Objective: To investigate the long-term characteristic changes of virus, immune status, and liver fibrosis markers in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients after receiving direct-antiviral agents (DAAs). Methods: HIV/HCV co-infected patients who visited the Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 2014 to December 2019 were selected as the research subjects. The changes of virological response rate, peripheral blood CD4(+)T lymphocyte level and serological markers of liver fibrosis (APRI score and FIB-4 index) were observed during 144 weeks of follow-up course after the end of DAAs treatment. Kruskal-Wallis test was used for statistical approach. Results: A total of 103 cases were included in the study. There were 87 males (87.5%), with a median age of 44 years. Sustained virological response rate at 12 weeks (SVR12) after DAAs treatment was 97.6%, and the SVR during the entire follow-up period was at least 95.9%. Compared with baseline, CD4(+)T lymphocyte count were significantly increased equally at 12 weeks (Z = -2.283, P = 0.022), 24 weeks (Z = -3.538, P < 0.001), 48 weeks (Z = -3.297, P = 0.001), 96 weeks (Z = -3.562, P < 0.001), and 144 weeks (Z = -2.842, P = 0.004). APRI score (Z = -6.394, P < 0.001) and FIB-4 index (Z = -2.528, P = 0.011) were significantly lower than baseline at week 4 of DAAs treatment, and thereafter remained at a low level, without further declination. Conclusion: HIV/HCV co-infected patients can maintain high SVR for a long time, acquire good immune reconstitution, and significantly improve liver fibrosis after DAAs treatment.
目的： 探讨人类免疫缺陷病毒（HIV）/丙型肝炎病毒（HCV）合并感染患者接受直接抗病毒药物（DAAs）治疗后病毒学、免疫学及肝纤维化指标长期变化特征。 方法： 以2014年5月至2019年12月广州医科大学附属市八医院HIV/HCV合并感染患者为研究对象，观察DAAs结束治疗后144周随访期间病毒学应答率、外周血CD4(+)T淋巴细胞水平及肝纤维化血清学指标（APRI评分及FIB-4指数）变化。统计学方法采用Kruskal-Wallis检验。 结果： 共103例患者纳入本研究，男性87例（87.5%），年龄中位数44岁，DAAs治疗结束后12周持续病毒学应答（SVR12）率达97.6%，整个随访过程SVR至少95.9%。与基线相比，CD4(+)T淋巴细胞计数治疗结束后12周（Z = -2.283，P = 0.022）、24周（Z = -3.538，P < 0.001）、48周（Z = -3.297，P = 0.001）、96周（Z = -3.562，P < 0.001）以及144周（Z = -2.842，P = 0.004）均显著升高。DAAs治疗第4周时，APRI评分（Z = -6.394，P < 0.001）和FIB-4指数（Z = -2.528，P = 0.011）即较基线显著下降，之后它们一直维持在较低水平，但未进一步下降。 结论： HIV/HCV合并感染者经DAAs治疗后可长期保持较高SVR，获得良好免疫重建，并明显改善肝纤维化。.
Keywords: Coinfection; Direct antiviral agent; Hepatitis C virus; Human immunodeficiency virus; Liver fibrosis.