Sun Hsin-Yun, Kung Hsiang-Chi, Ho Ya-Chi, Chien Yu-Fen, Chen Mao-Yuan, Sheng Wang-Huei, Hsieh Szu-Min, Wu Cheng-Hsin, Liu Wen-Chun, Hung Chien-Ching, Chang Shan-Chwen
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan.
Int J Infect Dis. 2009 Sep;13(5):e199-205. doi: 10.1016/j.ijid.2008.12.009. Epub 2009 Feb 8.
To retrospectively determine the prevalence of anti-hepatitis A virus (HAV) antibody in HIV-positive persons with different routes of HIV exposure and to describe its characteristics in order to guide vaccination policy.
The prevalence of anti-HAV antibody was compared between 1580 HIV-positive persons seeking medical attention and 2581 HIV-negative controls seeking health check-ups, who had undergone anti-HAV tests between 2004 and 2007. Comparisons were also made among groups of the HIV-positive patients who had acquired HIV via different routes of transmission. A multivariate logistic regression model was built to identify independent variables associated with anti-HAV seropositivity.
The overall prevalence of anti-HAV antibody was 60.9% in the HIV-positive and 48.0% in the controls (p<0.001). The overall adjusted odds ratio (AOR) for positive anti-HAV antibody was 2.604 (95% confidence interval (CI) 2.106-3.219) in HIV-positive persons compared with HIV-negative persons. In addition, HIV-positive men who have sex with men (MSM), heterosexuals, and injecting drug users (IDU) all had significantly higher AOR for positive anti-HAV antibody than HIV-negative persons. In HIV-positive persons, older age (AOR 1.284, 95% CI 1.246-1.322) and IDU (AOR 5.137, 95% CI 3.499-7.542) were independently associated with an increased prevalence of anti-HAV antibody. Nearly 90% of the IDU had become seropositive for HAV after age 36-40 years, compared with heterosexuals and MSM after age 46-50 years, and controls after age 51-55 years.
Our findings suggest that age groups to be targeted for HAV vaccination vary with the different routes of HIV exposure.
回顾性确定不同HIV暴露途径的HIV阳性者中抗甲型肝炎病毒（HAV）抗体的流行情况，并描述其特征以指导疫苗接种政策。
比较了2004年至2007年间接受抗HAV检测的1580例寻求医疗服务的HIV阳性者和2581例寻求健康检查的HIV阴性对照者中抗HAV抗体的流行情况。还对通过不同传播途径感染HIV的HIV阳性患者组进行了比较。建立多变量逻辑回归模型以确定与抗HAV血清阳性相关的独立变量。
HIV阳性者中抗HAV抗体的总体流行率为60.9%，对照组为48.0%（p<0.001）。与HIV阴性者相比，HIV阳性者抗HAV抗体阳性的总体调整优势比（AOR）为2.604（95%置信区间（CI）2.106 - 3.219）。此外，男男性行为者（MSM）、异性恋者和注射吸毒者（IDU）的HIV阳性者抗HAV抗体阳性的AOR均显著高于HIV阴性者。在HIV阳性者中，年龄较大（AOR 1.284，95% CI 1.246 - 1.322）和IDU（AOR 5.137，95% CI 3.499 - 7.542）与抗HAV抗体流行率增加独立相关。近90%的IDU在36 - 40岁后HAV血清学转为阳性相比，异性恋者和MSM在46 - 50岁后，对照组在51 - 55岁后。
我们的研究结果表明，HAV疫苗接种的目标年龄组因HIV暴露途径不同而有所差异。
