江西地区HIV感染者/AIDS患者合并HBV和HCV感染的疾病特征
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摘要
目的了解人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者合并乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染的流行情况和疾病特征。方法采用化学发光免疫测定法(CLIA)和酶联免疫吸附法(ELISA)检测血清标本中乙肝表面抗原本(HBsAg)、抗HCV和抗HIV指标,应用SPSS 16.0分析数据。结果共计收集1 038例HIV感染者/AIDS患者,其中单纯HIV感染者814例(78.4%),HIV-HBV感染者176例(17.0%),HIV-HCV感染者39例(3.7%),HIV-HBV-HCV感染者9例(0.9%)。天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和传播途径在单纯HIV组、HIV-HBV和HIV-HCV(含HIV-HBV-HCV)3组间的分布差异有统计学意义(P<0.05),其中AST异常率在HIV-HBV(33.9%)、HIV-HCV组(34.0%)均较HIV组(15.0%)高,ALT异常率以合并HBV组(38.3%)较高,指标差异性主要体现在男性人群中。HIV-HCV组以静脉注射与血液传播途径较高(54.2%),异性性传播次之(39.6%);HIV和HIV-HBV组以异性性传播途径较高(67.7%、71.0%),同性性传播次之(30.7%、23.9%)。结论 HIV-HBV/HCV合并感染应引起重视,疫苗被认为是行之有效的控制HBV合并感染的有效措施,然而在现有防控体系下,应进一步强化针对传播途径的控制措施。
[Objective]T o explore the epidemic situation and disease characteristics human immunodeficiency virus(HIV)infections/AIDS patients co-infected with hepatitis B virus(HBV) and hepatitis C virus(HCV).[Methods]The chemiluminescence immunoassay assay(CLI A) and enzyme linked immunosorbent assay(ELISA) were used to detect the indexes of HBs Ag,anti-HCV and anti-HIV,and the data were analyzed by SPSS 16.0.[Results]A total of 1 038 HIV infections/AIDS patients were collected,including 814(78.4%) cases of single HIV infection,176(17%) cases of HIV-HBV co-infection,39(3.7%) HIV-HCV co-infection, and 9( 0. 9 %) case s of HIV-HBV-HCV co-infection. There were statistically significant differences in levels of aspartate aminotransferase(AST) and alanine aminotransferase(ALT) and route of transmission among HIV,HIV-HBV,and HIV-HCV groups(including HIV-HBV-HCV)(P<0.05). The abnormal rate of AST in HIV-HBV group(33.9%) and HIV-HCV group(34%)was higher than that in HIV group(15%). The abnormal rate of ALT in HIV-HBV group was the highest(38.3%). And the difference of the AST and ALT mostly existed in the male population. Most of the HIV-HCV infection cases were transmitted by the vein injection and blood(54.2%),followed by the heterosexual transmission(39.6%). Most of the HIV cases and HIV-HBV cases were transmitted by heterosexual transmission(67.7%,71.0%), followed by the homosexual transmission(30.7%,23.9%).[Conclusion]It should be paid more attention to the coinfection of HIV-HBV/HCV. Under the prevention and control system nowaday,the prevention and control measures related to the transmission route need be strengthened,though the vaccine is recorded as the best useful control measure of HBV co-infection.
[Objective]T o explore the epidemic situation and disease characteristics human immunodeficiency virus(HIV)infections/AIDS patients co-infected with hepatitis B virus(HBV) and hepatitis C virus(HCV).[Methods]The chemiluminescence immunoassay assay(CLI A) and enzyme linked immunosorbent assay(ELISA) were used to detect the indexes of HBs Ag,anti-HCV and anti-HIV,and the data were analyzed by SPSS 16.0.[Results]A total of 1 038 HIV infections/AIDS patients were collected,including 814(78.4%) cases of single HIV infection,176(17%) cases of HIV-HBV co-infection,39(3.7%) HIV-HCV co-infection, and 9( 0. 9 %) case s of HIV-HBV-HCV co-infection. There were statistically significant differences in levels of aspartate aminotransferase(AST) and alanine aminotransferase(ALT) and route of transmission among HIV,HIV-HBV,and HIV-HCV groups(including HIV-HBV-HCV)(P<0.05). The abnormal rate of AST in HIV-HBV group(33.9%) and HIV-HCV group(34%)was higher than that in HIV group(15%). The abnormal rate of ALT in HIV-HBV group was the highest(38.3%). And the difference of the AST and ALT mostly existed in the male population. Most of the HIV-HCV infection cases were transmitted by the vein injection and blood(54.2%),followed by the heterosexual transmission(39.6%). Most of the HIV cases and HIV-HBV cases were transmitted by heterosexual transmission(67.7%,71.0%), followed by the homosexual transmission(30.7%,23.9%).[Conclusion]It should be paid more attention to the coinfection of HIV-HBV/HCV. Under the prevention and control system nowaday,the prevention and control measures related to the transmission route need be strengthened,though the vaccine is recorded as the best useful control measure of HBV co-infection.
引文
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[13]蒋均,查琏琦,阮建军,等.浙江省义乌市2015-2016年新报告艾滋病病毒感染者和艾滋病患者感染来源及特征分析[J].中华流行病学杂志,2018,39(1):21-26.
[14]刘云,袁也丰,徐丹,等.南昌市281例男男性接触人群HIV/AIDS的流行病学特征分析[J].实用临床医学,2016,17(7):93-96.
