Chandra Naval, Joshi Nayana, Raju Y S N, Kumar Ajit, Teja Vijay D
Department of General Medicine, Nizam's Institute of Medical Sciences, Hyderabad, India.
Indian J Med Res. 2013 Dec;138(6):950-4.
BACKGROUND & OBJECTIVES: Co-infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in human immunodeficiency virus (HIV) infected individuals results in increased hepatic complications. We undertook this study to evaluate the presence of HBV and HCV in HIV infected individuals attending a tertiary care centre in southern India.
A total of 120 cases with HIV infection and 120 healthy adult control subjects were included in the study. Samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies by enzyme linked immunosorbent assay (ELISA) method. HBsAg and anti-HCV positive serum samples were further tested for the presence of hepatitis B e antigen (HBeAg), anti-HBe antibodies, HBV-DNA and HCV-RNA.
The most common mode of transmission was sexual promiscuity (79%), followed by spouse positivity (15%) and history of blood transfusion (6%). HBsAg and anti-HCV were positive in 18 (15%) and 10 (8.3%) HIV infected patients; the corresponding figures in healthy controls being 2 (1.6%) 0 (0%) (P<0.0001). Among HIV infected patients, presence of HBeAg and anti-HBe antibodies was seen in 33.3 and 55.5 per cent, respectively; both HBeAg and anti-HBe antibodies were negative in 11.1 per cent. HBV DNA and HCV RNA were positive in 10 of 18 and in all anti-HCV positive samples. Triple infection with HBV, HCV and HIV was seen in three patients. CD4+ T-lymphocyte count less than 200/μl was seen in 22 of 28 co-infected cases.
INTERPRETATION & CONCLUSIONS: The findings of our study showed presence of HBV (15%) and HCV (8.3%) co-infections in HIV positive patients which was higher than that seen in HIV negative controls. Co-infection with HBV and HCV is a common problem in HIV infected patients in India. Hence, all HIV patients need to be routinely tested for markers of HBV and HCV infection.
人类免疫缺陷病毒（HIV）感染者合并感染乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）会导致肝脏并发症增加。我们开展本研究以评估在印度南部一家三级医疗中心就诊的HIV感染者中HBV和HCV的感染情况。
本研究共纳入120例HIV感染病例和120名健康成年对照者。采用酶联免疫吸附测定（ELISA）法检测样本中的乙型肝炎表面抗原（HBsAg）和抗-HCV抗体。对HBsAg和抗-HCV阳性血清样本进一步检测乙型肝炎e抗原（HBeAg）、抗-HBe抗体、HBV-DNA和HCV-RNA的存在情况。
最常见的传播方式是性乱交（79%），其次是配偶阳性（15%）和输血史（6%）。18例（15%）HIV感染患者的HBsAg和10例（8.3%）的抗-HCV呈阳性；健康对照者中的相应数字分别为2例（1.6%）和0例（0%）（P<0.0001）。在HIV感染患者中，HBeAg和抗-HBe抗体的存在率分别为33.3%和55.5%；11.1%的患者HBeAg和抗-HBe抗体均为阴性。18例中的10例HBV DNA和所有抗-HCV阳性样本中的HCV RNA呈阳性。3例患者出现HBV、HCV和HIV三重感染。28例合并感染病例中有22例的CD4+T淋巴细胞计数低于200/μl。
我们的研究结果显示，HIV阳性患者中存在HBV（15%）和HCV（8.3%）合并感染，高于HIV阴性对照者。在印度，HIV感染患者合并感染HBV和HCV是一个常见问题。因此，所有HIV患者都需要常规检测HBV和HCV感染标志物。
