Lee Shinwon, Lee Sun Hee, Lee Su Jin, Kim Kye-Hyung, Lee Jeong Eun, Cho Heerim, Lee Seung Geun, Chung Joo Seop, Kwak Ihm Soo
Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Intern Med. 2016 Jul;31(4):772-8. doi: 10.3904/kjim.2015.353. Epub 2016 Apr 27.
BACKGROUND/AIMS: Increasing incidences of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-infected men who have sex were reported in the United States and Europe. However, few studies regarding the epidemiology of HCV infection in HIV-infected patients in Asian countries have been reported.
To determine the prevalence and incidence of HCV infection in HIV-infected patients, a retrospective cohort study was conducted. All HIV-infected patients who visited a tertiary care hospital in Korea from 2000 to 2013 were identified. Patients with ≥ 1 HCV antibody (Ab) test were included and observed until December 2014.
Among 996 HIV-infected patients, 790 patients (79%) had baseline HCV Ab tests and 41 (5.2%) were positive at baseline and four at follow-up. Experience of injecting drug use (IDU; adjusted odds ratio, 16.20; 95% confidence interval [CI], 1.56 to 167.89; p < 0.01) was significantly associated with prevalent HCV infection. Conversion to HCV Ab positivity was observed in four of 384 included patients, with an incidence rate of 2.22 (95% CI, 0.60 to 5.80)/1,000 person-years (PYs); 164.89 (95% CI, 34.00 to 481.88)/1,000 PYs in patients with IDU, and 1.40 (95% CI, 0.35 to 7.79)/1,000 PYs in men who have sex with men who denied IDU. There was no significant increase in incidence rate of HCV in HIV-infected patients from 2009 to 2014 (p = 0.119). Among 19 patients who were positive for HCV RNA, genotype 1b (73%) was the most common following 2a/2c (20%).
IDU was an independent risk factor for prevalent HCV infection. Prevalence of HCV infection was low and incidence of HCV infection was not significantly increased in HIV-infected patients in South Korea.
背景/目的:在美国和欧洲,有报告称感染人类免疫缺陷病毒(HIV)的男性性行为者中丙型肝炎病毒(HCV)感染的发病率不断上升。然而,关于亚洲国家HIV感染患者中HCV感染流行病学的研究报道较少。
为确定HIV感染患者中HCV感染的患病率和发病率,进行了一项回顾性队列研究。确定了2000年至2013年期间在韩国一家三级护理医院就诊的所有HIV感染患者。纳入进行了≥1次HCV抗体(Ab)检测的患者,并观察至2014年12月。
在996例HIV感染患者中,790例(79%)进行了基线HCV Ab检测,41例(5.2%)在基线时呈阳性,4例在随访时呈阳性。注射吸毒史(IDU;调整后的优势比,16.20;95%置信区间[CI],1.56至167.89;p<0.01)与HCV感染流行显著相关。在384例纳入患者中有4例转为HCV Ab阳性,发病率为2.22(95%CI,0.60至5.80)/1000人年(PYs);IDU患者为164.89(95%CI,34.00至481.88)/1000 PYs,否认IDU的男男性行为者为1.40(95%CI,0.35至7.79)/1000 PYs。2009年至2014年期间,HIV感染患者中HCV发病率无显著增加(p = 0.119)。在19例HCV RNA阳性患者中,1b基因型(73%)最常见,其次是2a/2c基因型(20%)。
IDU是HCV感染流行的独立危险因素。韩国HIV感染患者中HCV感染患病率较低,HCV感染发病率未显著增加。