Epidemiological features of positive anti-HCV among the HIV-infected population in Guangxi,China
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摘要: 目的了解广西地区HIV感染人群HCV抗体阳性率的流行病学现状与特点。方法以2010年-2016年在广西7家医院就诊的HIV抗体阳性的广西籍患者为研究对象,收集患者基本人口学资料及HCV抗体检测结果、HIV/HCV共感染途径等资料。计数资料组间比较采用χ2检验方法或Fisher’s精确检验,采用Bonferroni法进行多个样本率的多重比较。因变量为二分类变量,采用二分类logistic回归模型进行单因素及多因素分析。结果共选取HIV抗体确证阳性患者6154例,其中HCV抗体阳性409例,阳性率为6. 65%[95%可信区间(CI):6. 03%~7. 27%],其中男性HCV抗体阳性率(7. 97%)高于女性(3. 57%),差异具有统计学意义(χ2=29. 294,P <0. 01); 18~44岁年龄段HCV抗体阳性率最高(10. 47%),45~59岁年龄段次之(5. 44%),均高于其他年龄段,两两分析比较差异均有统计学意义(P值均<0. 01);静脉吸毒人群HCV抗体阳性率最高(75. 12%),静脉吸毒+性接触次之(70. 00%),均高于其他感染途径,差异均有...Abstract: Objective To investigate the epidemiological status and features of anti-HCV positive rate among the HIV-infected population in Guangxi,China. Methods The patients from Guangxi who attended 7 hospitals in Guangxi form 2010 to 2016 and were confirmed with positive HIV antibody were enrolled as subjects. Their demographic data,anti-HCV test results,and route of HIV-HCV coinfection were collected. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups,and the Bonferroni method was used for multiple comparisons of sample rates. Since dependent variables were binary variables,the binary univariate and multivariate logistic regression analyses were performed. Results A total of 6154 patients with positive HIV antibody were enrolled,among whom 409(6. 65%; 95% confidence interval [CI]: 6. 03%-7. 27%) had positive HCV antibody. Male patients had a significantly higher anti-HCV positive rate than female patients(7. 97% vs 3. 57%,χ2= 29. 294,P < 0. 01). The age group of 18-44 years had the highest anti-HCV positive rate of 10. 47%,followed by the age group of 45-59 years(5. 44%),and these two groups had a significantly higher positive rate than the other age groups based on pairwise comparison(all P < 0. 01). Intravenous drug users had the highest anti-HCV positive rate of 75. 12%,followed by the intravenous drug users with sexual contact(70. 00%),and the patients with these two routes of infection had a significantly higher anti-HCV positive rate than those with other routes(all P < 0. 01). In the patients with positive HIV and HCV antibodies,intravenous drug users accounted for a higher proportion than the patients with other routes of infection; 72. 30% of the male patients were intravenous drug users,while 57. 58% of the female patients were infected via sexual transmission,and there was a significant difference in the distribution of the routes of infection between the male and female patients(P < 0. 01). The age group of 18-44 years had the highest proportion of intravenous drug users(71. 58%),followed by the age group of 45-59 years(63. 27%),and these twogroups had a significantly higher proportion than the other age groups based on pairwise comparison(all P < 0. 01). The age group of 60-80 years had a significantly higher proportion of patients with sexual transmission than the other age groups based on pairwise comparison(all P < 0. 01). The logistic regression analysis showed that for the patients with HIV infection,the risk of intravenous drug use and HCV infection was 60. 385 times(95% CI: 7. 909-461. 017) that of the other routes of infection,and the risk of intravenous drug use + sexual contact and HCV infection was 46. 667 times(95% CI: 4. 144-525. 501) that of the other routes of infection(P < 0. 01). Conclusion The anti-HCV positive rate remains high among the patients with HIV infection in Guangxi,and male patients have a higher anti-HCV positive rate than female patients. Young individuals have a higher anti-HCV positive rate than the other age groups. Among the male population and the young and middle-aged population,intravenous drug use is the main route of HIV/HCV infection,while in the female population and the elderly population,sexual contact is the main route of infection. Intravenous drug use is an independent risk factor for HIV-HCV coinfection.
