Bivigou-Mboumba B, Rouet F, Mouinga-Ondeme A, Deleplancque L, Sica J, Ndjoyi-Mbiguino A, Njouom R, François-Souquière S
Centre international de recherches médicales de Franceville, BP 769 Franceville, Gabon.
Ministère de la Santé, Franceville, Gabon.
Med Sante Trop. 2017 Aug 1;27(3):274-280. doi: 10.1684/mst.2017.0698.
Access to antiretrovirals has increased the life expectancy of patients living with HIV. However, HIV-viral hepatitis coinfections in countries endemic for these infections make management more difficult. To determine the extent of these coinfections in Gabon, we investigated markers of hepatitis B, C, and E viruses in 762 adults infected with HIV-1 by ELISA. We used real-time PCR to quantify plasma HBV DNA (HBV VL) and amplified HCV and HEV RNA by nested RT-PCR and PCR.The seroprevalence of chronic hepatitis B infection was 9.3 %. Among patients with isolated HBcAc profiles, the prevalence of occult hepatitis B infection was 26.7 %, for a real prevalence (detectable CV-HBV) of 17.3 % of the total population. HCV seroprevalence was 8.8 %. Of the 67 HIV-positive patients, 76.1 % had replicative profiles (detectable HCV RNA), that is, 6.7 % of the total population. For hepatitis E, seroprevalence was 3.5 %. No case of chronic HEV infection was found. In conclusion, this study highlights a high rate of HIV-Hepatitis B, C and E coinfections in Gabon. In addition, we show the interest of looking for chronic infections (replicative profiles) in HIV-infected patients in Gabon. The establishment of technical platforms for this type of research, accessible to middle-income countries, is necessary.
获得抗逆转录病毒药物提高了艾滋病毒感染者的预期寿命。然而，在这些感染的流行国家，艾滋病毒与病毒性肝炎合并感染使治疗变得更加困难。为了确定加蓬这些合并感染的程度，我们通过酶联免疫吸附测定法（ELISA）对762名感染HIV-1的成年人进行了乙型、丙型和戊型肝炎病毒标志物的调查。我们使用实时聚合酶链反应（PCR）对血浆乙肝病毒DNA（HBV VL）进行定量，并通过巢式逆转录PCR和PCR扩增丙肝病毒（HCV）和戊肝病毒（HEV）RNA。慢性乙型肝炎感染的血清流行率为9.3%。在仅HBcAc检测结果呈阳性的患者中，隐匿性乙型肝炎感染的患病率为26.7%，实际患病率（可检测到的隐匿性乙肝病毒）占总人口的17.3%。丙肝病毒血清流行率为8.8%。在67名艾滋病毒阳性患者中，76.1%有病毒复制情况（可检测到HCV RNA），即占总人口的6.7%。对于戊型肝炎，血清流行率为3.5%。未发现慢性戊型肝炎感染病例。总之，本研究突出了加蓬艾滋病毒与乙型、丙型和戊型肝炎合并感染的高发生率。此外，我们表明了在加蓬的艾滋病毒感染者中寻找慢性感染（病毒复制情况）的意义。为这类研究建立可供中等收入国家使用的技术平台是必要的。
