Zhou Kali, Hu Fengyu, Wang Charles, Xu Min, Lan Yun, Morano Jamie P, Lemon Stanley M, Tucker Joseph D, Cai Weiping
Guangzhou Eighth People's Hospital, Guangzhou, China.
UNC-Project - China, Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA.
BMC Infect Dis. 2015 Sep 30;15:401. doi: 10.1186/s12879-015-1135-1.
End-stage liver disease and hepatocellular carcinoma due to hepatitis C virus (HCV) co-infection are increasingly common causes of death among HIV-infected individuals. However, there are few clinical investigations of HIV/HCV co-infected individuals from low and middle-income nations. Here, we compare the epidemiology of HCV-infected and HIV/HCV co-infected individuals in Southern China and examine hepatic fibrosis scores in co-infected individuals.
We conducted a retrospective cross-sectional study of treatment-naïve HIV/HCV co-infected and HCV mono-infected subjects. Bivariate and multivariate models were used to examine the association between demographics and HCV genotype. Among co-infected individuals, we also studied the relationship between fibrosis scores derived from non-invasive studies and HCV genotype.
Data were collected from 175 HCV-infected individuals, including 89 (51 %) HIV/HCV co-infected individuals. HIV/HCV co-infection was correlated with intravenous drug use (AOR 46.25, p < 0.001) and not completing high school (AOR 17.39, p < 0.001) in a multivariate model. HIV/HCV co-infected individuals were more likely to be infected with HCV genotype 6a (p < 0.0001) or 3a (p < 0.023), whereas increased fibrosis (FIB-4 score) was associated with HCV genotype 3a infection (β 2.18, p < 0.001).
Our results suggest that intravenous drug use is driving HIV/HCV co-infection in Southern China. While additional studies are needed, HCV genotype 6a is more common and genotype 3a appears to be associated with more severe hepatic fibrosis in co-infected individuals.
Future HIV/HCV co-infection research in China should focus on at risk populations, HCV testing uptake, and genotype-specific treatment.
丙型肝炎病毒（HCV）合并感染所致的终末期肝病和肝细胞癌在HIV感染者中日益成为常见的死亡原因。然而，来自低收入和中等收入国家的HIV/HCV合并感染个体的临床研究较少。在此，我们比较了中国南方HCV感染个体和HIV/HCV合并感染个体的流行病学情况，并检测了合并感染个体的肝纤维化评分。
我们对未经治疗的HIV/HCV合并感染和HCV单感染受试者进行了一项回顾性横断面研究。采用双变量和多变量模型检测人口统计学特征与HCV基因型之间的关联。在合并感染个体中，我们还研究了来自非侵入性研究的纤维化评分与HCV基因型之间的关系。
共收集了175例HCV感染个体的数据，其中89例（51%）为HIV/HCV合并感染个体。在多变量模型中，HIV/HCV合并感染与静脉吸毒（调整后比值比[AOR]46.25，p<0.001）和未完成高中学业（AOR 17.39，p<0.001）相关。HIV/HCV合并感染个体更易感染HCV 6a基因型（p<0.0001）或3a基因型（p<0.023），而肝纤维化加重（FIB-4评分）与HCV 3a基因型感染相关（β2.18，p<0.001）。
我们的结果表明，静脉吸毒在中国南方导致了HIV/HCV合并感染。虽然还需要更多研究，但HCV 6a基因型更为常见，而3a基因型似乎与合并感染个体更严重的肝纤维化相关。
中国未来关于HIV/HCV合并感染的研究应关注高危人群、HCV检测接受情况以及基因型特异性治疗。