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Key words:
- HIV /
- hepacivirus /
- hepatitis C antibodies /
- epidemiologic studies
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[1] Chinese Society of Hepatology,Society of Infectious Diseases. Guidelines for the prevention and treatment of hepatitis C(2015 updated version)[J]. J Clin Hepatol,2015,31(12):1961-1979.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1961-1979. [2] DAI ZC,QI GM. Sero-epidemiological survey of viarl hepatitis in China(volumn 1)[M]. Beijing:Science and Technology Literature Publishing House,1997.(in Chinese)戴志澄,祈国明.中国病毒性肝炎:血清流行病学调查(上卷)[M].北京:科学技术文献出版社,1997. [3] CHEN YS,LI L,CUI FQ,et al. A sero-epidemiological study on hepatitis C in China[J]. Chin J Epidemiol,2011,32(9):888-891.(in Chinese)陈园生,李黎,崔富强,等.中国丙型肝炎血清流行病学研究[J].中华流行病学杂志,2011,32(9):888-891. [4] LU Y,MATTHEW R,ZHANG FJ. Human immunodeficiency virus and hepatitis C virus coinfection epidemiology,nature history and the situation in China[J]. Chin Medic J,2009,122(1):93-97. [5] ROSENTHAL E,POIRE M,PRADIER C,et al. Mortality due to hepatitis C-related liver disease in HIV-infected patients in France(Mortavic 2001 study)[J]. AIDS,2003,17(12):1803-1809. [6] WEBER R,SABIN CA,FRIIS-MLLER N,et al. Liver-related deaths in persons infected with the human immunodeficiency virus:the D:A:D study[J]. Arch Intern Med,2006,166(15):1632-1641. [7] MONGA HK,RODRIGUEZ-BARRADAS MC,BREAUX K,et al. Hepatitis C virus infection-related morbidity and mortality among patients with human immunodeficiency virus infection[J]. Clin Infect Dis,2001,33(2):240-247. [8] WHO. new standards for human age division criterion by the United Nations[N]. Hunan Agr Mach,2001(6).(in Chinese)世界卫生组织.联合国对人类年龄段划分有新标准[N].湖南农机,2001(6). [9] FREITAS SZ,TELES SA,LORENZO PC,et al. HIV and HCV coinfection:Prevalence, associated factors and genotype characterization in the Midwest Region of Brazil[J]. Rev Inst Med Trop Sao Paulo,2014,56(6):517-524. [10] WHO. Guidlines for the screen,care and treatment of persons with chronic hepatitis C infection[EB/OL]. 2016-04. http://origin. who. int/hepatitis/publications/hepatitis-c-guidelines-2016/en/. [11] HERRERO ME. Hepatitis B and hepatitis C co-infection in patients with HIV[J]. Rev Med Virol,2001,11(4):253-270. [12] ROCKSTROH JK,SPENGLER U. HIV and hepatitis C virus co-infection[J]. Lancet Infect Dis,2004,4(7):437-444. [13] MA JX,WANG JR,SHEN YZ,et al. Clinical epidemiology studies on HIV-1/AIDS subjects co-infected with HBV and/or HCV in Shanghai[J]. J Micro Infect,2006,1(4):207-210.(in Chinese)马建新,王江蓉,沈银忠,等.上海地区人类免疫缺陷病毒/艾滋病合并乙型、丙型肝炎病毒感染的临床流行病学研究[J].微生物与感染,2006,1(4):207-210. [14] LI L,BAO ZY,SUI HS,et al. Investigation on HCV co-infection in HIV-infected people in some areas of China[J]. Chin J AIDS STD,2008,14(1):9-11.(in Chinese)李林,鲍作义,隋洪帅,等.我国部分地区HIV感染者HCV协同感染状况的调查研究[J].中国艾滋病性病,2008,14(1):9-11. [15] DING LS,ZHANG GQ,JIANG Y,et al. Infection status and risk factors of HBV and HCV among HIV-infected people in Hunan,China[J]. Chin J Viral Dis,2011,1(5):358-362.(in Chinese)丁莉莎,张国强,江洋,等.湖南省HIV患者合并感染HBV及HCV现状调查及风险因素分析[J].中国病毒病杂志,2011,1(5):358-362. [16] LI CX,LIU J,BAI JS,et al. The epidemic characteristics of HIV/HCV co-infection in Kunming Area from 2010 to 2016[J]. J Kunming Med Univ,2018,39(12):103-107.(in Chinese)李重熙,刘俊,白劲松,等.昆明地区2010年~2016年HIV/HCV共感染流行特征[J].昆明医科大学学报,2018,39(12):103-107. [17] GUO Y,NING TL,ZHOU N. HCV infection status and associated factors among drug users in Tianjin from 2011 to 2015[J]. Int J Virol,2017,24(3):178-183.郭燕,宁铁林,周宁.天津市2011-2015年吸毒人群HCV感染状况及影响因素分析[J].国际病毒学杂志,2017,24(3):178-183. [18] JI Y,ZHUANG W,YANG C,et al. Follow-up observation on blood donors infected with HCV for 10 years[J]. Chin J Blood Transfusion,2004,17(6):399-403.