天津市2014-2016年新诊断艾滋病病毒合并丙型肝炎病毒感染者丙型肝炎病毒基因型分布特点
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摘要
目的了解天津市2014-2016年新诊断艾滋病病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)感染者HCV基因型分布特征。方法收集2014-2016年天津市新诊断HIV合并HCV感染者(63例)的性别、年龄、传播途径,并进行HCV基因型检测。同时随机入组天津市第二人民医院同期确诊的65例单纯HCV感染患者,并行HCV基因型检测,统计2组患者HCV基因型分布的差异。结果 2014-2016年,新诊断HIV感染者2 189例,HIV合并HCV感染患者占2.88%(63/2 189),其中HCV RNA阳性率为68.25%(43/63),HCV基因型以3型居多(48.84%,21/43),传播途径以静脉吸毒为主(93.65%,59/63)。单纯HCV感染者1b型最常见(69.23%,45/65),其次为2a型(21.54%,14/65),传播途径主要为输血(90.77%,59/65)。结论天津市新诊断HIV感染者以青年男男性行为人群为主,HIV合并HCV感染者与HCV单纯感染者的HCV基因型分布有明显差异,提示在HIV和HCV抗病毒治疗中需考虑这些情况。
Objective To understand the distribution of HCV genotypes in HIV/HCV co-infected patients in Tianjin of China from 2014 to 2016. Methods Information such as sex, age, and route of transmission of new-onset HIV/HCV patients from 2014 to 2016 was collected.HCV mono-infected patients in the Second People′s Hospital of Tianjin city during the same period were enrolled randomly.The HCV genotypes were measured in the two groups of patients, and differences in the genotype distributions were analyzed. Results From 2014 to 2016, there were 2 189 new cases of HIV in Tianjin of China.A total of 63 HIV/HCV co-infected cases were identified, and 65 HCV mono-infected patients were enrolled randomly.The HIV/HCV co-infection rate in Tianjin was 2.88%, and the HCV RNA positive rate was 68.25%(43/63).The dominant HCV genotype was type 3(48.84%,21/43), and the main route of transmission was intravenous drug use(93.65%,59/63) in HIV/HCV co-infections.In HCV mono-infection, the dominant HCV genotype was 1 b(69.23%,45/65), followed by type 2 a(21.54%,14/65), and the main route of transmission was blood transfusion(90.77%,59/65). Conclusions New HIV infections in Tianjin are dominated by young men who have sex with men.The main HCV genotype of HIV/HCV co-infections is type 3, followed by type 1 b, and was different from those of HCV mono-infection.
Objective To understand the distribution of HCV genotypes in HIV/HCV co-infected patients in Tianjin of China from 2014 to 2016. Methods Information such as sex, age, and route of transmission of new-onset HIV/HCV patients from 2014 to 2016 was collected.HCV mono-infected patients in the Second People′s Hospital of Tianjin city during the same period were enrolled randomly.The HCV genotypes were measured in the two groups of patients, and differences in the genotype distributions were analyzed. Results From 2014 to 2016, there were 2 189 new cases of HIV in Tianjin of China.A total of 63 HIV/HCV co-infected cases were identified, and 65 HCV mono-infected patients were enrolled randomly.The HIV/HCV co-infection rate in Tianjin was 2.88%, and the HCV RNA positive rate was 68.25%(43/63).The dominant HCV genotype was type 3(48.84%,21/43), and the main route of transmission was intravenous drug use(93.65%,59/63) in HIV/HCV co-infections.In HCV mono-infection, the dominant HCV genotype was 1 b(69.23%,45/65), followed by type 2 a(21.54%,14/65), and the main route of transmission was blood transfusion(90.77%,59/65). Conclusions New HIV infections in Tianjin are dominated by young men who have sex with men.The main HCV genotype of HIV/HCV co-infections is type 3, followed by type 1 b, and was different from those of HCV mono-infection.
引文
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[13] Bian DD,Zheng SJ.Influencing factors for the therapeutic effect of direct-acting antiviral agents in hepatitis C[J].Linchuang Gandanbing Zazhi,2017,33 (11):2205-2208.(in Chinese)卞丹丹,郑素军.直接抗病毒药物对丙型肝炎治疗效果的影响因素[J].临床肝胆病杂志,2017,33 (11):2205-2208.
