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乙型肝炎病毒(HBV)在 HBV 血清学阴性南非 HIV 患者中的感染率以及单感染和合并感染的临床过程回顾性评估。

Prevalence of hepatitis B virus (HBV) co-infection in HBV serologically-negative South African HIV patients and retrospective evaluation of the clinical course of mono- and co-infection.

机构信息

Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Int J Infect Dis. 2012 Apr;16(4):e268-72. doi: 10.1016/j.ijid.2011.12.007. Epub 2012 Feb 3.

Abstract

OBJECTIVES

Hepatitis B virus (HBV) infection with undetectable hepatitis B surface antigen (HBsAg) has been reported in HIV patients, but the clinical significance is unknown. This study presents the prevalence of HBV DNA in HIV-positive patients negative for all HBV serological markers and a retrospective evaluation of the clinical course of mono- and co-infection.

METHODS

Of 502 HIV-positive patients, 222 tested negative for HBsAg, antibody to hepatitis B surface antigen (anti-HBs), and antibody to hepatitis B core antigen (anti-HBc). An in-house real-time PCR targeting the HBV S-region was used to quantify HBV DNA. HBV isolates were genotyped. Baseline demographic and clinical characteristics of HBV DNA-positive and HBV DNA-negative patients were described. Treatment outcomes of patients at 6, 12, and 24 months after initiation of antiretroviral therapy (ART) were summarized.

RESULTS

HBV DNA was detected in 5.4% (12/222) of serologically negative patients. Mean HBV viral load was 5359.2 IU/ml (standard deviation (SD) ±12 768.27). Eleven HBV isolates belonged to genotype A and one to genotype C. There were no significant differences in baseline characteristics or clinical course between the HBV DNA-positive and HBV DNA-negative groups.

CONCLUSIONS

We found 5.4% of the HBV serologically-negative HIV-positive patients had low levels of HBV DNA. There were no significant differences in clinical outcome between the mono- and co-infected groups.

摘要

目的

已有研究报道 HIV 患者中存在乙型肝炎病毒(HBV)感染且乙型肝炎表面抗原(HBsAg)检测不到的情况,但临床意义尚不清楚。本研究报告了所有乙型肝炎血清学标志物均阴性的 HIV 阳性患者中 HBV DNA 的流行情况,并对单感染和合并感染的临床病程进行了回顾性评估。

方法

在 502 例 HIV 阳性患者中,有 222 例 HBsAg、乙型肝炎表面抗体(抗-HBs)和乙型肝炎核心抗体(抗-HBc)检测均为阴性。采用针对 HBV S 区的内部实时 PCR 定量检测 HBV DNA。对 HBV 分离株进行基因分型。描述 HBV DNA 阳性和 HBV DNA 阴性患者的基线人口统计学和临床特征。总结了抗逆转录病毒治疗(ART)开始后 6、12 和 24 个月时患者的治疗结局。

结果

在血清学阴性的患者中,有 5.4%(12/222)检测到 HBV DNA。平均 HBV 病毒载量为 5359.2 IU/ml(标准差(SD)±12 768.27)。11 株 HBV 分离株属于基因型 A,1 株属于基因型 C。HBV DNA 阳性和 HBV DNA 阴性组的基线特征或临床病程无显著差异。

结论

我们发现 5.4%的乙型肝炎血清学阴性的 HIV 阳性患者存在低水平的 HBV DNA。单感染和合并感染组的临床结局无显著差异。

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