中国部分地区HIV阳性男男性行为者合并HCV感染状况及其自然清除率调查

Study on the rates of infection and spontaneous clearance on HCV among HIV-infected men who have sex with men in China

目的分析中国部分城市HIV阳性男男性行为者（MsM）中丙型肝炎病毒（HCV）感染状况及自然清除能力。方法以沈阳、北京、长沙和昆明市HIV确证阳性的MSM为研究对象，收集基本人口学资料及CD4^＋T细胞淋巴细胞计数、HIV病毒载量、肝脏相关生化指标等临床信息，并进行HCV抗体和HCV-RNA检测，并将HCV抗体阳性标本分为病毒自然清除（RNA-／Ab＋）和慢性感染（RNA＋／Ab＋）两种感染状态。结果在513例HIV阳性MSM中，检出HCV抗体阳性10例（阳性率为1．94％），其中4例HCV-RNA阳性（阳性率为0．77％），除l例HCV感染者正在接受抗病毒治疗HCV核酸检测阴性外，共5例感染者能够自然清除HCV-RNA。HCV自然清除者相对于慢性感染（病毒血症）者具有较低的氨基转移酶水平和较高的CD4^＋T细胞淋巴细胞水平。结论目前调查地区HIV阳性的MSM中HCV感染率处于较低水平，但仍需定期监测。

Objective The aim of this study was to understand the rates of infection and spontaneous clearance on hepatitis C virus （HCV） among HIV-infected men who have sex with men （MSM） in China. Methods H/V-infected MSM from Shenyang, Beijing, Changsha and Kunming were selected to take the HCV antibody and HCV-RNA tests, and then classified into ＇ under recovery （RNA-/Ab ＋ ） ＇ or being chronic （RNA ＋/Ab ＋ ）. Information on demography, CD4 ＋T cell, HIV viral load and liver biochemical indicators were also collected. Results In 513 HIV-infected MSM, the positive rate of HCV antibody was 1.94% （10/513） and the positive rate of HCV-RNA was 0.77% （4/513）. Five patients showed clearance of HCV-RNA, spontaneously. These 5 patients had low levels of both alanine transaminase （ALT） and aspartate aminotransferase （AST）, and with high level of CD4 ^＋ T cells, when compared to those who were not able to clear the HCV-RNA. Conclusion Currently, the HCV infection rate was still at quite low level among the HIV-infeeted MSM in China. Dynamic of HIV/HCV co-infection should be monitored so as to develop suitable strategy on prevention and treatment among this population, in China.