浙江省台州市新报告成年HIV感染者中HCV合并感染研究

Co-infection of hepatitis C virus among newly diagnosed HIV-infected adults in Taizhou prefecture of Zhejiang province, China

目的了解浙江省台州市2009--2012年新报告成年HIV感染者中合并感染HCV的情况，分析HIV／HCV合并感染者中血浆HCV病毒载量水平。方法对2009--2012年浙江省台州市新报告的572例成年HIV感染者检测HCV抗体，并对HCV抗体阳性的标本进行HCVRNA定量检测。结果共有42例HCV抗体检测阳性，HIV感染者中HCV合并感染率为7．3％（95％CI：5．2％-9．5％）。46—86岁HIV感染者的HCV合并感染率显著低于18～45岁年龄组（OR=0．12，95％CI：0.02—0．58）；高中及以上文化程度的HIV感染者HCV合并感染率显著低于小学及以下文化程度者（OR=0．13，95％CI：0．02-0．78）；经血传播HIV感染者HCV合并感染率显著高于异性传播HIV感染者（0R=49．46，95％CI：13．71—178．48）；同性传播HIV感染者HCV合并感染率则低于异性传播HIV感染者（OR=0．11，95％CI：0．01～0．86）。42例HIV／HCV合并感染者中33例（78．6％）血浆HCV病毒载量在检测限以上，HCV复制相对活跃，其中HBsAg阳性者血浆HCVRNA检出率（100％）显著高于HBsAg阴性者（75．7％）（P=0．002）。9例（21．4％）血浆HCV病毒载量则低于检测下限（5．0×10^2IU／m1），处于相对抑制状态。单因素logistic回归分析未发现HIV／HCV合并感染者HCV相对抑制率与其社会人口学特征、HIV传播途径、CD4＋T淋巴细胞计数等有关联。结论浙江省台州市HIV感染者中HCV感染率较高，多数HIV／HCV合并感染者血浆HCV病毒载量也较高，其对病情进展影响有待持续观察。

Objective To examine the prevalence and correlates of hepatitis C virus （HCV） co-infection as well as plasma HCV viral load among newly diagnosed HIV-infected adults during 2009-2012 in Taizhou prefecture of Zhejiang province, China. Methods Five hundred and seventy-two adults who were newly diagnosed as HIV-infection were screened for anti-HCV immunoglobulin G （IgG）. Plasma HCV RNA was quantified if positive for HCV IgG. Results Forty-two （7.3%） out of the 572 HIV-infected adults were tested positive for HCV IgG. HCV infection was more likely to occur among participants who were infected with HIV through blood transmission （OR = 49.46,95% CI： 13.71-178.48 ）. Otherwise, HCV infection was less likely to occur among participants who were under 46-86 years of age （OR=0.12, 95%CI： 0.02-0.58）, those with mode of homosexual transmission of HIV （OR=0.11,95% CI： 0.01-0.86）, with education of high school or above （OR=0.13, 95% CI： 0.02-0.78）. Thirty-three （78.6%） of the total 42 HIV-HCVpatients with coinfection had detectable plasma HCV RNA, whereas 9 （21.4% ） had undetectable plasma HCV RNA （i.e., lower than 5.0 × 10^2 IU/ml） or known as relative HCV viral suppression. No significant associations were noticed on factors as： HCV viral suppression and demographics, HIV transmission route and CD4 ＋ T-cell counts according to univariate regression analyses. Conclusion Prevalence of HCV co-infection was relatively high among newly diagnosed HIV-infected adults in this study area. Majority of the HIV-HCV coinfected patients had detectable plasma HCV RNA, of which the long term impact on disease progression deserves called for further research.