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格鲁吉亚艾滋病毒阳性患者中乙型和丙型肝炎的患病率及其相关风险因素。

Prevalence of hepatitis B and C among HIV positive patients in Georgia and its associated risk factors.

作者信息

Badridze N, Chkhartishvili N, Abutidze A, Gatserelia L, Sharvadze L

机构信息

Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.

出版信息

Georgian Med News. 2008 Dec(165):54-60.

Abstract

The aim of the study was to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection among HIV positive patients, to identify most relevant risk factors of co-infection and develop preventive interventions. Study participants were voluntary individuals 18 years of age or older recruited from AIDS Center VCT unit in Tbilisi, Georgia. Eligibility criteria of participants were: HIV positive result confirmed by western blot; age; and voluntary participation. Total 175 patients undergo interview with specially designed questionnaires. Most of the participants were male (71.4%), age range of HIV positives varied from 20 to 77 years old. Prevalence of HCV among HIV positive patients is high. Almost half (48.57%) HIV positive patients are co-infected with HCV. Men were more likely than women co-infected with HCV (60.80% and 18% accordingly). Major risk factor of male co-infection was related to drug use, needle and injection equipment sharing. Prevalence of HCV among injecting drug users was (73.40%). Drug users had 3.25 times more risk (PR 3.25; 95%CI; CL--1.89-5.26; p<0.01) to be infected with HCV compare non IDUs. Prevalence of being infected with HBV (Anti-HBc) among HIV positives was 43.42% (76/175) and the prevalence of Chronic HBV (HBsAg positive) was 6.86% (12/175). Prevalence rate of HBsAg among IDUs was 8.51% and among non IDU participants 5.26%. Triple infection (HIV, Hepatitis C and chronic form of Hepatitis B--HBsAg) was among 9 patients (5.14%). Infections were associated with injection drug use (88.88%) and mostly were related to share of needles/syringes and other injecting medical equipment. Transmission of HBV and HCV by sexual contact was not observed among those 9 participants. High risk behavior among HIV positive participants mostly related to drug use and unprotected sex with non regular partners. Other risk factors for Hepatitis transmission were associated with invasive medical manipulations, blood transfusion, surgery, abortions and etc. None of cases of HIV, or Hepatitis (B, C) transmission through medical manipulations can be documentary proved based on those research data.

摘要

本研究的目的是确定艾滋病毒阳性患者中乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)合并感染的患病率,确定合并感染最相关的危险因素,并制定预防干预措施。研究参与者是从格鲁吉亚第比利斯艾滋病中心自愿咨询检测(VCT)部门招募的18岁及以上的自愿者。参与者的入选标准为:经免疫印迹法确认艾滋病毒呈阳性;年龄;以及自愿参与。共有175名患者接受了专门设计的问卷调查。大多数参与者为男性(71.4%),艾滋病毒阳性者的年龄范围为20至77岁。艾滋病毒阳性患者中丙型肝炎病毒的患病率很高。几乎一半(48.57%)的艾滋病毒阳性患者合并感染丙型肝炎病毒。男性合并感染丙型肝炎病毒的可能性高于女性(分别为60.80%和18%)。男性合并感染的主要危险因素与药物使用、共用针头和注射设备有关。注射吸毒者中丙型肝炎病毒的患病率为(73.40%)。与非注射吸毒者相比,吸毒者感染丙型肝炎病毒的风险高3.25倍(PR 3.25;95%置信区间;下限-1.89-5.26;p<0.01)。艾滋病毒阳性者中感染乙肝病毒(抗-HBc)的患病率为43.42%(76/175),慢性乙肝病毒(HBsAg阳性)的患病率为6.86%(12/175)。注射吸毒者中HBsAg的患病率为8.51%,非注射吸毒者参与者中为5.26%。9名患者(5.14%)存在三重感染(艾滋病毒、丙型肝炎和慢性乙型肝炎——HBsAg)。感染与注射吸毒有关(88.88%),主要与共用针头/注射器和其他注射医疗设备有关。在这9名参与者中未观察到通过性接触传播乙肝病毒和丙型肝炎病毒。艾滋病毒阳性参与者中的高危行为主要与药物使用和与非固定性伴侣的无保护性行为有关。肝炎传播的其他危险因素与侵入性医疗操作、输血、手术、堕胎等有关。根据这些研究数据,无法书面证明艾滋病毒或肝炎(B、C)通过医疗操作传播的任何病例。

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