浙江省台州市新报告成年HIV感染者中HCV合并感染研究

周琳; 吴琼海; 沈伟伟; 高眉扬; 丁盈盈; 林海江; 何纳

Abstract

周琳,吴琼海,沈伟伟,高眉扬,丁盈盈,林海江,何纳.浙江省台州市新报告成年HIV感染者中HCV合并感染研究[J].Chinese journal of Epidemiology,2015,36(8):862-866

浙江省台州市新报告成年HIV感染者中HCV合并感染研究

Co-infection of hepatitis C virus among newly diagnosed HIV-infected adults in Taizhou prefecture of Zhejiang province, China

Received:January 27, 2015

DOI：10.3760/cma.j.issn.0254-6450.2015.08.020

KeyWord: 艾滋病病毒丙型肝炎病毒合并感染病毒载量

English Key Word: HIV Hepatitis C virus Coinfection Viral load

FundProject:国家自然科学基金(81373062)

Author Name	Affiliation	E-mail
Zhou Lin	Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
Wu Qionghai	Taizhou Prefecture Center for Disease Control and Prevention, Zhejiang Province
Shen Weiwei	Taizhou Prefecture Center for Disease Control and Prevention, Zhejiang Province
Gao Meiyang	Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
Ding Yingying	Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
Lin Haijiang	Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China Taizhou Prefecture Center for Disease Control and Prevention, Zhejiang Province	linhaijiang@hotmail.com
He Na	Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China	nhe@shmu.edu.cn

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Abstract:

目的了解浙江省台州市2009-2012年新报告成年HIV感染者中合并感染HCV的情况, 分析HIV/HCV合并感染者中血浆HCV病毒载量水平。方法对2009-2012年浙江省台州市新报告的572例成年HIV感染者检测HCV抗体, 并对HCV抗体阳性的标本进行HCV RNA定量检测。结果共有42例HCV抗体检测阳性, HIV感染者中HCV合并感染率为7.3%(95%CI: 5.2%~9.5%)。46~86岁HIV感染者的HCV合并感染率显著低于18~45岁年龄组(OR=0.12, 95%CI: 0.02~0.58);高中及以上文化程度的HIV感染者HCV合并感染率显著低于小学及以下文化程度者(OR=0.13, 95%CI: 0.02~0.78);经血传播HIV感染者HCV合并感染率显著高于异性传播HIV感染者(OR=49.46, 95%CI: 13.71~178.48);同性传播HIV感染者HCV合并感染率则低于异性传播HIV感染者(OR=0.11, 95%CI: 0.01~0.86)。42例HIV/HCV合并感染者中33例(78.6%)血浆HCV病毒载量在检测限以上, HCV复制相对活跃, 其中HBsAg阳性者血浆HCV RNA检出率(100%)显著高于HBsAg阴性者(75.7%)(P=0.002)。9例(21.4%)血浆HCV病毒载量则低于检测下限(5.0×10² IU/ml), 处于相对抑制状态。单因素logistic回归分析未发现HIV/HCV合并感染者HCV相对抑制率与其社会人口学特征、HIV传播途径、CD₄⁺T淋巴细胞计数等有关联。结论浙江省台州市HIV感染者中HCV感染率较高, 多数HIV/HCV合并感染者血浆HCV病毒载量也较高, 其对病情进展影响有待持续观察。

English Abstract:

Objective To examine the prevalence and correlates of hepatitis C virus (HCV) co-infection as well as plasma HCV viral load among newly diagnosed HIV-infected adults during 2009-2012 in Taizhou prefecture of Zhejiang province, China. Methods Five hundred and seventy-two adults who were newly diagnosed as HIV-infection were screened for anti-HCV immunoglobulin G (IgG). Plasma HCV RNA was quantified if positive for HCV IgG. Results Forty-two (7.3%) out of the 572 HIV-infected adults were tested positive for HCV IgG. HCV infection was more likely to occur among participants who were infected with HIV through blood transmission (OR=49.46, 95%CI: 13.71-178.48). Otherwise, HCV infection was less likely to occur among participants who were under 46-86 years of age (OR=0.12, 95%CI: 0.02-0.58), those with mode of homosexual transmission of HIV (OR=0.11, 95%CI: 0.01-0.86), with education of high school or above (OR=0.13, 95%CI: 0.02-0.78). Thirty-three (78.6%) of the total 42 HIV-HCV patients with coinfection had detectable plasma HCV RNA, whereas 9(21.4%) had undetectable plasma HCV RNA (i.e., lower than 5.0×10² IU/ml) or known as relative HCV viral suppression. No significant associations were noticed on factors as: HCV viral suppression and demographics, HIV transmission route and CD₄⁺ T-cell counts according to univariate regression analyses. Conclusion Prevalence of HCV co-infection was relatively high among newly diagnosed HIV-infected adults in this study area. Majority of the HIV-HCV coinfected patients had detectable plasma HCV RNA, of which the long term impact on disease progression deserves called for further research.

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