ART And Its Combined IFN And RBV Regimen On The Clinical Efficacy Of HIV/AIDS Combined With HCV In 5 Years

Objective:1.To investigate the general situation of adult HIV/AIDS patients and HIV/AIDS combined with HCV patients,observe the effection after 5 years Anti-retroviral Therapy?ART?,which can through CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,HIVRNA,Fibrosis Index Based on the 4 factor?FIB-4 index?,Aspartate Aminotransferase-to-platelet Ratio Index score?APRI score?changes to konw.The research aim is to evaluate HIV/AIDS combined with HCV patients not only need ART,but also need Anti-HCV treatment,which provide clinical evidence for patients.2.To observe the effection after 5 years ART combined with Interferon?IFN?and Ribavirin?RBV?treatment of HIV/AIDS combined with HCV patients,which can through CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,HIVRNA,HCVRNA,Aspartate Aminotransferase?AST?,Alanine Aminotransferase?ALT?,FIB-4 index,APRI score changes to konw.To understand the effection on patients with T lymphocytes and liver fibrosis after ART combined with IFN and RBV treatment within 5 years.Methods:1.Retrospectively collected the basic information of 299 patients who met the inclusion and exclusion criteria from 2006 to 2014,these patients came from the outpatient department of the Fifth Affiliated?Zhuhai?Hospital of Zunyi Medical University,the Fifth Affiliated Hospital of Sun Yat-sen University and Luoding People's Hospital.A total of 232 HIV/AIDS patients and 67 HIV/AIDS combined with HCV patients were collected,the basic information including gender,age,route of infection,baseline CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,FIB-4 index,APRI score.232 HIV/AIDS patients were treated with ART as a control group,67 HIV/AIDS combined with HCV patients were treated with ART?refusal of anti-hepatitis C virus treatment for economic reasons?whom were set as an observation group.The CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,FIB-4 index,and APRI score of the two groups of patients were collected after ART 6 months,1,3,and 5years,at the same time,the virus suppression of the two groups of patients after ART was collected.?² test was used for the count data of the two groups,if the normal distribution is met,the t test is used for comparison between the two groups,if the normal distribution is not met,the mann-whitney u test of non-parametric test is used for comparison between groups,the wilcoxon test of non-parametric test is used for comparison within the group.2.Retrospectively collected the basic information of HIV/AIDS combined with HCV patients who met the inclusion and exclusion criteria from 2006 to 2014,these patients came from the outpatient department of the Fifth Affiliated?Zhuhai?Hospital of Zunyi Medical University,the Fifth Affiliated Hospital of Sun Yat-sen University and Luoding People's Hospital.60 HIV/AIDS combined with HCV patients with CD₄⁺T lymphocytes counts>200cells/uL,30 HIV/AIDS combined with HCV patients came from the Chapter 1 who were only treated with ART?refused anti-hepatitis C virus treatment for economic reasons?as control group,and the other 30 HIV/AIDS combined with HCV patients were treated ART combined with IFN and RBV treatment as observation group.The CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,AST,ALT,FIB-4 index,and APRI score of the two groups of patients were collected before treatment,and after treatment at 6months,1,3,and 5 years,and to understand the inhibition of HIVRNA and HCVRNA after antiviral therapy.?² test was used for the count data of the two groups,if the normal distribution is met,the t test is used for comparison between the two groups,if the normal distribution is not met,the mann-whitney u test of non-parametric test is used for comparison between groups,the wilcoxon test of non-parametric test is used for comparison within the group.Results:1.General situation:In the first chapter of this study,a total of 299 patients were collected from 2006 to 2014.Mainly 31?50 years old male patients,54%of patients aged 31?50 years old,and the ratio of men and women was close to 3:1,71%of patients transmitted sexually,and 27%transmitted intravenously.2.The baseline CD₄⁺T lymphocytes counts and CD₄⁺/CD₈⁺T lymphocytes ratio of 67HIV/AIDS combined with HCV patients in observation group were significantly lower than those in 232 HIV/AIDS patients in control group,the difference was significant?P<0.05?.The baseline FIB-4 index and APRI score of the observation group were significantly higher than the control group,the difference was significant?P<0.05?.there was no statistically significant difference in baseline CD₈⁺T lymphocytes counts between the two groups.The CD₄⁺T lymphocytes counts and CD₄⁺/CD₈⁺T lymphocytes ratio in the observation group after ART was gradually increased within 5 years,which was significantly higher than the baseline and always lower than the control group,the difference was significant?P<0.05?.The CD₈⁺T lymphocytes counts in the observation group gradually increased within 5 years after ART,which was significantly higher than the baseline,but always higher than the control group,the difference was significant?P<0.05?.The FIB-4 index and APRI score of the observation group after 5 years of ART were not significantly different from the baseline,but they were always higher than the control group,and the difference between the groups was significant?P<0.05?.The HIVRNA negative conversion rate of the observation group after ART for 1 year was 53.73%,while that of the control group was 71.12%,the difference was significant?P<0.05?.3.The baseline CD₄⁺T lymphocytes counts,CD₈⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,AST,ALT,FIB-4 index and APRI score were not statistically different between the two groups.The CD₄⁺T lymphocytes counts and CD₄⁺/CD₈⁺T lymphocytes ratio in 30 HIV/AIDS combined with HCV patients after ART combined with IFN and RBV treatment within 5 years gradually increased,significantly higher than baseline,and always higher than the control group,the difference was significant?P<0.05?.The CD₈⁺T lymphocytes counts of the observation group after 5 years of ART combined with IFN and RBV treatment were no significant difference from baseline,and it was only lower than the control group at 1 year of antiviral,the difference was significant?P<0.05?.After 5 years of ART combined with IFN and RBV treatment,AST and ALT were not significantly different from the control group.The FIB-4 index and APRI score of the observation group after 5 years of ART combined with IFN and RBV treatment were significantly lower than the control group,the difference was significant?P<0.05?.After 5 years of ART combined with IFN and RBV treatment,the negative conversion rate of HIVRNA and HCVRNA in the observation group reached 100%.Conclusion:1.The plan of ART is beneficial to the increase of CD₄⁺T lymphocyte counts and CD₄⁺/CD₈⁺T lymphocyte ratio of HIV/AIDS patients,it is also beneficial to the reduction of FIB-4 index and APRI score of HIV/AIDS patients.The plan of ART is beneficial for the recovery of cellular immunity in HIV/AIDS patients and delays the progression of liver fibrosis.2.The plan of ART is beneficial to the increase of CD₄⁺T lymphocyte counts and CD₄⁺/CD₈⁺T lymphocyte ratio of HIV/AIDS combined with HCV patients,however,within 5 years of ART,the increase in CD₄⁺T lymphocyte counts and CD₄⁺/CD₈⁺T lymphocyte ratio was significantly lower than that in HIV/AIDS patients.HCV co-infection is not conducive to down-regulation of CD₈⁺T lymphocytes counts during ART in HIV/AIDS combined with HCV patients,and is not conducive to patients'short-term HIVRNA suppression.3.ART combined with IFN and RBV treatment is beneficial to the recovery of CD₄⁺T lymphocytes counts,CD₄⁺/CD₈⁺T lymphocytes ratio,prevents CD₈⁺T lymphocytes counts down-regulation in HIV/AIDS combined with HCV patients,and delays the progression of liver fibrosis.