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静脉注射吸毒——HIV/HCV合并感染患者中丙型肝炎病毒3型和4型感染的独立预测因素。

Intravenous drug use - an independent predictor for HCV genotypes 3 and 4 infection among HIV/HCV co-infected patients.

作者信息

Salemovic Dubravka, Pesic-Pavlovic Ivana, Jevtovic Djordje, Bojovic Ksenija, Ranin Jovan, Brmbolic Branko, Stanojevic Maja

机构信息

Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia.

Virology Department, Clinical Center Serbia, NRL HIV/AIDS, Belgrade, Serbia.

出版信息

Arch Med Sci. 2017 Apr 1;13(3):652-658. doi: 10.5114/aoms.2017.66022. Epub 2017 Apr 20.

Abstract

INTRODUCTION

About one quarter of human immunodeficiency virus (HIV) infected persons in Serbia have also been found to be hepatitis C virus (HCV) co-infected. In the general population, HCV genotype 1 has been shown to be the most prevalent one. Here, we present the first study on the distribution of HCV genotypes among HIV/HCV co-infected patients in Serbia, in relation to epidemiological and clinical features.

MATERIAL AND METHODS

The study included HIV/HCV co-infected and a group of HCV mono-infected patients in the period 1998-2012, with collection of epidemiological, clinical, and behavioral data using a standardized questionnaire. The HCV genotyping to the level of pure genotype was performed by reverse hybridization.

RESULTS

Intravenous drug use (IDU) was found to be significantly more prevalent among the co-infected patients ( < 0.01). HCV genotype 1 was detected in 87% of patients with mono-infection, compared to 46.3% of patients with co-infection ( < 0.01); genotypes 3 and 4 were significantly more common among co-infected patients (6% and 5%, vs. 27% and 25%, respectively). Multivariate logistic regression confirmed IDU, infection with non-1 HCV genotype and HCV viral load over 5 log to be predictors of HIV co-infection.

CONCLUSIONS

The HCV genotypes 3 and 4 were found to be significantly more prevalent among HIV/HCV co-infected patients in Serbia, compared to HCV mono-infected patients, but also more prevalent compared to the European HIV/HCV co-infected cohort. History of IDU represents an independent predictor of HCV genotypes 3 and 4 infection, with important implications for treatment.

摘要

引言

在塞尔维亚,约四分之一的人类免疫缺陷病毒(HIV)感染者同时被发现感染了丙型肝炎病毒(HCV)。在普通人群中,HCV 基因型 1 已被证明是最普遍的一种。在此,我们展示了关于塞尔维亚 HIV/HCV 合并感染患者中 HCV 基因型分布的首项研究,以及其与流行病学和临床特征的关系。

材料与方法

该研究纳入了 1998 年至 2012 年期间 HIV/HCV 合并感染患者以及一组 HCV 单一感染患者,通过标准化问卷收集流行病学、临床和行为学数据。采用反向杂交法进行 HCV 基因分型至纯基因型水平。

结果

发现静脉注射吸毒(IDU)在合并感染患者中显著更为普遍(<0.01)。在单一感染患者中,87%检测出 HCV 基因型 1,而合并感染患者中这一比例为 46.3%(<0.01);基因型 3 和 4 在合并感染患者中显著更为常见(分别为 6%和 5%,而单一感染患者中分别为 27%和 25%)。多因素逻辑回归证实 IDU、非 1 型 HCV 基因型感染以及 HCV 病毒载量超过 5 log 是 HIV 合并感染的预测因素。

结论

与 HCV 单一感染患者相比,在塞尔维亚 HIV/HCV 合并感染患者中,HCV 基因型 3 和 4 显著更为普遍,而且与欧洲 HIV/HCV 合并感染队列相比也更为普遍。IDU 史是 HCV 基因型 3 和 4 感染的独立预测因素,对治疗具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545c/5420631/fef0dc3a3de0/AMS-13-29502-g001.jpg

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