HIV感染成人中的隐匿性HBV感染及HBV核酸扩增检测联合检测的评估
Occult HBV infection in HIV-infected adults and evaluation of pooled NAT for HBV.
作者信息
Dinesha T R, Boobalan J, Sivamalar S, Subashini D, Solomon S S, Murugavel K G, Balakrishnan P, Smith D M, Saravanan S
机构信息
Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Viral Hepat. 2018 Jun;25(6):718-723. doi: 10.1111/jvh.12858. Epub 2018 Feb 19.
The study aimed to determine the prevalence of occult hepatitis B virus infection among HIV-infected persons and to evaluate the use of a pooling strategy to detect occult HBV infection in the setting of HIV infection. Five hundred and two HIV-positive individuals were tested for HBV, occult HBV and hepatitis C and D with serologic and nucleic acid testing (NAT). We also evaluated a pooled NAT strategy for screening occult HBV infection among the HIV-positive individuals. The prevalence of HBV infection among HIV-positive individuals was 32 (6.4%), and occult HBV prevalence was 10%. The pooling HBV NAT had a sensitivity of 66.7% and specificity of 100%, compared to HBV DNA NAT of individual samples. In conclusion, this study found a high prevalence of occult HBV infection among our HIV-infected population. We also demonstrated that pooled HBV NAT is highly specific, moderately sensitive and cost-effective. As conventional HBV viral load assays are expensive in resource-limited settings such as India, pooled HBV DNA NAT might be a good way for detecting occult HBV infection and will reduce HBV-associated complications.
该研究旨在确定艾滋病毒感染者中隐匿性乙型肝炎病毒感染的患病率，并评估在艾滋病毒感染情况下采用混合检测策略来检测隐匿性乙肝病毒感染的效果。对502名艾滋病毒阳性个体进行了乙肝、隐匿性乙肝以及丙肝和丁肝的血清学和核酸检测（NAT）。我们还评估了一种混合NAT策略，用于在艾滋病毒阳性个体中筛查隐匿性乙肝病毒感染。艾滋病毒阳性个体中乙肝感染的患病率为32例（6.4%），隐匿性乙肝的患病率为10%。与单个样本的乙肝DNA NAT相比，混合乙肝NAT的灵敏度为66.7%，特异性为100%。总之，本研究发现我们的艾滋病毒感染人群中隐匿性乙肝病毒感染的患病率很高。我们还证明，混合乙肝NAT具有高度特异性、中度敏感性且具有成本效益。由于在印度等资源有限的环境中，传统的乙肝病毒载量检测方法成本高昂，混合乙肝DNA NAT可能是检测隐匿性乙肝病毒感染的一种好方法，并将减少与乙肝相关的并发症。
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