:10.1590/S0004-28032016000300011
PMID:27438424
Abstract

BACKGROUND

  • The increase in the survival following the introduction of highly active antiretroviral therapy (HAART) has seen the emergence of hepatitis C virus (HCV) infection, renal and cardiovascular diseases as important morbidity and mortality causes together with HIV.

OBJECTIVE

  • The present study aimed to investigate the differences between HIV/hepatitis C virus coinfected and HIV-monoinfected regarding demographic and clinical aspects from a HIV/AIDS clinic in Porto Alegre, Brazil.

METHODS

  • Review of medical records of 1,030 HIV infected individuals aged 18 years or more in an urban HIV/AIDS clinic based in Porto Alegre, Southern Brazil. Clinical and demographical Data were collected from the records of the patients attended between March 2008 and December 2012.

RESULTS

  • The present study is a cross-sectional study among HIV-infected patients attended at a public HIV/AIDS clinic in Porto Alegre, Brazil. The prevalence of hepatitis C virus in the present study cohort was 11.8% (CI 95%: 9.9%-13.8%). Hypertension and pathological proteinuria were more common in the coinfected compared to monoinfected group. By the other hand, dyslipidemia were more common among monoinfected patients. There was no difference between the groups regarding CD4+ count or HIV-RNA. Variables significant in the univariate analysis with P<0.05 were further analyzed using a Poisson regression model with robust variance. Coinfected were likely to be older, with lower lipid levels and higher prevalence of pathological proteinuria compared to HIV-monoinfected patients. Although coinfected patients had higher prevalence of tenofovir-based regimen, there was a strong association between hepatitis C virus individuals to pathological proteinuria and dyslipidemia.

CONCLUSION

  • Clinicians should recognize that coinfected and monoinfected individuals are different groups regarding the traditional and HIV-related risk factors and should be managed and screened individually in order to prevent cardiovascular and renal complications.
摘要

背景

随着高效抗逆转录病毒疗法(HAART)的引入,生存率有所提高,丙型肝炎病毒(HCV)感染、肾脏和心血管疾病已成为与HIV相关的重要发病和死亡原因。

目的

本研究旨在调查巴西阿雷格里港一家HIV/AIDS诊所中,HIV/丙型肝炎病毒合并感染患者与HIV单感染患者在人口统计学和临床方面的差异。

方法

回顾巴西南部阿雷格里港一家城市HIV/AIDS诊所中1030名18岁及以上HIV感染个体的病历。从2008年3月至2012年12月就诊患者的记录中收集临床和人口统计学数据。

结果

本研究是在巴西阿雷格里港一家公共HIV/AIDS诊所对HIV感染患者进行的横断面研究。本研究队列中丙型肝炎病毒的患病率为11.8%(95%CI:9.9%-13.8%)。与单感染组相比,合并感染组高血压和病理性蛋白尿更为常见。另一方面,血脂异常在单感染患者中更为常见。两组在CD4+细胞计数或HIV-RNA方面无差异。对单因素分析中P<0.05的变量,使用具有稳健方差的泊松回归模型进行进一步分析。与HIV单感染患者相比,合并感染患者年龄可能更大,血脂水平更低,病理性蛋白尿患病率更高。尽管合并感染患者基于替诺福韦的治疗方案患病率更高,但丙型肝炎病毒个体与病理性蛋白尿和血脂异常之间存在强关联。

结论

临床医生应认识到,在传统和HIV相关危险因素方面,合并感染和单感染个体是不同的群体,应分别进行管理和筛查,以预防心血管和肾脏并发症。

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