The Alfred Hospital, Melbourne, Victoria 3004, Australia.
Neurology. 2010 May 11;74(19):1538-42. doi: 10.1212/WNL.0b013e3181dd436d.
Sensory neuropathy (SN) is common in patients with HIV. Hepatitis C (HCV) coinfection is often cited as an HIV-SN risk factor, but data to support this are lacking. This collaboration aimed to examine the association between HCV serostatus and SN risk among ambulatory HIV-positive patients.
Patients with HIV were assessed in cross-sectional studies in Baltimore, Jakarta, Johannesburg, Kuala Lumpur, Melbourne, and Sydney for SN (defined by both supportive symptoms and signs). HCV seropositivity was assessed as an SN risk using a chi(2) test, followed by logistic regression modeling to correct for treatment exposures and demographics.
A total of 837 patients of African, Asian, and Caucasian descent were studied. HCV seroprevalence varied by site (Baltimore n = 104, 61% HCV+; Jakarta 96, 51%; Johannesburg 300, 1%; Kuala Lumpur 97, 10%; Melbourne 206, 16%; Sydney 34, 18%). HCV seropositivity was not associated with increased SN risk at any site, but was associated with reduced SN risk in Melbourne (p = 0.003). On multivariate analyses, the independent associations with SN were increasing age, height, and stavudine exposure. HCV seropositivity was not independently associated with an increased SN risk at any site, but associated independently with reduced SN risk in Baltimore (p = 0.04) and Melbourne (p = 0.06).
Hepatitis C (HCV) seropositivity was not associated with increased sensory neuropathy risk among HIV-positive patients at any site. While we were unable to assess HCV RNA or liver damage, the data suggest that HCV coinfection is not a major contributor to HIV-SN. HCV = hepatitis C; SN = sensory neuropathy.
感觉神经病变(SN)在 HIV 患者中很常见。丙型肝炎(HCV)合并感染常被认为是 HIV-SN 的一个危险因素,但缺乏支持这一观点的数据。本合作旨在研究 HCV 血清阳性状态与门诊 HIV 阳性患者 SN 风险之间的关系。
在巴尔的摩、雅加达、约翰内斯堡、吉隆坡、墨尔本和悉尼进行的横断面研究中,对 HIV 患者进行 SN(通过支持症状和体征定义)评估。使用卡方检验评估 HCV 血清阳性状态作为 SN 风险,然后进行逻辑回归模型校正治疗暴露和人口统计学因素。
共研究了 837 名非洲裔、亚洲裔和白种人患者。HCV 血清流行率因地点而异(巴尔的摩 104 例,61% HCV+;雅加达 96 例,51%;约翰内斯堡 300 例,1%;吉隆坡 97 例,10%;墨尔本 206 例,16%;悉尼 34 例,18%)。HCV 血清阳性与任何地点的 SN 风险增加无关,但与墨尔本的 SN 风险降低相关(p=0.003)。在多变量分析中,与 SN 独立相关的因素是年龄、身高和司他夫定暴露。HCV 血清阳性与任何地点的 SN 风险增加无关,但与巴尔的摩(p=0.04)和墨尔本(p=0.06)的 SN 风险降低独立相关。
HCV 血清阳性与任何地点的 HIV 阳性患者的感觉神经病变风险增加无关。虽然我们无法评估 HCV RNA 或肝损伤,但数据表明 HCV 合并感染不是 HIV-SN 的主要原因。HCV=丙型肝炎;SN=感觉神经病变。