Rodríguez-Méndez M L, González-Quintela A, Aguilera A, Carballo E, Barrio E
Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, Spain.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2093-7.
BACKGROUND/AIMS: HBV, HCV, and HIV have some transmission routes in common. Viral liver disease is a leading cause of mortality in HIV-infected patients. The study was aimed at evaluating the prevalence of HBV and HCV markers in subjects with different risk practices for HIV infection.
A total of 699 subjects were studied Of these subjects, 517 were intravenous drug users (373 HIV-positive and 144 HIV-negative), 127 had heterosexual risk practice (66 HIV-positive and 61 HIV-negative), 31 had homosexual risk practice (all HIV-positive), 15 had post-transfusional HIV infection, and nine had HIV infection of unknown source. Patients with anti-HBc antibody were considered HBV-positive, and cases with anti-HCV antibodies were considered HCV-positive.
Among patients with HIV infection, most intravenous drug users (79%) had markers of both HBV and HCV, compared with 20%, 11%, and 10% of cases infected by transfusional, heterosexual, and homosexual route, respectively (p < 0.001). Absence of both HBV and HCV markers was observed in most HIV-positive heterosexuals (62%) compared with 40% of post-transfusional cases, 32% of homosexuals and 4% of intravenous drug users (p: NS, p = 0.009, and p < 0.001, respectively). Isolated HBV-positivity was the most frequent pattern in HIV-infected homosexuals (58%), compared with 27% of post-transfusional, 21% of heterosexuals and 11% of intravenous drug users (p: NS, p < 0.001 and p < 0.001, respectively). HIV-negative intravenous drug users had a lower prevalence of HBV/HCV association than HIV-positive cases (p < 0.001). Isolated HCV-positivity was more frequent in HIV-negative than in HIV-positive intravenous drug users (27% vs. 6%, p < 0.001). In heterosexuals, isolated HBV-positivity was more prevalent in HIV-positive than in HIV-negative cases (21% vs. 7%, p = 0.04).
HBV and HCV seroprevalence in HIV infected patients vary depending on the risk practice. This suggests a variable transmissibility depending on the route considered. Within the same risk practice, differences in HCV and HBV seroprevalence between HIV-positive and HIV-negative cases suggest that some factors associated with HIV infection may influence the rate of infection by HCV and HBV.
背景/目的：乙肝病毒（HBV）、丙肝病毒（HCV）和人类免疫缺陷病毒（HIV）有一些共同的传播途径。病毒性肝病是HIV感染患者死亡的主要原因。本研究旨在评估具有不同HIV感染风险行为的人群中HBV和HCV标志物的流行情况。
共研究了699名受试者。其中，517名是静脉吸毒者（373名HIV阳性和144名HIV阴性），127名有异性性行为感染风险（66名HIV阳性和61名HIV阴性），31名有同性性行为感染风险（均为HIV阳性），15名有输血后HIV感染，9名HIV感染来源不明。抗-HBc抗体阳性的患者被视为HBV阳性，抗-HCV抗体阳性的病例被视为HCV阳性。
在HIV感染患者中，大多数静脉吸毒者（79%）同时有HBV和HCV标志物，相比之下，经输血、异性性行为和同性性行为感染的病例分别为20%、11%和10%（p<0.001）。大多数HIV阳性异性性行为者（62%）未检测到HBV和HCV标志物，相比之下，输血后感染病例为40%，同性性行为者为32%，静脉吸毒者为4%（p：无统计学意义，p = 0.009，p<0.001）。单独HBV阳性是HIV感染同性性行为者中最常见的模式（58%），相比之下，输血后感染病例为27%，异性性行为者为21%，静脉吸毒者为11%（p：无统计学意义，p<0.001，p<0.001）。HIV阴性静脉吸毒者中HBV/HCV合并感染的患病率低于HIV阳性病例（p<0.001）。单独HCV阳性在HIV阴性静脉吸毒者中比在HIV阳性静脉吸毒者中更常见（27%对6%，p<0.001）。在异性性行为者中，单独HBV阳性在HIV阳性者中比在HIV阴性者中更普遍（21%对7%，p = 0.04）。
HIV感染患者中HBV和HCV的血清流行率因感染风险行为而异。这表明根据所考虑的传播途径，传播性存在差异。在相同的感染风险行为中，HIV阳性和HIV阴性病例之间HCV和HBV血清流行率的差异表明，一些与HIV感染相关的因素可能会影响HCV和HBV的感染率。
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