Hsieh Meng-Hsuan, Hsieh Ming-Yen, Huang Chung-Feng, Yeh Ming-Lun, Wang Shu-Chi, Yang Jeng-Fu, Chang Ko, Lin Wei-Ru, Lin Chun-Yu, Chen Tun-Chieh, Huang Jee-Fu, Dai Chia-Yen, Tsai Jih-Jin, Chuang Wan-Long, Yu Ming-Lung
Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Kaohsiung J Med Sci. 2016 Feb;32(2):96-102. doi: 10.1016/j.kjms.2016.01.008. Epub 2016 Feb 20.
In Taiwan, the number of new cases of human immunodeficiency virus (HIV) infection via drug injection has been increasing since 2003. Due to HIV and hepatitis B virus (HBV) having similar transmission routes, HBV and HIV infections among injecting drug users (IDUs) has become an important public health issue. The aim of this study was explore the prevalence of HBV infection among IDUs with and without HIV infection, and examine whether HIV infection is associated with HBV infection among IDUs in Southern Taiwan. We enrolled 566 IDUs, including 87 anti-HBV positive IDUs and 479 anti-HBV negative IDUs, and also analyzed the results of liver function tests, HBV DNA, anti-HIV, HIV RNA, and CD4 cell count. The results showed that the prevalence of HBV infection among IDUs was 15.4%. The prevalence of hepatitis B surface antigen (HBsAg) was higher among individuals born before 1985 (15.9% vs. 4.0%), but this was not significant. Anti-HIV seropositivity was related to HBsAg seropositivity [odds ratio (OR) = 2.47, 95% confidence interval = 1.26-4.82, p = 0.008). Anti-HCV and anti-HIV were risk factors for abnormal alanine aminotransferase (ALT; OR = 2.11, 95% confidence interval = 1.005-4.42, p = 0.048 and OR = 1.47, 95% confidence interval = 1.02-2.10, p = 0.04, respectively), and HBsAg was not a factor related to abnormal ALT. In conclusion, the prevalence of HBV infection was similar in the general population and in IDUs, and due to anti-HIV seropositivity being significantly related to HBsAg seropositivity, HBV infection among IDUs is still important. We suggest that for IDUs, HBsAg should be monitored closely.
在台湾，自2003年以来，通过注射毒品感染人类免疫缺陷病毒（HIV）的新病例数量一直在增加。由于HIV和乙型肝炎病毒（HBV）具有相似的传播途径，注射吸毒者（IDUs）中的HBV和HIV感染已成为一个重要的公共卫生问题。本研究的目的是探讨有无HIV感染的注射吸毒者中HBV感染的患病率，并检验台湾南部注射吸毒者中HIV感染是否与HBV感染相关。我们招募了566名注射吸毒者，包括87名抗HBV阳性的注射吸毒者和479名抗HBV阴性的注射吸毒者，并分析了肝功能检查、HBV DNA、抗HIV、HIV RNA和CD4细胞计数的结果。结果显示，注射吸毒者中HBV感染的患病率为15.4%。1985年以前出生的个体中乙型肝炎表面抗原（HBsAg）的患病率较高（15.9%对4.0%），但差异无统计学意义。抗HIV血清阳性与HBsAg血清阳性相关[比值比（OR）=2.47，95%置信区间=1.26 - 4.82，p = 0.008]。抗HCV和抗HIV是丙氨酸氨基转移酶（ALT）异常的危险因素[OR分别为2.11，95%置信区间=1.005 - 4.42，p = 0.048和OR = 1.47，95%置信区间=1.02 - 2.10，p = 0.04]，而HBsAg不是与ALT异常相关的因素。总之，普通人群和注射吸毒者中HBV感染的患病率相似，并且由于抗HIV血清阳性与HBsAg血清阳性显著相关，注射吸毒者中的HBV感染仍然很重要。我们建议对注射吸毒者应密切监测HBsAg。
