Key Laboratory of AIDS Immunology of Ministry of Health, No 1 Hospital of China Medical University, Shenyang, Liaoning, China.
PLoS One. 2010 May 27;5(5):e10631. doi: 10.1371/journal.pone.0010631.
Co-infection with HIV-1 and HCV is a significant global public health problem and a major consideration for anti-HIV-1 treatment. HCV infection among HIV-1 positive people who are eligible for the newly launched nationwide anti-HIV-1 treatment program in China has not been well characterized.
A nationwide survey of HIV-1 positive injection drug uses (IDU), former paid blood donors (FBD), and sexually transmitted cases from multiple provinces including the four most affected provinces in China was conducted. HCV prevalence and genetic diversity were determined. We found that IDU and FBD have extremely high rates of HCV infection (97% and 93%, respectively). Surprisingly, people who acquired HIV-1 through sexual contact also had a higher rate of HCV infection (20%) than the general population. HIV-1 subtype and HCV genotypes were amazingly similar among FBD from multiple provinces stretching from Central to Northeast China. However, although patterns of overland trafficking of heroin and distinct HIV-1 subtypes could be detected among IDU, HCV genotypes of IDU were more diverse and exhibited significant regional differences.
Emerging HIV-1 and HCV co-infection and possible sexual transmission of HCV in China require urgent prevention measures and should be taken into consideration in the nationwide antiretroviral treatment program.
HIV-1 和 HCV 的合并感染是一个重大的全球公共卫生问题，也是抗 HIV-1 治疗的主要考虑因素。在中国新启动的全国性抗 HIV-1 治疗项目中，有资格接受治疗的 HIV-1 阳性人群中的 HCV 感染情况尚未得到充分描述。
对来自中国多个省份（包括四个受影响最严重的省份）的 HIV-1 阳性注射吸毒者（IDU）、前有偿献血者（FBD）和性传播病例进行了全国范围的调查。确定了 HCV 的流行率和遗传多样性。我们发现 IDU 和 FBD 的 HCV 感染率极高（分别为 97%和 93%）。令人惊讶的是，通过性接触感染 HIV-1 的人群的 HCV 感染率（20%）也高于一般人群。来自中国中部到东北部多个省份的 FBD 中，HIV-1 亚型和 HCV 基因型惊人地相似。然而，尽管可以检测到 IDU 中存在的海洛因越境贩运和独特的 HIV-1 亚型模式，但 IDU 的 HCV 基因型更加多样化，并表现出明显的地区差异。
中国新出现的 HIV-1 和 HCV 合并感染以及 HCV 可能的性传播需要紧急采取预防措施，并应在全国性抗逆转录病毒治疗项目中加以考虑。
