昆明地区人类免疫缺陷病毒(HIV-1)合并丙型肝炎病毒(HCV)感染及丙肝病毒基因亚型分析

Reseach of patients infected with human immunodeficiency virus 1(HIV-1) combined with hepatitis C virus(HCV)and hepatitis C virus subtype analysis

目的了解昆明市2011~2016年新入组进行艾滋病抗病毒治疗HIV/AIDS患者合并丙型肝炎病毒感染情况及丙肝基因亚型情况。方法收集昆明市第三人民医院感染一科(2011~2016)年新入组进行抗病毒治疗HIV/AIDS患者的临床资料,分析其基线情况,同期我院检验科测序分析HCV基因分型并进一步进行整理分析。结果近5年HIV-1合并HCV占HIV-1总体感染率19.2%(687/3 571),HCV合并HIV-1感染呈逐年下降趋势(2011年27.3%、2012年24.1%、2013年18.1%、2014年17.5%、2015年14.4%),HIV/HCV共感染率及静脉吸毒患者比例均逐年下降(P=0.000)。HIV/HCV共感染322例HCV基因分型以3a(24.2%)、3b(41.7%)型为主,6a(6.2%)、1b(18.6%)、不能确定分型(9.3%),2a(0%),单纯HCV感染2 140例HCV基因分型亚型以2a(12.5%)、3a(18.5%)、3b(41.3%)为主,6a(3.2%)、1b(15.5%)、不能确定分型(9%),经卡方检验两组感染者在各基因亚型之间差异具有统计学意义(χ2=87.169,P<0.05.)。结论昆明市新入组抗病毒治疗HIV/AIDS患者合并HCV感染较为常见,昆明市HCV基因分型以3a、3b亚型为主,3a、6a、1b亚型在HIV/HCV共感染者中的感染率高于在单纯HCV感染者,而2a基因亚型在HIV/HCV感染者中暂未检出。

Objective To understand the situation of hepatitis C virus infection and hepatitis C gene subtype in new AIDS patients treated with antiret- roviral therapy in Kunming in the past 2011-2016 years. Methods The clinical data of new AIDS patients conducted with antiretroviral therapy in the past 2011-2016 years of one department of infection in third people＇s hospital were collected, to analyze its baseline situation, and at the same period, our hospi- tal clinical laboratory to sequence HCV gene and further analyze genotype. Results HIV-1 combined with HCV occupies 19.2% of total HIV infection rate （687/3 571 ） in recent 5 years, the trends of HCV combined with HIV-1 infection declines year by year （that is 27,3% in 2011, 24.1% in 2012, 18.1% in 2013, 17.5% in 2014 and 14.4% in 2015）, the coinfection rate of HIV/HCV and the proportion of intravenous drug users decreased year by year（P =0.000） . The HCV genotype of 322 cases HIV/HCV coinfection was dominated by 3A （24.2%） and 3b （41.7%） type, then is 6a （6.2%）, 1B （18.6%）, unidentified type （9,3%）, 2A （0%）, and 2140 HCV subtypes of simpleHCV infection was 2A （12.5%）, 3A （18.5%）, and 3b （41.3%））. The difference between the infection subtypes in two groups was statistically significant （χ^2=87.169, P =0.000.）. Conclusion It is common that new AIDS patients conducted with antiretroviral therapy combined with HCV infection, the HCV genotype was mainly 3a and 3b, and the infection rate of3a, 6a and lb subtype was significantly higher than those in simple HCV infected persons, while 2A gene subtypes were not detected in HIV/HCV co infected persons.