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[目的]研究云南少数民族地区静脉药瘾者(IDU)血源性病毒感染、重叠感染状况以及T细胞亚群变化与多重病毒感染的关系。[方法]以406名无肝炎病史的云南少数民族地区IDU为研究对象,用酶联免疫吸附法、免疫层析法和多聚酶链反应检测血源传播的常见病毒(HBV等)的感染标志物,用免疫荧光法检测CD3、CD4和CD8T细胞;用ELISA和放射免疫法检测诱生的细胞因子和血清的细胞因子。同时选取同一地区102名健康体检者作对照。[结果]在406例IDU中,HBV、HCV、HIV、HDV、HGV和HCMV感染率分别为36.45%,69.7%,47.3%,2.22%,1.97%和3.45%,均明显高于对照组,大多数IDU 62.81%,存在两种以上病毒感染。HIV易重叠HCV和HBV等病毒感染,重叠感染率为83.85%。对照组仅存在HBV感染17.65%。IDU的CD3+和CD4+细胞比例减少,CD8+细胞比例无明显变化,单个核细胞诱生的IL-4、IFN-γ以及血清IL-2减少,血清IL-4增高(P﹤0.01)。发生HIV感染或HIV重叠HCV/HBV病毒感染时,诱生的IFN-γ和CD4细胞比例进一步降低。当HIV合并HBV感染的IDU,51.72%表现HBV-DNA阳性和37.93%的HBeAg阳性;但无HIV感染时,HBV-DNA阳性率仅为1.68%。[结论]IDU易出现多种病毒感染,主要是HIV、HCV和HBV的感染。IDUTh1细胞功能减弱,出现HIV感染或重叠感染使Th1/Th2细胞平衡紊乱,进一步证实了HIV可能通过减弱Th1细胞功能,促进HBV的复制。
[Objective] To investigate the relationship between the infection of blood-borne virus (IDU), the status of overlapping infection and the change of T cell subsets and the infection of multiple viruses in Yunnan IDUs. [Method] With IDU of 406 patients without history of hepatitis as the research object, the infection markers of common virus (HBV, etc.) transmitted by blood were detected by enzyme - linked immunosorbent assay, immunochromatography and polymerase chain reaction. The CD3, CD4 and CD8 T cells were detected by immunofluorescence. The induced cytokines and serum cytokines were detected by ELISA and radioimmunoassay. At the same time, 102 healthy people in the same area were selected as control. [Results] The infection rates of HBV, HCV, HIV, HDV, HGV and HCMV in 406 IDUs were 36.45%, 69.7%, 47.3%, 2.22%, 1.97% and 3.45% respectively, which were significantly higher than that of the control group Most IDU 62.81%, there are two or more virus infections. HIV easily overlap HCV and HBV infection, the overlapping infection rate was 83.85%. The control group only had HBV infection 17.65%. The proportion of CD3 + and CD4 + cells in IDU was decreased, while the proportion of CD8 + cells was not changed. IL-4 and IFN-γ induced by mononuclear cells and IL-2 in serum were decreased and IL-4 in serum was increased (P <0.01). The proportion of induced IFN-γ and CD4 cells was further reduced in the case of HIV infection or HIV-overvirus infection with HCV / HBV. When HIV-infected IDUs were infected with HBV, 51.72% showed HBV-DNA positive and 37.93% HBeAg-positive. However, without HIV infection, the positive rate of HBV-DNA was only 1.68%. [Conclusion] IDU is prone to multiple viral infections, mainly HIV, HCV and HBV infection. IDUTh1 cell function weakened, HIV infection or overlap infection Th1 / Th2 balance disorders, further evidence that HIV may attenuate Th1 cell function, promote HBV replication.