[15]郭巍,李一,周宁,等.男男性行为人群艾滋病病毒新发感染风险的队列研究[J].中华流行病学杂志,2018,39(1):16-20.
[16]IVAN CB,TIMOTHY F,MARIA AP,et al.High Substance Use and HIV Risk Behavior Among Young Argentine Men Who Have Sex with Men[J].AIDS Behav,2018,22(4):1373-1382.
[17]路亮,徐丹,涂志斌,等.南昌市2010-2014年15~24岁男男性行为者艾滋病哨点监测结果[J].中国艾滋病性病,2016,22(6):444-447.
[18]YONGCHAN K,JINYONG A,JUNEMYUNG K,et al.Human Immunodeficiency Virus(HIV)and Hepatitis Virus Coinfection among HIV-Infected Kor ean Patients:The Korea HIV/AIDS Cohort Study[J].Infect Chemother,2017,49(4):268-274.
[2]SAEED S,STRUMPF E,MOODIE E,et al.Disparities in direct acting antivirals uptake in HIV-hepatitis C co-infected populations in Canada[J].J Int AIDS Soc,2017,20(3):e25013.
[3]SUSAN EB,ELIZABETH AB,JOHN DS,et al.Hepatitis B and C infection and liver disease trends among human immunodeficiency virusinfected individuals[J].World J Gastroenterol,2011,17(14):1807-1816.
[4]XI C,JIANMEI H,LISHA D,et al.Prevalence of hepatitis B virus and hepatitis C virus in patients with human immunodeficiency virus infection in Central China[J].Arch Virol,2013,158(9):1889-94.
[5]JING X,YANG H,ZHIFENG Q,et al.Prevalence of hepatitis B and Cviruses in HIV-positive patients in China:a cross-sectional study[J].J Int AIDS Soc,2016,19(1):20659.
[6]LONITA G,MALVIYA A,RAJBHANDARI R,et al.Seroprevalence of hepatitis B virus and hepatitis C virus co-infection among people living with HIV/AIDS visiting antiretroviral therapy centres in Nepal:a first nationally representative study[J/OL].Int J Infect Dis,2017,60:64-69.[2018-07-12].http://xueshu.baidu.com/s?wd=paperuri%3A%286ee8c108d5857e14a4925ba1fd399cc4%29&filter=sc_long_sign&tn=SE_xueshusource_2kduw22v&sc_vurl=http%3A%2F%2Feuropepmc.org%2Fabstract%2FMED%2F28483724&ie=utf-8&sc_us=3759176441552856161.DOI:10.1016/j.ijid.2017.04.011
[7]王熠,张欣,孙丽梅,等.比较不同感染途径HIV感染者合并HBV、HCV感染的情况[J].中国实验诊断学,2017,21(6):974-977.
[8]DEGENHARDT L,PEACOCK A,COLLEDGE S,et al.Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV,HBV,and HCV in people who inject drugs:a multistage systematic review[J].Lancet Glob Health,2017,5(12):e1192-e1207.
[9]KHATIB A,MATIKO E,KHALID F,et al.HIV and hepatitis B and C coinfection among people who inject drugs in Zanzibar[J].BMC Public Health,2017,17(1):917.
[10]POKORSKA-PIEWAK M,STANSK-PERKA A,POPIELSKA J,et al.Prevalence and predictors of liver disease in HIV-infected children and adolescents[J].Sci Rep,2017,7(1):12309.
[11]BENHAMMOU V,TUBIANA R,MATHERON S,et al.Hbv or Hcv Coinfection in Hiv-1-Infected Pregnant Women in France:Prevalence and Pregnancy Outcomes[J].J Acquir Immune Defic Syndr,2018,77(5):439-450.
[12]CRESPO M,NAVARRO J,MORENO S,et al.Hepatic safety of maraviroc in HIV-1-infected patients with hepatitis C and/or B co-infection.The Maraviroc Cohort Spanish Group[J].Enferm Infecc Microbiol Clin,2017,35(8):493-498.
[13]蒋均,查琏琦,阮建军,等.浙江省义乌市2015-2016年新报告艾滋病病毒感染者和艾滋病患者感染来源及特征分析[J].中华流行病学杂志,2018,39(1):21-26.
[14]刘云,袁也丰,徐丹,等.南昌市281例男男性接触人群HIV/AIDS的流行病学特征分析[J].实用临床医学,2016,17(7):93-96.
[15]郭巍,李一,周宁,等.男男性行为人群艾滋病病毒新发感染风险的队列研究[J].中华流行病学杂志,2018,39(1):16-20.
[16]IVAN CB,TIMOTHY F,MARIA AP,et al.High Substance Use and HIV Risk Behavior Among Young Argentine Men Who Have Sex with Men[J].AIDS Behav,2018,22(4):1373-1382.
[17]路亮,徐丹,涂志斌,等.南昌市2010-2014年15~24岁男男性行为者艾滋病哨点监测结果[J].中国艾滋病性病,2016,22(6):444-447.
[18]YONGCHAN K,JINYONG A,JUNEMYUNG K,et al.Human Immunodeficiency Virus(HIV)and Hepatitis Virus Coinfection among HIV-Infected Kor ean Patients:The Korea HIV/AIDS Cohort Study[J].Infect Chemother,2017,49(4):268-274.