HIV感染者丙型肝炎病毒抗体与病毒载量关系

Relationship between hepatitis C virus antibody and viral load in HIVinfected individuals:a hospital-based study in Yunnan province

目的了解HIV感染者合并感染丙型肝炎病毒(HCV)后抗体与病毒载量(HCV RNA)之间的相关性,为HCV抗体评估HCV RNA的预测价值提供依据。方法于2022年11月—2023年3月在云南省传染病医院收集确诊为HIV感染者血清和信息资料,采用酶联免疫吸附法检测HCV抗体,qRT-PCR法测定HCV RNA。采用t检验、χ^(2)检验等统计学方法进行数据分析。结果收集到HIV感染者979例,HCV抗体检测阳性率为17.9%(176例),其中男性和女性分别为17.1%(110例)和19.6%(66例)。HCV抗体阳性率与年龄有关(χ^(2)=107.662,P<0.001),41~60岁感染者最高为29.6%(158例),而<20岁感染者最低为0。在HCV抗体阳性感染者中进行HCV RNA检测阳性率为46.6%(82例),男性和女性阳性率分别为50%(55例)和40.9%(27例),经统计分析,HCV RNA阳性率与年龄无关(P>0.05)。Spearman等级分析显示,HCV RNA阳性与HCV抗体水平呈正相关(r=0.237,P<0.05)。采用ROC曲线对预测值进行分析,结果发现当HCV抗体值≥16.78(S/CO)时HCV RNA为阳性。结论HIV感染者人群中HCV抗体阳性率较高,HCV抗体与HCV RNA水平之间呈正相关,HCV抗体对HCV RNA阳性预测的最佳临界值确定为16.78(S/CO),为HIV合并感染HCV患者诊断和治疗提供实验室依据。

Objective To understand the correlation between hepatitis C virus(HCV)antibodies and HCV RNA viral load in HIV co-infected individuals and to provide a basis for predicting HCV RNA based on HCV antibody detection.Methods The blood samples and relevant data were collected from 979 HIV-infected individuals with HCV antibody detection at the Yunnan Provincial Infectious Disease Hospital from November 2022 to March 2023.HCV antibodies were detected by enzyme-linked immunosorbent assay(ELISA),and HCV RNA was measured by real-time reverse transcription-PCR(qRT-PCR).T-test and chi-squared test were used for data analysis.Results Among all participants,17.9%(n=176)were HCV antibody positive,and the positive rates were 17.1%(n=110)and 19.6%(n=66)for male and female participants,respectively.The rate of HCV antibody positivity was associated with age(χ^(2)=107.662,P<0.001),with the highest rate of 29.6%in participants aged 41–60 years and the lowest rate of 0%in participants younger than 20 years.Among participants who were HCV antibody positive,the HCV RNA positivity rate was 46.6%,with positive rates of 50.0%and 40.9%in male and female participants,respectively,and the positive rate was not related to age(P>0.05).Spearman rank correlation analysis showed a positive correlation between HCV RNA positivity and HCV antibody levels(r=0.237,P<0.05).Receiver operating characteristic(ROC)curve analysis showed that an HCV antibody level≥16.78(signal to cutoff ratio,S/CO)indicated HCV RNA positivity.Conclusion The rate of HCV antibody positivity was high in the HIV-infected population and positively correlated with HCV RNA levels,with an S/CO value of 16.78 being an optimal threshold for predicting HCV RNA positivity,which could be used in the diagnosis and management of patients co-infected with HIV and HCV.