某三甲医院HIV/AIDS患者合并HBV感染情况分析
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摘要
目的通过回顾性研究,了解四川省人民医院艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者的乙型肝炎病毒(HBV)感染的阳性率,为防治HIV/AIDS和HBV共感染提供理论依据。方法回顾分析四川省人民医院2013年1月至2017年12月间HIV/AIDS患者的人口学、流行病学资料,并采用描述性统计方法分析HIV/AIDS患者HBV感染率。结果 500例HIV/AIDS患者完成乙肝表面抗原检测,占40.4%(500/1238);80.8%(404/500)为男性;以40-65岁的性活跃期中年为主;文化程度主要集中于初中以下,占65.4%(327/500);91.4%(457/500)通过性途径感染。合并HBV感染54例,合并感染率10.8%,HIV/AIDS和HIV/AIDS/HBV人群中,在传播途径、性别、年龄、文化程度、民族间无统计学差异(P>0.05)。结论 HIV/AIDS合并HBV感染率较一般人群高,但临床中对HIV/AIDS患者进行表面抗原检测率仅40.4%,因此应该加强医务人员对HIV/AIDS合并HBV感染的监测,及早进行治疗,以减少HIV/AIDS患者由于肝脏疾病进展而引起死亡。
Objective To make a retrospective study on the positive rate of hepatitis B virus(HBV)co-infection in cases with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)so as to provide basis for preventing and controlling the co-infection of HIV/AIDS/HBV.Methods A retrospective analysis was made to the demographic and epidemiological data of the cases with HIV/AIDS during the period from Jan.,2013 to Dec.,2017 in Sichuan Provincial People's Hospital and the the HBV infection rate of the cases was analyzed by descriptive statistics.Results 500 cases with HIV/AIDS received hepatitis B surface antigen detection,taking up 40.4%(500/1238);80.8%(404/500)were males;cases at the middle age from 40 to 65 years old were sex active;most cases were of cultural level under junior middle school,accounting for 65.4%(327/500);sexually transmitted infection occurred in 457 cases(91.4%);54 cases were complicated with infection of HBV,the co-infection rate was 10.8%;there existed no statistical differences in transmission route,gender,age,cultural level and nationality between the cases with HIV/AIDS and those with HIV/AIDS/HBV(P>0.05).Conclusions The rate of HBV co-infection in cases with HIV/AIDS is higher while the rate of hepatitis B surface antigen detection in cases with HIV/AIDS is only 40.4%in clinic;medical staff should strengthen the survey of HBV co-infection in cases with HIV/AIDS,and early treatment may decrease the mortality in cases with HIV/AIDS due to the progression of liver diseases.
Objective To make a retrospective study on the positive rate of hepatitis B virus(HBV)co-infection in cases with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)so as to provide basis for preventing and controlling the co-infection of HIV/AIDS/HBV.Methods A retrospective analysis was made to the demographic and epidemiological data of the cases with HIV/AIDS during the period from Jan.,2013 to Dec.,2017 in Sichuan Provincial People's Hospital and the the HBV infection rate of the cases was analyzed by descriptive statistics.Results 500 cases with HIV/AIDS received hepatitis B surface antigen detection,taking up 40.4%(500/1238);80.8%(404/500)were males;cases at the middle age from 40 to 65 years old were sex active;most cases were of cultural level under junior middle school,accounting for 65.4%(327/500);sexually transmitted infection occurred in 457 cases(91.4%);54 cases were complicated with infection of HBV,the co-infection rate was 10.8%;there existed no statistical differences in transmission route,gender,age,cultural level and nationality between the cases with HIV/AIDS and those with HIV/AIDS/HBV(P>0.05).Conclusions The rate of HBV co-infection in cases with HIV/AIDS is higher while the rate of hepatitis B surface antigen detection in cases with HIV/AIDS is only 40.4%in clinic;medical staff should strengthen the survey of HBV co-infection in cases with HIV/AIDS,and early treatment may decrease the mortality in cases with HIV/AIDS due to the progression of liver diseases.
引文
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[12]李建维,张小凤,李爱萍,等.佑安医院HIV/AIDS病人中HBV HCV及TP感染情况分析[J].中国艾滋病性病,2016(8):608-610.
[13]JOHAN V G,LAY P,KIMCHENG C,et al.Hepatitis Band C Co-Infection among HIV-Infected Adults while on Antiretroviral Treatment:Long-Term Survival,CD4 Cell Count Recovery and Antiretroviral Toxicity in Cambodia[J].Plos One,2014,9(2):e88552.
[14]MALLET V,VALLETPICHARD A,POL S.The impact of human immunodeficiency virus on viral hepatitis.[J].Liver International,2011,31(s1):135-139.
[2]MUGOMERI E,SENAUOANE M B,RUHANYA V,et al.Occurrence of HBV/HIV coinfection by laboratory values in Roma,Lesotho[J].Germs,2015,5(1):8-11.
[3]KOURTIS A P,BULTERYS M,HU D J,et al.HIV-HBVcoinfection--aglobal challenge[J].New England Journal of Medicine,2012,366(19):1749-1752.
[4]OCAMA P,SEREMBA E.Management of HIV and hepatitis C virus infections in resource-limited settings.[J].Current Opinion in Hiv&Aids,2011,6(6):539-545.
[5]EASTERBROOK P,SANDS A,HARMANCI H.Challenges and priorities in the management of HIV/HBV and HIV/HCV coinfection in resource-limited settings[J].Seminars in Liver Disease,2012,32(02):147-157.
[6]尹婷,吴忠兰,赵立华,等.宁夏HIV/AIDS及合并HBV感染状况分析[J].宁夏医科大学学报,2016,38(4):408-411.
[7]陈昭云,张翰明,孙燕,等.HIV/AIDS病人合并HBV和HCV感染状况分析[J].中国艾滋病性病,2016(9):699-702.
[8]SPRADLING P R,RICHARDSON J T,BUCHACZ K,et al.Prevalence of chronic hepatitis B virus infection among patients in the HIV Outpatient Study,1996-2007[J].Journal of Viral Hepatitis,2010,17(12):879-886.
[9]李在村,高艳青,代丽丽,等.艾滋病患者抗逆转录病毒治疗的肝毒性特点分析[J].中国病原生物学杂志,2009(6):405-407.
[10]PAN C Q,DUAN Z,DAI E,et al.Tenofovir to Prevent Hepatitis B Transmission in Mothers with High Viral Load.[J].New England Journal of Medicine,2016,374(24):2324.
[11]BOULOUGOURA A,SERETI I.HIV infection and immune activation:the role of coinfections[J].Current Opinion in Hiv&Aids,2015,11(2):191.
[12]李建维,张小凤,李爱萍,等.佑安医院HIV/AIDS病人中HBV HCV及TP感染情况分析[J].中国艾滋病性病,2016(8):608-610.
[13]JOHAN V G,LAY P,KIMCHENG C,et al.Hepatitis Band C Co-Infection among HIV-Infected Adults while on Antiretroviral Treatment:Long-Term Survival,CD4 Cell Count Recovery and Antiretroviral Toxicity in Cambodia[J].Plos One,2014,9(2):e88552.
[14]MALLET V,VALLETPICHARD A,POL S.The impact of human immunodeficiency virus on viral hepatitis.[J].Liver International,2011,31(s1):135-139.