[14] Andreone P,Colombo MG,Enejosa JV,et al.ABT-450,ritonavir,ombitasvir,and dasabuvir achieves 97% and 100% sustained virologic response with or without ribavirin in treatment-experienced patients with HCV genotype 1b infection[J].Gastroenterology,2014,147(2):359-365.
[15] Feld JJ,Kowdley KV,Coakley E,et al.Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin[J].N Engl J Med,2014,370(17):1594-1603.
[16] Lawitz E,Mangia A,Wyles D,et al.Sofosbuvir for previously untreated chronic hepatitis C infection[J].N Engl J Med,2013,369(7):678-679.
[17] Hull MW,Yoshida EM,Montaner JS.Update on current evidence for hepatitis C therapeutic options in HCV mono-infected patients[J].Curr Infect Dis Rep,2016,18(7):22.
[2] Shepard CW,Finelli L,Alter MJ.Global epidemiology of hepatitis C virus infection[J].Lancet Infect Dis,2005,5(9):558-567.
[3] Thomas DL,Astemborski J,Rai RM,et al.The natural history of hepatitis C virus infection:host,viral,and environmental factors[J].JAMA,2000,284(4):450-456.
[4] Tan YJ,Lim SG,Hong W.Understanding human immunodeficiency virus type 1 and hepatitis C virus coinfection[J].Curr HIV Res,2006,4(1):21-30.
[5] Maida I,Babudieri S,Selva C,et al.Liver enzyme elevation in hepatitis C virus (HCV)-HIV-coinfected patients prior to and after initiating HAART:role of HCV genotypes[J].AIDS Res Hum Retroviruses,2006,22(2):139-143.
[6] Brant LJ,Ramsay ME,Tweed E,et al.Planning for the healthcare burden of hepatitis C infection:hepatitis C genotypes identified in England,2002-2007[J].J Clin Virol,2010,48(2):115-119.
[7] Zhou K,Hu F,Wang C,et al.Genotypic distribution and hepatic fibrosis among HIV/HCV co-infected individuals in Southern China:a retrospective cross-sectional study[J].BMC Infect Dis,2015,15:401.
[8] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for hepatitis C:a 2015 update[J].Zhongguo Bingdubing Zazhi,2015,5(6):425-447.(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].中国病毒病杂志,2015,5(6):425-447.
[9] Tian D,Li L,Liu Y,et al.Different HCV genotype distributions of HIV-infected individuals in Henan and Guangxi,China[J].Plos One,2012,7(11):e50343.
[10] Zhao R,Peng J,Tang L,et al.Epidemiological distribution and genotype characterization of hepatitis C virus and HIV co-infection in Wuhan,China,where the prevalence of HIV is low[J].J Med Virol,2013,85(10):1712-1723.
[11] Chan DP,Lee SS,Lee KC.The effects of widespread methadone treatment on the molecular epidemiology of hepatitis C virus infection among injection drug users in Hong Kong[J].J Med Virol,2011,83(7):1187-1194.
[12] Mp M,Jg M,Sc G.Peginterferon alfa-2b plus ribavirin compared with interferon alfa-ab plus ribavirin for initial treatment of chronic hepatitis C:a randomised trial[J].Lancet,2001,358(9286):958-965.
[13] Bian DD,Zheng SJ.Influencing factors for the therapeutic effect of direct-acting antiviral agents in hepatitis C[J].Linchuang Gandanbing Zazhi,2017,33 (11):2205-2208.(in Chinese)卞丹丹,郑素军.直接抗病毒药物对丙型肝炎治疗效果的影响因素[J].临床肝胆病杂志,2017,33 (11):2205-2208.
[14] Andreone P,Colombo MG,Enejosa JV,et al.ABT-450,ritonavir,ombitasvir,and dasabuvir achieves 97% and 100% sustained virologic response with or without ribavirin in treatment-experienced patients with HCV genotype 1b infection[J].Gastroenterology,2014,147(2):359-365.
[15] Feld JJ,Kowdley KV,Coakley E,et al.Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin[J].N Engl J Med,2014,370(17):1594-1603.
[16] Lawitz E,Mangia A,Wyles D,et al.Sofosbuvir for previously untreated chronic hepatitis C infection[J].N Engl J Med,2013,369(7):678-679.
[17] Hull MW,Yoshida EM,Montaner JS.Update on current evidence for hepatitis C therapeutic options in HCV mono-infected patients[J].Curr Infect Dis Rep,2016,18(7):22.