广西两市2014—2015年新入组抗艾滋病病毒治疗者合并HBV、HCV感染的流行病学研究
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摘要
目的了解桂林、河池两市2014—2015年新入组抗艾滋病病毒治疗者合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)的流行病学特征,为有效开展艾滋病抗病毒治疗提供科学依据。方法采用描述性流行病学方法,分析广西桂林、河池市2014—2015年新入组艾滋病抗病毒治疗的艾滋病患者病例资料。病例个案资料来源于"艾滋病综合防治信息系统"的治疗信息数据库。结果广西桂林、河池两市2014—2015年新收治2 543例患者进行艾滋病抗病毒治疗。新入组治疗的艾滋病患者合并HBV、HCV的感染率分别为14.14%和2.96%,HIV+HBV+HCV三重感染率为0.53%。壮族、初中文化程度者HIV+HBV双重感染率较高,初中文化程度者HIV+HBV+HCV三重感染率也较高。HIV+HBV双重感染率为男性高于女性;10~40岁年龄组高于40岁以上年龄组;HIV传播途径为输血及血制品者高于其它传播途径者。HIV+HCV、HIV+HBV+HCV感染率也以10~40岁年龄组高于40岁以上年龄组。合并HBV、HCV、HBV+HCV感染的患者,其ALT水平显著高于单纯HIV感染者,差异有统计学意义(χ2=45.795,P=0.000)。结论桂林、河池两市艾滋病患者合并HBV、HCV感染较为常见,合并感染HBV和(或)HCV的艾滋病患者肝功能受损较重,提示抗HIV治疗时应加强监测,以减少肝脏损害。
Objectives To understand the epidemiology of co-infection with HBV and/or HCV among individuals who were recruited for anti-HIV therapy in Guilin and Hechi City between 2014 and 2015 and provide scientific basis for effective anti-HIV therapy. Methods Data of HIV positive individuals who were newly recruited for anti-HIV therapy in Guilin and Hechi City between 2014 and 2015 were analyzed using descriptive epidemiological methods. Results The total number of 2 543 individuals was newly recruited for anti-HIV therapy between 2014 and 2015 in the two cities. The prevalence of HIV+HBV, HIV+HCV co-infection and HIV+HBV+HCV triple infection was 14.14%, 2.96% and 0.53%, respectively. The rate of co-infection or triple infection was higher in Zhuang minority or those with education of junior high school. The prevalence of HIV + HBV coinfection in male was higher than in female. The prevalence of HIV+HBV co-infection and HIV+HBV+HCV triple infection were all higher in the age group of10-40 than in those with 40 years old. The prevalence of HIV+HBV, HIV+HCV co-infection and HIV+HBV+HCV triple infection was higher in those with HIV infection route of transfusion and blood products than in those with other infection route. The abnormal rate of alanine aminotransferase(ALT) in the patients co-infection with HBV and/or HCV was higher than that of HIV mono-infection group(χ2= 45.795, P = 0.000). Conclusions HIV co-infection with HBV and/or HCV is common in Guilin and Hechi City. Co-infection with HBV and/or HCV is associated with severely liver damage, suggesting that enhanced monitoring should be taken during anti-HIV therapy for reducing the damage of the liver.
Objectives To understand the epidemiology of co-infection with HBV and/or HCV among individuals who were recruited for anti-HIV therapy in Guilin and Hechi City between 2014 and 2015 and provide scientific basis for effective anti-HIV therapy. Methods Data of HIV positive individuals who were newly recruited for anti-HIV therapy in Guilin and Hechi City between 2014 and 2015 were analyzed using descriptive epidemiological methods. Results The total number of 2 543 individuals was newly recruited for anti-HIV therapy between 2014 and 2015 in the two cities. The prevalence of HIV+HBV, HIV+HCV co-infection and HIV+HBV+HCV triple infection was 14.14%, 2.96% and 0.53%, respectively. The rate of co-infection or triple infection was higher in Zhuang minority or those with education of junior high school. The prevalence of HIV + HBV coinfection in male was higher than in female. The prevalence of HIV+HBV co-infection and HIV+HBV+HCV triple infection were all higher in the age group of10-40 than in those with 40 years old. The prevalence of HIV+HBV, HIV+HCV co-infection and HIV+HBV+HCV triple infection was higher in those with HIV infection route of transfusion and blood products than in those with other infection route. The abnormal rate of alanine aminotransferase(ALT) in the patients co-infection with HBV and/or HCV was higher than that of HIV mono-infection group(χ2= 45.795, P = 0.000). Conclusions HIV co-infection with HBV and/or HCV is common in Guilin and Hechi City. Co-infection with HBV and/or HCV is associated with severely liver damage, suggesting that enhanced monitoring should be taken during anti-HIV therapy for reducing the damage of the liver.