(in Chinese)季阳,庄文,杨翠,等.丙型肝炎病毒感染的献血者10年追踪观察[J].中国献血杂志,2004,17(6):399-403. [19] MENG ZH,WEI Y,YANG RY,et al. Research of the co-infection of hepatitis B virus and hepatitis C virus among AIDS in Guangxi Guizhong areas[J]. Chin J New Clin Med,2010,3(7):607-608.(in Chinese)蒙志好,韦一,杨日耀,等.广西桂中地区艾滋病患者乙型和丙型肝炎病毒感染调查研究[J].中国临床新医学,2010,3(7):607-608. [20] World Health Oragnization. WHO issues its first hepatitis C treatment guidelines[R/OL]. http://www. who. int/mediacentre/news/releases/2014/hepatitis-guidelines/en/. [21] ZHANG M,HU QH,ZHAO F,et al. Investigation of HIV coinfection with hepatitis C virus through different infectious routs[J]. Chin J Public Health,2008,24(12):1409-1411.(in Chinese)张旻,胡清海,赵飞,等.不同地区及途径HIV/HCV合并感染状况调查[J].中国公共卫生,2008,24(12):1409-1411. [22] MAST EE,HWANG LY,SETO DS,et al. Risk factors for perinatal transmission of hepatitis C virus(HCV)and the natural history of HCV infection acquired in infancy[J]. J Infect Dis,2005,192(11):1880-1889. [23] BICA I,MCGOVERN B,DHAR R,et al. Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection[J]. Clin Infect Dis,2001,32(3):492-497. [24] SULKOWSKI MS,THOMAS DL. Hepatitis C in the HIV-infected person[J]. Ann Inter Med,2003,138(3):197-207. [25] FALCONER K,GONZALEZ VD,REICHARD O,et al. Spontaneous HCV clearance in HCV/HIV-1 coinfection associated with normalized CD4 counts,low level of chronic immune activation and high level of T cell function[J]. J Clin Virol,2008,41(2):160-163. [26] BONACINI M,GOVINDARAJAN S,BLATT LM,et al. Patients co-infected with human immunodeficiency virus and hepatitis C virus demonstrate higher levels of hepatic HCV RNA[J]. J Viral Hepat,1999,6(3):203-208. [27] GAO YQ,LOU JL. Effect of co-infection of HIV/HCV on HCV clearance and immune function[J]. Chin J Misdiagn,2009,9(15):3594-3595.(in Chinese)高艳青,娄金丽.HIV/HCV共同感染对HCV病毒清除及免疫功能的影响[J].中国误诊学杂志,2009,9(15):3594-3595. [28] BOURCIER V,WINNOCK M,AIT AHMED M,et al. Primary liver cancer is more aggressive in HIV-HCV coinfection than in HCV infection. A prospective study(ANRS CO13 Hepavih and CO12 Cirvir)[J]. Clin Res Hepatol Gastroenterol,2012,36(3):214-221. [29] SHIRE NJ,WELGE JA,SHERMAN KE. Response rates to pegylated interferon and ribavirin in HCV/HIV coinfection:A research synthesis[J]. J Viral Hepat,2007,14(4):239-248. [30] LIU JH,SUN HQ,ZHAO Y,et al. Influence of HIV infection on hepatitis C progress in patients co-infected with HIV/HCV[J].Chin J Epidemiol,2015,36(7):738-742.(in Chinese)刘金花,孙焕芹,赵艳,等.HIV对HIV/HCV共感染患者丙型肝炎病程进展的影响[J].中华流行病学杂志,2015,36(7):738-742. [31] WU ZF,ZHANG WG,YANG X. Influence of concurrent HIV infection on antiviral therapy in patients with chronic hepatitis C[J]. J Clin Hepatol,2015,31(11):1837-1840.(in Chinese)武志峰,张文光,杨萱.合并HIV感染对慢性丙型肝炎患者抗病毒治疗的影响[J].临床肝胆病杂志,2015,31(11):1837-1840. [32] WANG HB,YOU J,LIU N. Impact of HIV/HCV coinfection on HIV RNA and T-lymphocyte subsets[J]. J Pract Med,2013,29(19):3149-3151.(in Chinese)王海斌,游晶,刘娜.HIV/HCV混合感染对HIV RNA及T淋巴细胞亚群的影响[J].实用医学杂志,2013,29(19):3149-3151. [33] ZHAO JH,ZHAO Y,SUN HQ,et al. Effect of HCV on disease progression in patients with HIV/HCV coinfection[J]. J Clin Hepatol,2014,30(6):501-504.(in Chinese)赵金花,赵艳,孙焕芹,等.HCV对HIV/HCV共感染患者病情进展的影响[J].临床肝胆病杂志,2014,30(6):501-504. [34] LASKUS T,KIBLER KV,CHMIELEWSKI M,et al. Effect of hepatitis C infection on HIV-induced apoptosis[J]. PLo S One,2013,8(10):e75921. [35] WANG JQ,GUO CP,LI ZC,et al. Effect of HCV on HIV viral load in patients with HIV/HCV co-infection[J]. Clin Focus,2007,22(3):162-164.(in Chinese)王景泉,郭彩萍,李在村,等.丙型肝炎病毒与人类免疫缺陷病毒共感染对人类免疫缺陷病毒病毒载量影响[J].临床荟萃,2007,22(3):162-164. [36] WILLIAMS CF,KLINZMAN D,YAMASHITA TE,et al. Persistent GB virus C infection and survival in HIV-infected men[J]. N Engl J Med,2004,350(10):981-990.
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