广西壮族自治区性病门诊就诊的人类免疫缺陷病毒I型感染者丙型肝炎病毒感染的调查

Hepatitis C virus infection among sexually transmitted disease clinic attendees infected with human immunodeficiency virus type 1： a survey in Guangxi Zhuang Autonomous Region

目的了解广西壮族自治区性病门诊就诊的人类免疫缺陷病毒I型（HIV-1）感染者中丙型肝炎病毒（HCV）感染情况。方法对11553份性病门诊就诊者血浆标本进行HIV抗体筛查、确证，并采用病例对照研究方法，按年龄、婚姻状况和1：2的比例，140份HIV-1抗体确证阳性标本配对282份HIV-1抗体阴性标本。422份标本采用酶联免疫吸附试验（EusA）进行HCV抗体检测。利用卡方检验对HIV-1抗体阳性者及HIV-1抗体阴性者HCV抗体阳性率进行比较，采用Logistic回归对HCV和HIV合并感染进行危险性分析。结果HIV-1抗体阳性标本HCV抗体阳性率为33．57％（47，140），HIV-1抗体阴性标本为1．06％（3，282），后者显著低于前者（r=94．66，P〈0．05）。危险因素分析显示，多个性伴合并感染HCV和HIV的概率高于单个性伴[OR=2．4，95％CI（1．0～5．6），P=0．05]，静脉吸毒者合并感染HCV和HIV的概率高于非静脉吸毒者[OR=20．8，95％CI（5．7～76．5），P〈0．05]。结论HCV感染与HIV感染相关，对HIV-1就诊者进行综合干预能降低HCV的传播。

Objective To estimate the prevalence of hepatitis C virus （HCV） infection among sexually transmitted disease （STD） clinic attendees infected with human immunodeficiency virus type 1 （HIV-1） in Guangxi Zhuang Autonomous Region. Methods Totally, 11 553 blood plasma samples were collected from STD clinic attendees in Guangxi Zhuang Autonomous Region, and subjected to HIV-1 antibody screening and confirmatory testing. Enzyme linked immunosorbent assay （ELISA） was performed to detect anti-HCV antibodies in 140 anti-HIV-1 antibody-positive samples and 282 anti-HIV-1 antibody-negative samples from age- and marital status-matched attendees. Chi-square test was performed to assess the differences in the prevalence rate of HCV infection between anti-HIV-l-negative and -positive samples, and Logistic regression analysis to evaluate the risk factors for HCV and HIV co-infection. Results The positivity rate of anti-HCV antibodies was 33.57% （47/140） among anti-HIV-l-positive samples, significantly higher than that in anti-HIV-l-negative samples （1.06% （3/282）, X2 = 94.66, P 〈 0.05）. Logistic regression analysis showed a statistical increase in the prevalence of HCV/HIV co-infection in individuals reporting more than one sexual partners compared with those reporting only one sexual partner （OR = 2.4, 95% CI （1.0-5.6）, P = 0.05） , and in intravenous drug users compared with non-intravenous drug users （OR = 20.8, 95% CI（5.7-76.5）, P 〈 0.05）. Conclusions HCV infection appears to be associated with HIV-1 infection, and comprehensive intervention on HIV-l-infected patients may slow down HCV transmission.