National Infection Service, Public Health England, London, UK.
The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK.
HIV Med. 2018 Nov;19(10):708-715. doi: 10.1111/hiv.12662. Epub 2018 Jul 26.
In persons with hepatitis C virus (HCV) infection, HIV coinfection leads to faster progression to advanced liver disease. The aim of our study was to estimate diagnosed HIV prevalence among people with evidence of current HCV infection (polymerase chain reaction positive) and examine predictors of coinfection.
Adults (≥ 15 years old) with a current HCV infection reported to the Public Health England (PHE) sentinel surveillance of blood-borne viruses were linked to the PHE national HIV database using a deterministic methodology. Descriptive and multivariate analyses were conducted.
Between 2008 and 2014, 5.0% (999/20 088) of adults with a current HCV infection were diagnosed with HIV coinfection. The majority acquired HIV through sex between men (441; 64.9%), followed by injecting drug use (153; 22.5%) and heterosexual contact (84; 12.4%). Of persons who were coinfected, 65.5% had been diagnosed with HIV infection > 6 months before their HCV diagnosis, 41.4% of whom had a negative anti-HCV test between their HIV and HCV diagnoses. In a multivariable model among persons with current HCV infection, an HIV diagnosis was more likely among men [adjusted odds ratio (aOR) 3.29; 95% confidence interval (CI) 2.60-4.16] and persons of black ethnicity (aOR 3.19; 95% CI 1.36-7.46), and less likely among older adults (aOR 0.85 per 10-year increase; 95% CI 0.79-0.92) and persons of Asian ethnicity (aOR 0.59; 95% CI 0.41-0.86).
Our results indicate that the majority of diagnosed HIV and current HCV coinfections are among men who have sex with men. Safer sex campaigns should include awareness of transmission of HCV among MSM living with HIV.
在丙型肝炎病毒(HCV)感染者中,HIV 合并感染会导致更快地进展为晚期肝病。本研究的目的是估计当前 HCV 感染(聚合酶链反应阳性)人群中诊断出的 HIV 流行率,并研究合并感染的预测因素。
向英国公共卫生署(PHE)报告的当前 HCV 感染的成年人(≥15 岁)通过确定性方法与 PHE 国家 HIV 数据库相关联。进行描述性和多变量分析。
在 2008 年至 2014 年期间,5.0%(999/20088)的当前 HCV 感染成年人被诊断为 HIV 合并感染。大多数人通过男男性行为(441;64.9%),其次是注射吸毒(153;22.5%)和异性接触(84;12.4%)获得 HIV。在合并感染的人群中,65.5%在 HCV 诊断前 6 个月以上被诊断出 HIV 感染,其中 41.4%在 HIV 和 HCV 诊断之间进行了阴性抗 HCV 检测。在当前 HCV 感染人群的多变量模型中,男性(调整后的优势比[aOR]3.29;95%置信区间[CI]2.60-4.16)和黑人(aOR 3.19;95% CI 1.36-7.46)感染 HIV 的可能性更大,而年龄较大的成年人(aOR 每增加 10 岁减少 0.85;95% CI 0.79-0.92)和亚洲人(aOR 0.59;95% CI 0.41-0.86)感染 HIV 的可能性更小。
我们的结果表明,大多数诊断出的 HIV 和当前 HCV 合并感染发生在男男性行为者中。针对 HIV 感染者的安全性行为运动应包括对 MSM 中 HCV 传播的认识。