浙江省十家医院门诊HIV感染者合并HBV感染的流行病学调查

目的探讨浙江省十家医院门诊人类免疫缺陷病毒(HIV)感染者合并乙型肝炎病毒(HBV)的流行病学特征及影响因素。方法随机选取浙江省十家医院,应用多中心横断面流行病学调查方法,采取随机整群抽样,对门诊HIV患者进行问卷调查,收集患者的一般情况、临床及实验室检查资料,分析合并HBV感染的相关影响因素。结果260例患者中,36例合并HBV感染(13.85%)。合并HBV感染组,25~45年龄段、静脉吸毒感染、具有HBV家族史的患者比例明显高于未合并HBV感染组(P<0.05);CD4+T淋巴细胞计数明显低于未合并HBV感染组(P<0.05)。多因素Logistic回归分析显示,年龄(OR=1.263,95%CI=0.441~2.347)、感染途径(OR=3.767,95%CI=1.433~5.288)、HBV家族史(OR=1.286,95%CI=1.021~1.620)、CD4+T淋巴细胞计数(OR=1.215,95%CI=0.776~2.276)是HIV患者合并HBV感染的独立影响因素(P<0.05)。结论年龄在25~45岁、静脉吸毒感染、具有HBV家族史、CD4+T淋巴细胞计数较低的HIV感染者合并HBV感染风险高,建议重视对该类人群的早期筛查。

Objective To investigate the epidemiological characteristics and influencing factors of human immunodeficiency virus(HIV)patients complicated with hepatitis B virus(HBV)in 10 hospitals in Zhejiang Province.Methods Ten hospitals in Zhejiang province were randomly selected,multi-center cross-sectional epidemiological survey method was adopted,and random cluster sampling was adopted to carry out a questionnaire survey on outpatients with HIV.The general situation,clinical and laboratory examination data of the patients were collected,and the related influencing factors of HBV infection were analyzed.Results Of the 260 subjects,36(13.85%)were complicated with HBV infection.The proportion of 25~45 years old patients with intravenous drug abuse infection and family history of HBV infection in group with HBV infection was significantly higher than that in group without HBV infection(P<0.05).The count of CD4+T lymphocytes was significantly lower than that of the group without HBV infection(P<0.05).Multivariate Logistic regression analysis showed that age(OR=1.263,95%CI=0.441~2.347),infection route(OR=3.767,95%CI=1.433~5.288),HBV family history(OR=1.286,95%CI=1.021~1.620)and CD4+T lymphocyte count(OR=1.215,95%CI=0.776~2.276)were independent influencing factors of HIV patients with HBV infection(P<0.05).Conclusion HIV patients aged 25~45 years,intravenous drug abuse infection,family history of HBV and low CD4+T lymphocyte count are at high risk of HBV infection.It is suggested to pay attention to early screening of these people.