Chen Marcelo, Wong Wing-Wai, Law Matthew G, Kiertiburanakul Sasisopin, Yunihastuti Evy, Merati Tuti Parwati, Lim Poh Lian, Chaiwarith Romanee, Phanuphak Praphan, Lee Man Po, Kumarasamy Nagalingeswaran, Saphonn Vonthanak, Ditangco Rossana, Sim Benedict L H, Nguyen Kinh Van, Pujari Sanjay, Kamarulzaman Adeeba, Zhang Fujie, Pham Thuy Thanh, Choi Jun Yong, Oka Shinichi, Kantipong Pacharee, Mustafa Mahiran, Ratanasuwan Winai, Durier Nicolas, Chen Yi-Ming Arthur
Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.
PLoS One. 2016 Mar 2;11(3):e0150512. doi: 10.1371/journal.pone.0150512. eCollection 2016.
We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region.
Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test.
A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive.
In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.
我们评估了乙型肝炎（HBV）或丙型肝炎（HCV）合并感染对纳入亚太地区多中心HIV感染患者队列——亚太地区HIV观察数据库（TAHOD）的HIV感染患者抗逆转录病毒治疗（ART）结局的影响。
在TAHOD入组时检测乙肝表面抗原（Ag）或丙肝抗体（Ab）呈阳性的患者被视为合并HBV或HCV感染。通过逻辑回归模型评估与HBV和/或HCV合并感染相关的因素。还确定了与ART后HIV免疫反应（6个月后CD4变化）和病毒学反应（12个月后HIV RNA<400拷贝/ml）相关的因素。通过Kaplan-Meier方法和对数秩检验评估生存率。
截至2012年12月，共招募了7455名受试者。在接受检测的患者中，591/5656（10.4%）乙肝表面抗原呈阳性，794/5215（15.2%）丙肝抗体呈阳性，88/4966（1.8%）两种标志物均呈阳性。在多变量分析中，HCV合并感染、年龄、HIV感染途径、基线CD4计数、基线HIV RNA和HIV-1亚型与免疫恢复相关。年龄、HIV感染途径、基线CD4计数、基线HIV RNA、ART方案、既往ART和HIV-1亚型，但不是HBV或HCV合并感染，影响HIV RNA抑制。影响死亡率的危险因素包括HCV合并感染、年龄、疾病控制中心（CDC）分期、基线CD4计数、基线HIV RNA和既往单一/双重ART。HBV和HCV均呈阳性的受试者生存时间最短。
在这个亚洲HIV感染患者队列中，HCV合并感染而非HBV合并感染与ART后较低的CD4细胞恢复及死亡率增加相关。
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