目的比较人免疫缺陷病毒(human immunodeficiency virus,HIV)/乙型肝炎病毒(hepatitis B virus,HBV)合并感染者与HBV单一感染者外周血HBV核心(core,C)蛋白和多聚合酶(polymerase,P)蛋白的特异性细胞毒性T细胞(cytotoxic T lymphocyte,C...目的比较人免疫缺陷病毒(human immunodeficiency virus,HIV)/乙型肝炎病毒(hepatitis B virus,HBV)合并感染者与HBV单一感染者外周血HBV核心(core,C)蛋白和多聚合酶(polymerase,P)蛋白的特异性细胞毒性T细胞(cytotoxic T lymphocyte,CTL)表位变异的差异,探讨HIV/HBV合并感染者肝病进程加快的可能致病机制。方法收集慢性HBV感染者的基本检查结果和血标本,并依据抗病毒前HIV抗体检测结果,分为HIV/HBV合并感染组和HBV单一感染组。提取HBV DNA,巢式PCR法扩增HBV C基因与P基因并送PCR产物测序,ContigExpress软件进行序列拼接,Vector NTI软件进行序列比对,参照相应基因型标准序列,分析2组患者的HBV CTL表位变异差异。结果成功扩增的HBV C基因与P基因的患者共151例,其中HIV/HBV合并感染者83例,HBV单一感染者68例。HIV/HBV合并感染组较HBV单一感染组CTL表位变异发生率均偏高,其中C18-27、C88-96、C139-148表位变异发生率差异比较有统计学意义(χ^2=7.509,P=0.006;χ^2=3.902,P=0.048;χ^2=4.238,P=0.040)。HIV/HBV合并感染组的C18-27表位主要变异氨基酸的类型增多,出现新的S26N(4.8%)、S26T(4.8%)变异类型,而C88-96、C139-148表位主要变异氨基酸相同(L95I、T147A)。结论HIV/HBV合并感染可增加HBV C蛋白和P蛋白的CTL表位变异,尤其是C18-27、C88-96、C139-148表位变异。C蛋白CTL表位变异增多可能与HIV/HBV合并感染肝病进程加快的致病机制相关。展开更多
Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the ...Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the prevalence of HBV and HCV in people living with HIV and to evaluate the performance of a combined rapid test for the simultaneous detection of HIV, HBV, and HCV. Methods: This is a cross-sectional study that took place from February 2017 to November 2018 and included 139 HIV-infected individuals followed up at different medical centers in Ouagadougou, Burkina Faso. HBV and HCV serology tests were performed on-site using finger prick whole blood with HIV/HCV/HBsAg combined rapid test and then serum with two reference tests “Architect HBsAg Qualitative” and “Architect HIV Ag/Ab Combo”. Results: The mean age of the participants was 57 ± 8 years. Of the 139 participants, 10% (14/139) were HIV-1 positive, 71.9% (100/139) were HIV-2 positive, and 18.0% (25/139) were HIV-1/HIV-2 coinfected. The sensitivity and specificity of the HIV/HCV/HBsAg combined rapid test were 33.33% vs 99.11% and 20% vs 99.25% compared to Architect HBsAg Qualitative and Architect HIV Ag/Ab Combo, respectively. The Kappa and Youden Index values were 0.4262 and 0.3244 and 0.2707 and 0.1925, respectively, compared to each of the two reference tests. Conclusion: The results show that the HIV/HCV/HBsAg combined rapid test has poor diagnostic efficiency and should not be recommended for the diagnosis of these viruses.展开更多
Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determi...Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.展开更多
文摘Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the prevalence of HBV and HCV in people living with HIV and to evaluate the performance of a combined rapid test for the simultaneous detection of HIV, HBV, and HCV. Methods: This is a cross-sectional study that took place from February 2017 to November 2018 and included 139 HIV-infected individuals followed up at different medical centers in Ouagadougou, Burkina Faso. HBV and HCV serology tests were performed on-site using finger prick whole blood with HIV/HCV/HBsAg combined rapid test and then serum with two reference tests “Architect HBsAg Qualitative” and “Architect HIV Ag/Ab Combo”. Results: The mean age of the participants was 57 ± 8 years. Of the 139 participants, 10% (14/139) were HIV-1 positive, 71.9% (100/139) were HIV-2 positive, and 18.0% (25/139) were HIV-1/HIV-2 coinfected. The sensitivity and specificity of the HIV/HCV/HBsAg combined rapid test were 33.33% vs 99.11% and 20% vs 99.25% compared to Architect HBsAg Qualitative and Architect HIV Ag/Ab Combo, respectively. The Kappa and Youden Index values were 0.4262 and 0.3244 and 0.2707 and 0.1925, respectively, compared to each of the two reference tests. Conclusion: The results show that the HIV/HCV/HBsAg combined rapid test has poor diagnostic efficiency and should not be recommended for the diagnosis of these viruses.
文摘Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.
