The impact of HBV/HCV coinfection on HBV DNA levels and the severity of liver diseases in HBV-infected patients undergoing hemodialysis
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摘要:
目的探讨HCV重叠感染对HBV感染的维持性血液透析(MHD)患者HBV DNA水平的影响。方法选取HBV感染血清标志物阳性的MHD患者178名,将其分为HBV合并HCV感染组(HBV+HCV+组,n=86)和单纯HBV感染组(HBV+HCV-组,n=92),同时检测两组HBV DNA水平及主要血生化指标。结果两组ALT、AST水平无明显差异(P>0.05),HBV+HCV+组HBVDNA水平较HBV+HCV-组明显降低[(0.42±0.10)log scale/ml vs(1.25±0.28)log scale/ml,P<0.01]。多元Logistic回归分析显示HCV感染与低HBV DNA水平独立相关(OR=0.316,95%CI:0.124~0.703,P<0.01)。结论在HBV感染的MHD患者中,合并HCV感染能显著降低患者的HBV DNA水平,而不引起明显的肝功能损害加重。
Abstract:Objective To investigate the impact of hepatitis B virus (HBV) /hepatitis C virus (HCV) coinfection on HBV DNA levels and the severity of liver diseases in HBV-infected patients undergoing hemodialysis.Methods A total of 178 hemodialysis patients showing positivity for HBV infection were enrolled for study and divided into two groups according to co-or monoinfection status.Eighty-six patients tested positive for both HBV and HCV (HBV+/HCV+ group) , and 92 patients tested positive for HBV and negative for HCV (HBV+/HCV-group) .HBV DNA levels and blood biochemical parameters were measured.The significance of inter-group differences was assessed by t-test (normally distributed data) or Mann-Whitney U test (non-normally distributed data) .Multivariate logistic stepwise regression was use to evaluate the association of parameters with HCV infection.Results The two groups showed similar levels of serum aminotransferase (P>0.05) .In contrast, the HBV+/HCV+ patients showed significantly lower levels of serum HBV DNA than the HBV+/HCV-patients [ (0.42±0.10) vs. (1.25±0.28) log scale/ml, P<0.01].HCV infection was found to be independently associated with lower HBV DNA levels (OR=0.316, 95% CI:0.236-0.865, P<0.01) .Conclusion In hemodialysis patients, HBV/HCV coinfection is associated with lower HBV DNA levels but not more severe liver diseases.
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Key words:
- hepatitis B virus /
- hepacivirus /
- superinfection /
- hemodiafiltration
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