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丙型肝炎病毒在感染HIV的受试者与其主要异性伴侣之间的性传播。

Sexual Transmission of Hepatitis C Virus Between HIV Infected Subjects and Their Main Heterosexual Partners.

作者信息

Alipour Abbas, Rezaianzadeh Abbas, Hasanzadeh Jafar, Rajaeefard Abdorreza, Davarpanah Mohammad Ali

机构信息

Community Medicine Department, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.

Epidemiology Department, School of Health and Nutrition, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran.

出版信息

Hepat Mon. 2013 Nov 5;13(11):e13593. doi: 10.5812/hepatmon.13593. eCollection 2013.

Abstract

BACKGROUND

Overall, 60-70% of the hepatitis c virus (HCV) transmission routes is parenteral, and in 30-40% of the cases is unknown (e.g. sexual route). Knowing these routes in HIV infected dyads is very important due to clinical and methodological reasons.

OBJECTIVES

The present study aimed to identify and quantitatively investigate HIV-infected individuals and their main heterosexual partners regarding the risk factors of HCV transmission.

PATIENTS AND METHODS

One hundred sixty eight of 984 couples were chosen through random generated numbers using a computer program from behavioral consultation center in Shiraz, Iran. We used actor partner independent model (APIM) and multilevel analysis to assess multiple risk factors for HCV, while partitioning the source of risk at the individual and couple levels.

RESULTS

Age of the index samples was 38.71 ± 7 years, and 33.2 ± 6.3 for their main heterosexual partners; the mean duration of sexual relationship for couples was 11.9 (median = 8.5) years. Multivariate analysis showed that actor risk factor of intravenous drug using (IDU) (AOR= 13.03; 95% CI: 3.9- 43.82) and actor cofactors of HIV positivity (AOR = 7.1; 95% CI: 1.37- 36.97), razor sharing (AOR = 4.81; 95% CI: 1.84- 12.55), sex (AOR = 8.83; 95% CI: 3.16- 24.87), and condom use in sexual activity with main partner (AOR = 0.15; 95% CI: 0.02- 0.44) were associated with actor HCV positivity.

CONCLUSIONS

Health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals, and should recommend control/preventive measures for HCV sexual transmission.

摘要

背景

总体而言,丙型肝炎病毒(HCV)60%-70%的传播途径为非肠道途径,30%-40%的传播途径不明(如性传播途径)。出于临床和方法学原因,了解HIV感染伴侣中的这些传播途径非常重要。

目的

本研究旨在识别并定量调查HIV感染个体及其主要异性伴侣的HCV传播风险因素。

患者与方法

通过计算机程序从伊朗设拉子行为咨询中心随机生成的数字中选取984对伴侣中的168对。我们使用行为者-伴侣独立模型(APIM)和多水平分析来评估HCV的多种风险因素,同时在个体和伴侣层面划分风险来源。

结果

索引样本的年龄为38.71±7岁,其主要异性伴侣的年龄为33.2±6.3岁;伴侣间性关系的平均持续时间为11.9年(中位数=8.5年)。多变量分析显示,静脉注射吸毒(IDU)的行为者风险因素(调整后比值比[AOR]=13.03;95%置信区间[CI]:3.9-43.82)、HIV阳性的行为者协同因素(AOR=7.1;95%CI:1.37-36.97)、共用剃须刀(AOR=4.81;95%CI:1.84-12.55)、性行为(AOR=8.83;95%CI:3.16-24.87)以及与主要伴侣进行性活动时使用避孕套(AOR=0.15;95%CI:0.02-0.44)与行为者HCV阳性相关。

结论

医疗保健提供者需要特别关注HIV感染个体中HCV的性传播,并应推荐针对HCV性传播的控制/预防措施。

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