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目的观察干扰素α联合利巴韦林对中国人丙型肝炎病毒(HCV)与人类免疫缺陷病毒(HIV) 混合感染(HCV/HIV)患者的治疗效果及不良反应,并与其对单独HCV患者的治疗进行对比。方法10 例HCV/HIV患者和17例HCV患者,以肌肉注射干扰素α5 MU,隔日1次,口服利巴韦林0.3 g,3次/d, 动态观察两组的HCV RNA水平和HIV RNA水平,CD4+和CD8+T淋巴细胞计数,主要的肝功能和血细胞指标,以及主要的不良反应。结果HCV/HIV患者与HCV患者治疗12周和24周,HCV RNA较用药前平均分别下降1.14 log(t=3.843,P<0.01)和2.08 log(t=6.564,P<0.01),1.48 log(t=6.438,P <0.01)和2.33 log(t=7.343,P<0.01);同时HIV RNA也较用药前平均下降了1.22 log(t=3.662, P<0.01)和1.73 log(t=6.119,P<0.01),但两组用药前后的CD4+、CD8+T淋巴细胞计数变化不大, 27例患者的氨基转移酶除2例稍高以外其余均降至正常值。用药过程中部分病例发生流感样症状和消化道反应(多见于用药早期),白细胞总数和血红蛋白各有4例轻度下降;未发现明显精神神经异常和自身免疫疾病表现。结论以干扰素α联合利巴韦林治疗中国人HCV/HIV患者,用药24周的抗HCV效果不低于两种药物联合治疗单独HCV患者的效果,并有一定的抗HIV作用。两组的生化反应和不良反应差异无统计学意义。
Objective To observe the therapeutic effects and adverse reactions of interferon α combined with ribavirin in Chinese patients with Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection (HCV / HIV) Treatment comparison. Methods Ten patients with HCV / HIV and 17 HCV patients were treated with intramuscular interferon α5 MU, once every other day and oral administration of ribavirin 0.3 g, 3 times / d. The levels of HCV RNA and HIV RNA , CD4 + and CD8 + T lymphocyte counts, major liver and blood cell markers, and major adverse reactions. Results The HCV RNA decreased by 1.14 log (t = 3.843, P <0.01) and 2.08 log (t = 6.564, P <0.01) and 1.48 log (t = 6.438, P <0.01) and 2.33 log (t = 7.343, P <0.01). HIV RNA also decreased by 1.22 log (t = 3.662, P <0.01) and 1.73 log (t = P <0.01). However, the counts of CD4 + and CD8 + T lymphocytes before and after treatment changed little in both groups. The aminotransferase in 27 patients decreased to normal except for 2 cases slightly higher. In some cases during the course of medication, flu-like symptoms and digestive tract reactions (more common in early drug use) occurred in some cases, and the number of leukocytes and hemoglobin decreased slightly in 4 cases. No obvious neuropsychiatric abnormalities and autoimmune diseases were found. Conclusion The anti-HCV efficacy of interferon α combined with ribavirin in Chinese patients with HCV / HIV at 24 weeks is not lower than that of the combination of two drugs in patients with HCV alone and has certain anti-HIV effect. There was no significant difference in biochemical reaction and adverse reaction between the two groups.