湖南省HIV患者合并感染HBV及HCV现状调查及风险因素分析

Infection status and risk factors of HBV and HCV among HIV-infected people in Hunan,China

目的对湖南省人类免疫缺陷病毒（HIV）感染者合并乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）感染的情况进行流行病学调查,统计和分析合并感染发生率及各种影响因素。方法收集湖南省疾病预防控制中心和衡阳市疾病预防控制中心2006-2008年确诊的HIV阳性患者血样974份,采用酶联免疫吸附法（ELISA）检测乙肝五项（HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc）和HCV抗体;用SPSS软件对不同情况下HIV患者合并感染HBV或HCV的发生率进行统计学分析。结果 974例HIV感染者中,男性756例,女性218例,年龄1.5~85.0岁,平均（37.5±10.0）岁;HBsAg阳性患者185例（18.99%）,HBeAg阳性患者34例（3.49%）,抗-HBc阳性者673例（69.10%）;抗-HCV阳性者597例（61.29%）。HIV、HBV和HCV三重感染者115例,约占11.81%。χ2分析显示,男性及青壮年（26~45岁）的HIV/HCV合并感染率以及HIV/HBV/HCV三重感染率显著高于女性和其他年龄组（P〈0.01）;静脉吸毒史是HIV/HCV感染和三重感染的危险因素,未发现同性或异性性行为与合并感染有直接关联。结论对湖南省HIV合并HBV、HCV感染的流行现状及相关风险因子进行的大规模调查显示：HIV/HCV合并感染率高于HIV/HBV合并感染率,且易发于26~45岁年龄组男性中,静脉吸毒是HIV合并HCV感染以及三重感染的主要传播途径。应采取积极措施对HIV、HCV和HBV感染者进行治疗、健康教育和行为干预。

Objective The study is to assess the prevalence of HBV,HCV and related risk factors among HIV-infected people in Hunan,China.Methods Blood specimens were collected from HIV infected patients by Hunan provincial CDC and Hengyang municipal CDC between year 2006 and 2008.HBV and HCV antibodies were tested with ELISA.The co-infection of HBV or/and HCV with HIV was analyzed statistically with SPSS software.Results A total of 974 subjects were recruited,including 756 men and 218 women.The mean age was 37.5±10.0 years old（range 1.5-85.0）.The prevalence rates of positive HIV/HBsAg,HIV/HBeAg,HIV/anti-HBc,HIV/HCV and HIV-HBV-HCV were 18.99%,21.97%,69.10%,61.29% and 11.81%,respectively.The co-infection of HIV-HCV was significantly higher in male than in females（P0.01）.Intravenous drug use but not sex was the risk factor of HIV/HCV co-infection.Conclusions Drug use is associated with HIV/HCV co-infection in Hunan.Risk reduction programs,including health education and the treatment for drug addition are urgently required for young population,especially for males aged 25-45.