Stenkvist Jenny, Weiland Ola, Sönnerborg Anders, Blaxhult Anders, Falconer Karolin
From the Unit of Infectious Diseases, Department of Medicine , Huddinge , Karolinska Institutet , Sweden.
Scand J Infect Dis. 2014 Sep;46(9):624-32. doi: 10.3109/00365548.2014.921932. Epub 2014 Jul 1.
HCV co-infection is a leading cause of death in HIV-positive patients. Despite a strong indication for the treatment of HCV, treatment uptake is generally lower than in HCV mono-infected patients. The aim of this study was to determine the HCV treatment uptake and to define factors associated with initiation or deferral of HCV treatment in Swedish HIV/HCV co-infected patients.
All 5315 adult HIV-positive patients in Sweden are included in the InfCare HIV database. Demographic, virologic, and treatment data for 652 HIV/HCV co-infected patients were extracted from this database in September 2010. Factors associated with initiation of interferon-based HCV treatment were analysed. Patient- and physician-reported reasons for deferring HCV treatment were investigated in a subgroup.
The anti-HCV prevalence was 14% and the chronic HCV infection rate 11%. In total, 25% of HIV/HCV co-infected patients had initiated HCV treatment. HCV genotype 2 or 3, HIV transmission route other than intravenous drug use, and ongoing HIV treatment were factors associated with a higher HCV treatment rate. The main reason for not having initiated HCV treatment was intravenous drug use or alcohol abuse.
The 14% prevalence of anti-HCV noted in Swedish HIV-infected patients was low by international comparisons. The 25% HCV treatment rate noted in our HIV/HCV co-infected patients was high and of the same magnitude as that published for HCV mono-infected patients in Sweden. People who inject drugs had the lowest HCV treatment uptake.
丙型肝炎病毒（HCV）合并感染是HIV阳性患者死亡的主要原因。尽管有强烈的HCV治疗指征，但治疗的接受率普遍低于HCV单一感染患者。本研究的目的是确定瑞典HIV/HCV合并感染患者的HCV治疗接受情况，并确定与HCV治疗开始或推迟相关的因素。
瑞典所有5315名成年HIV阳性患者均纳入InfCare HIV数据库。2010年9月从该数据库中提取了652名HIV/HCV合并感染患者的人口统计学、病毒学和治疗数据。分析了与基于干扰素的HCV治疗开始相关的因素。在一个亚组中调查了患者和医生报告的推迟HCV治疗的原因。
抗HCV患病率为14%，慢性HCV感染率为11%。总共有25%的HIV/HCV合并感染患者开始了HCV治疗。HCV基因2型或3型、非静脉吸毒的HIV传播途径以及正在进行的HIV治疗是与较高HCV治疗率相关的因素。未开始HCV治疗的主要原因是静脉吸毒或酗酒。
与国际比较，瑞典HIV感染患者中14%的抗HCV患病率较低。我们的HIV/HCV合并感染患者中25%的HCV治疗率较高，与瑞典公布的HCV单一感染患者的治疗率相当。注射毒品者的HCV治疗接受率最低。
