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中国云南省丙型肝炎病毒单一感染及HCV/HIV合并感染个体的血浆丙型肝炎病毒载量

Plasma Hepatitis C Virus Viral Load Among Hepatitis C Virus Mono-Infected and HCV/HIV Co-Infected Individuals in Yunnan Province,China.

作者信息

Liu Xing, He Na, Fu Zhuohua, Duan Song, Gao Meiyang, Zhang Zuo Feng

机构信息

Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China ; Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA.

出版信息

Hepat Mon. 2012 Jul;12(7):453-9. doi: 10.5812/hepatmon.6160. Epub 2012 Jul 30.

Abstract

BACKGROUND

Hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection has become a serious public health problem especially in high risk groups such as injection drug users in China. However, the impact of HIV infection and antiretroviral therapy (ART) on HCV viral load which is usually regarded as a predictor of liver disease progress had not been well studied in this country.

OBJECTIVES

To explore correlations of HIV co-infection and ART with plasma HCV load among HCV-infected patients in an ethnic minority area in Yunnan Province, China.

PATIENTS AND METHODS

HCV/HIV co-infected patients and HCV mono-infected controls were examined and compared for plasma HCV RNA and related risk factors.

RESULTS

A total of 145 HCV/HIV co-infected patients and 25 HCV mono-infected controls were studied. The majority of the participants were male, belonged to an ethnic minority and were younger than 45 years old. HCV viral suppression rate with undetectable plasma HCV viral load was 28.3% in the HCV/HIV co-infected patients, 36% among HCV mono-infected controls and 29.4% overall. ART-prescribed HCV/HIV co-infected patients had significantly higher HCV viral loads (IQR: (3.80-6.44)*log(10) copies ml-1) than those naïve to ART (IQR: (undetectable-6.41)*log(10) copies ml-1) and HCV mono-infected patients (IQR: (undetectable-5.44)*log(10) copies ml-1). Men, from the Dai minority and those with more than six years education, were also shown to have a higher plasma HCV viral load,according to multiple logistic regression analysis.

CONCLUSIONS

ART potentially increases the plasma HCV viral load among HCV/HIV coinfected patients in an ethnic minority area in China. Future large scale prospective cohort studies are needed to address the controversy associated between HIV co-infection and the natural history of HCV.

摘要

背景

丙型肝炎病毒(HCV)/人类免疫缺陷病毒(HIV)合并感染已成为一个严重的公共卫生问题,在中国,尤其是在注射吸毒者等高风险人群中。然而,在该国,HIV感染和抗逆转录病毒疗法(ART)对通常被视为肝病进展预测指标的HCV病毒载量的影响尚未得到充分研究。

目的

探讨中国云南省一个少数民族地区HCV感染患者中HIV合并感染及ART与血浆HCV载量的相关性。

患者与方法

对HCV/HIV合并感染患者和HCV单一感染对照者进行检查,并比较其血浆HCV RNA及相关危险因素。

结果

共研究了145例HCV/HIV合并感染患者和25例HCV单一感染对照者。大多数参与者为男性,属于少数民族,年龄小于45岁。血浆HCV病毒载量不可检测的HCV病毒抑制率在HCV/HIV合并感染患者中为28.3%,在HCV单一感染对照者中为36%,总体为29.4%。接受ART治疗的HCV/HIV合并感染患者的HCV病毒载量(四分位距:(3.80 - 6.44)*log(10)拷贝/毫升)显著高于未接受ART治疗的患者(四分位距:(不可检测 - 6.41)*log(10)拷贝/毫升)和HCV单一感染患者(四分位距:(不可检测 - 5.44)*log(10)拷贝/毫升)。根据多因素逻辑回归分析,男性、傣族人群以及受教育年限超过六年者的血浆HCV病毒载量也较高。

结论

在中国一个少数民族地区,ART可能会增加HCV/HIV合并感染患者的血浆HCV病毒载量。未来需要进行大规模前瞻性队列研究,以解决HIV合并感染与HCV自然史之间相关的争议。

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