Hallager Sofie, Lundh Andreas, Ladelund Steen, Gerstoft Jan, Laursen Alex Lund, Clausen Mette Rye, Balslev Ulla, Weis Nina
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
Centre for Evidence-Based Medicine Odense (CEBMO) and Odense Patient Data Exploratory Network (OPEN), Odense University Hospital, Denmark.
Open Forum Infect Dis. 2018 Nov 21;5(12):ofy310. doi: 10.1093/ofid/ofy310. eCollection 2018 Dec.
Early identification of patients with chronic viral hepatitis coinfected with human immunodeficiency virus (HIV) is essential for optimal care. The objectives of this study were to estimate the prevalence of HIV coinfection among patients newly diagnosed with chronic viral hepatitis, HIV testing prevalence, and identify factors associated with coinfection.
Patients with chronic viral hepatitis newly enrolled in The Danish Database for Hepatitis B and C between 2002 and 2015 were identified. The HIV coinfection prevalence was calculated, and risk factors associated with HIV coinfection were estimated by logistic regression.
In total, 8490 patients were included: 3091 had chronic hepatitis B (CHB), 5305 had chronic hepatitis C (CHC), and 94 had CHB and CHC. The prevalence of HIV coinfection was 4.4% (95% confidence interval [CI], 4.0-4.9) and was higher among CHC and CHB-CHC patients than CHB patients with a prevalence of 5.3% (95% CI, 4.7-5.9), 6.4% (95% CI, 2.4-13.4), and 2.9 (95% CI, 2.3-3.5), respectively ( < .0001). The HIV testing prevalence increased from 65% to 88% between 2002 and 2014 concurrently with a decrease in the HIV coinfection prevalence from 7.8% (95% CI, 5.5-10.7) to 1.6% (95% CI, 0.7-3.2). Age 35-50 years, male sex, and sexual route of viral hepatitis transmission were associated with HIV coinfection with odds ratios of 4.42 (95% CI, 1.40-13.94), 2.21 (95% CI, 1.74-2.81), and 8.81 (95% CI, 6.30-12.33), respectively.
The prevalence of HIV coinfection among patients with newly diagnosed chronic viral hepatitis decreased concurrently with an increase in HIV testing prevalence.
早期识别合并感染人类免疫缺陷病毒(HIV)的慢性病毒性肝炎患者对于优化治疗至关重要。本研究的目的是估计新诊断的慢性病毒性肝炎患者中HIV合并感染的患病率、HIV检测率,并确定与合并感染相关的因素。
确定2002年至2015年间新纳入丹麦乙型和丙型肝炎数据库的慢性病毒性肝炎患者。计算HIV合并感染患病率,并通过逻辑回归估计与HIV合并感染相关的危险因素。
共纳入8490例患者:3091例患有慢性乙型肝炎(CHB),5305例患有慢性丙型肝炎(CHC),94例同时患有CHB和CHC。HIV合并感染的患病率为4.4%(95%置信区间[CI],4.0 - 4.9),在CHC和CHB - CHC患者中高于CHB患者,患病率分别为5.3%(95% CI,4.7 - 5.9)、6.4%(95% CI,2.4 - 13.4)和2.9%(95% CI,2.3 - 3.5)(P <.0001)。2002年至2014年间,HIV检测率从65%增至88%,同时HIV合并感染患病率从7.8%(95% CI,5.5 - 10.7)降至1.6%(95% CI,0.7 - 3.2)。35 - 50岁、男性以及病毒性肝炎的性传播途径与HIV合并感染相关,比值比分别为4.42(95% CI,1.40 - 13.94)、2.21(95% CI,1.74 - 2.81)和8.81(95% CI,6.30 - 12.33)。
新诊断的慢性病毒性肝炎患者中HIV合并感染的患病率随HIV检测率的增加而降低。