引文
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[10]刘俊,黄瑛,金永梅,等.昆明地区2013年艾滋病抗病毒治疗患者流行病学特点分析[J].皮肤病与性病,2014,36(6):347-348.
[11]陈栋,陈俐丽,钭慧芬,等.温州地区艾滋病感染者和病人合并感染乙肝、丙肝、梅毒等疾病的研究[J].中国卫生检验杂志,2012,22(3):587-590.
[12]李建维,张小凤,李爱萍,等.佑安医院HIV/AIDS中HBV、HCV及TP感染情况分析[J].中国艾滋病性病,2016,22(8):608-610.
[13]徐玲,戴国瑞,种雪静,等.HIV/AIDS病人HBV/HCV梅毒感染率的调查分析[J].中国艾滋病性病,2017,23(2):138-141
[14]MUGOMERIE,SENAUOANE MB,RUHANYA V,et al.Occurrence of HBV/HIV coinfection by laboratory values in Roma,Lesotho[J].Germs,2015,5(1):8-11.
[15]张茹薏,游晶,杨微波,等.HIV/AIDS合并HBV/HCV感染病毒载量水平及与T淋巴细胞相关性的探讨[J].重庆医学,2016,45(7):912-914.
[16]孙洪清,肖宏,杨菲,等.HCV RNA水平对HCV/HIV合并感染自然进程的影响[J].医学研究杂志,2014,43(4):91-95.
[17]温小凤,蒋忠胜,柯柳.HIV感染者/AIDS合并乙型病毒性肝炎的研究现状[J].医学综述,2013,19(23):4294-4296.
[2]SULKOW SKI M S,MAST E E,SEEFF L B,et al.Hepatitis C virus infection as an opportunistic disease in persons infected with human immunodeficiency virus[J].Clin Infect Dis,2000,30(1):S77-84.
[3]BENFIELD T.Hepatitis C in the Euro AIDS cohort of European HIV-infected patients.Prevalence and Prognosis Value.Abstract 22261[C].12th World AIDS Conference,Geneva,1998.
[4]王中秋,杨敏,陈子君.艾滋病感染者/患者合并感染乙肝病毒、丙肝病毒、梅毒的检测与分析[J].实用预防医学,2012,19(10):1560-1561.
[5]SALMON C D,LEWDEN C,MORLAT P,et al.Liver disease as a major cause of death among HIV infected patients:role of hepatitis C and B viruses and alcohol[J].J Hepatol,2005,42(6):799-805.
[6]王学燕,葛宪民,唐振柱,等.广西壮族自治区2008—2013年艾滋病流行趋势分析[J].应用预防医学,2015,21(4):217-222.
[7]葛宪民,唐振柱,朱秋映,等.广西2010—2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[8]JANSEN K,THAMM M,BOCK CT,et al.High prevalence and high incidence of coinfection with hepatitis B,hepatitis C,and syphilis and low rate of effective vaccination against hepatitis B in HIV positive men who have sex with men with known date of HIV seroconversion in Germany[J].PLo S One,2015,10(11):eo142515
[9]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.
[10]刘俊,黄瑛,金永梅,等.昆明地区2013年艾滋病抗病毒治疗患者流行病学特点分析[J].皮肤病与性病,2014,36(6):347-348.
[11]陈栋,陈俐丽,钭慧芬,等.温州地区艾滋病感染者和病人合并感染乙肝、丙肝、梅毒等疾病的研究[J].中国卫生检验杂志,2012,22(3):587-590.
[12]李建维,张小凤,李爱萍,等.佑安医院HIV/AIDS中HBV、HCV及TP感染情况分析[J].中国艾滋病性病,2016,22(8):608-610.
[13]徐玲,戴国瑞,种雪静,等.HIV/AIDS病人HBV/HCV梅毒感染率的调查分析[J].中国艾滋病性病,2017,23(2):138-141
[14]MUGOMERIE,SENAUOANE MB,RUHANYA V,et al.Occurrence of HBV/HIV coinfection by laboratory values in Roma,Lesotho[J].Germs,2015,5(1):8-11.
[15]张茹薏,游晶,杨微波,等.HIV/AIDS合并HBV/HCV感染病毒载量水平及与T淋巴细胞相关性的探讨[J].重庆医学,2016,45(7):912-914.
[16]孙洪清,肖宏,杨菲,等.HCV RNA水平对HCV/HIV合并感染自然进程的影响[J].医学研究杂志,2014,43(4):91-95.
[17]温小凤,蒋忠胜,柯柳.HIV感染者/AIDS合并乙型病毒性肝炎的研究现状[J].医学综述,2013,19(23):4294-4296.