Ndjoyi-Mbiguino Angélique, Kombe Kombe Arnaud John, Bivigou-Mboumba Berthold, Zoa-Assoumou Samira, Akombi Falone Larissa, Nzengui Nzengui Francis, M'boyis Kamdem Hervé, François-Souquière Sandrine
Laboratoire National de Référence IST/Sida, Département de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé, Université des Sciences de la Santé, Owendo, Gabon.
Unité Mixte de Recherches VIH et Maladies Infectieuses Associées (UMR VIH-MIA), Centre International de Recherches Médicales (CIRMF), Libreville, Gabon.
PLoS One. 2018 Jan 31;13(1):e0190529. doi: 10.1371/journal.pone.0190529. eCollection 2018.
Gabon is an endemic area for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and the risk of co-infection is high.
Between November 2015 and April 2016, we conducted retrospective study on HCV infection among people living with HIV/AIDS (PLHA). A total of 491 PLHA were included in this study and tested for the presence of HCV infection. HIV viral loads were obtained using the Generic HIV viral Load® assay and the CD4+ T cells count was performed using BD FACSCount™ CD4 reagents. HCV screening was performed using the MP Diagnostics HCV ELISA 4.0 kit. HCV genotypes were determined by sequence analysis of NS5B and Core regions. The Mann-Whitney test was used to compare the groups. Chi-2 test and Fisher's Exact Test were used to compare prevalence.
HCV seroprevalence was 2.9% (14/491), (95% confidence interval (CI):1.4-4.3%). The percentage of HCV viremic patients, defined by the detection of HCV RNA in plasma, was 57% (8/14), representing 1.6% of the total population. HCV seroprevalence and replicative infection were not statistically differ with gender. The percentage of co-infection increased with age. No correlation with CD4+ T cells count and HIV viral load level was registered in this study. Identified HCV strains were predominantly of genotype 4 (87.5%) including 4k, 4e, 4g, 4p, 4f and 4c subtypes. Only one strain belonged to genotype 2 (subtype 2q). Analysis of the NS5B region did not reveal the presence of resistance-associated substitutions for sofosbuvir.
A systematic screening of hepatitis C is therefore strongly recommended as well as genotyping of HCV strains in order to adapt treatments for the specific case of people living with HIV/AIDS in Central Africa.
加蓬是人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）的流行地区，合并感染的风险很高。
2015年11月至2016年4月，我们对艾滋病毒/艾滋病感染者（PLHA）中的丙型肝炎病毒感染进行了回顾性研究。本研究共纳入491名PLHA，并对其进行丙型肝炎病毒感染检测。使用通用HIV病毒载量检测法获得HIV病毒载量，并使用BD FACSCount™ CD4试剂进行CD4 + T细胞计数。使用MP诊断丙型肝炎病毒ELISA 4.0试剂盒进行丙型肝炎病毒筛查。通过对NS5B和核心区域的序列分析确定丙型肝炎病毒基因型。使用曼-惠特尼检验比较各组。使用卡方检验和费舍尔精确检验比较患病率。
丙型肝炎病毒血清阳性率为2.9%（14/491），（95%置信区间（CI）：1.4 - 4.3%）。通过检测血浆中的丙型肝炎病毒RNA定义的丙型肝炎病毒血症患者百分比为57%（8/14），占总人口的1.6%。丙型肝炎病毒血清阳性率和复制性感染在性别上无统计学差异。合并感染百分比随年龄增加。本研究中未发现与CD4 + T细胞计数和HIV病毒载量水平相关。鉴定出的丙型肝炎病毒株主要为4型（87.5%），包括4k、4e、4g、4p、4f和4c亚型。仅一株属于2型（2q亚型）。对NS5B区域的分析未发现索磷布韦耐药相关替代位点。
因此，强烈建议对丙型肝炎进行系统筛查以及对丙型肝炎病毒株进行基因分型，以便针对中非艾滋病毒/艾滋病感染者的具体情况调整治疗方案。
