HCV genotype and clinical features of patients with HIV/HCV coinfection in Guizhou,China: An analysis of 383 cases

Objective To investigate the distribution of HCV genotypes in 383 patients with HIV/HCV coinfection in Guizhou,China and the effect of coinfection on HIV viral load,CD4+T lymphocytes,and platelet count( PLT),and to provide a basis for individualized treatment of patients with HIV/HCV coinfection. Methods Related clinical data were collected from 383 patients with HIV/HCV coinfection who were treated in Guiyang Public Health Clinical Center from March 2015 to December 2019,and HCV genotype,HIV viral load,CD4+T lymphocytes,and PLT were determined. A total of 1068 patients with HIV alone were enrolled as control. The Kruskal-Wallis H test was used for comparison between multiple groups,the Wilcoxon rank-sum test was used for comparison between two groups,and the Bonferroni method was used for further comparison between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results Among the 4664 patients with HIV infection,383( 8. 21%) had HCV coinfection,and the main HCV genotypes were genotype 6 a( 35. 51%), genotype 3 b( 27. 42%), and genotype 1 b( 21. 41%), followed by genotypes3 a( 13. 32%),1 a( 1. 31%),2 a( 0. 52%),6 n( 0. 26%),and 6 xa( 0. 26%). The most common route of infection was intravenous drug addiction( 72. 59%),followed by sexual contact( 24. 80%). Compared with the patients with HIV infection alone,the patients with HIV/HCV coinfection had a significantly higher HIV RNA load and significantly lower CD4+T lymphocytes and PLT( Z = 6. 716,11. 813,and9. 192,all P < 0. 05). Among the patients with coinfection,the patients with HCV genotype 3 b had the highest HIV RNA load and the lowest CD4+T lymphocytes and PLT,while the patients with HCV genotype 1 a had the lowest HIV RNA load and the highest CD4+T lymphocytes( all P < 0. 05). Among the patients with different clinical stages,the patients with compensated cirrhosis had the highest HIV RNA load,the patients with chronic hepatitis C had the lowest HIV RNA load,the patients with end-stage liver disease had the lowest count of CD4+T lymphocytes,and the patients with chronic hepatitis C had the highest PLT( all P < 0. 05). Conclusion The distribution of HCV genotypes is diverse in the patients with HIV/HCV coinfection in Guizhou,and HCV strains with genotypes 6 a,3 b,and 1 b are the main epidemic strains. Intravenous drug addiction is the main route of infection. Coinfection may affect HIV replication and immune status,with a significantly marked effect on HCV genotype 3 b and liver cirrhosis or end-stage liver disease.