香港、台北、东京地区 HIV 阳性患者中急性 HCV 感染的分子流行病学研究。

Molecular epidemiology of acute HCV infection in HIV-positive patients from Hong Kong, Taipei, Tokyo.

机构信息

Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

National Center for Global Health and Medicine, AIDS Clinical Center, Tokyo, Japan.

出版信息

Liver Int. 2019 Jun;39(6):1044-1051. doi: 10.1111/liv.14073. Epub 2019 Mar 13.

DOI:10.1111/liv.14073

PMID:30770636

Abstract

BACKGROUND

Acute hepatitis C virus (HCV) infections have been increasingly reported among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in the Asia-Pacific region. It remains unknown whether international network of HCV transmission has occurred in this region.

METHODS

HIV-positive patients with acute HCV infection, defined as HCV seroconversion within a year or documented acute hepatitis with seroconversion, diagnosed in Hong Kong, Taipei and Tokyo during 2010-2016 were included in this molecular epidemiology study. The NS5B region of the HCV genome (365 bp) was amplified using nested polymerase chain reaction and sequenced.

RESULTS

Of 234 HIV-positive patients with acute HCV infection, all were male with 94% being MSM. At the diagnosis of acute HCV infection, 73.5% had concurrent sexually transmitted diseases and 88.0% were receiving combination antiretroviral therapy. The most prevalent HCV genotype was 3a, 2a and 1b in Hong Kong, Taipei and Tokyo respectively. Nine independent clusters belonging to five genotypes (1b, 2a, 2c, 3a and 6a) were identified, each of which occurred in one city without overlapping except for one 3a sequence from Taipei that was closely related genetically to the Hong Kong cluster.

CONCLUSIONS

No international network of HCV transmission was identified among HIV-positive patients in the three Asia-Pacific cities. The transmission dynamics of sexually acquired HCV differed by city, but the risk of intercity clustering should not be ignored.

摘要

背景

在亚太地区，人类免疫缺陷病毒（HIV）阳性的男男性行为者（MSM）中，急性丙型肝炎病毒（HCV）感染的报道日益增多。目前尚不清楚该地区是否存在 HCV 传播的国际网络。

方法

本分子流行病学研究纳入了 2010 年至 2016 年期间在香港、台北和东京诊断的急性 HCV 感染的 HIV 阳性患者，定义为一年内 HCV 血清转换或有明确的急性肝炎伴血清转换。使用巢式聚合酶链反应扩增 HCV 基因组的 NS5B 区（365bp）并进行测序。

结果

234 例急性 HCV 感染的 HIV 阳性患者均为男性，其中 94%为 MSM。在急性 HCV 感染的诊断时，73.5%同时患有性传播疾病，88.0%正在接受联合抗逆转录病毒治疗。最常见的 HCV 基因型分别为香港、台北和东京的 3a、2a 和 1b。鉴定出 9 个独立的聚类，属于 5 种基因型（1b、2a、2c、3a 和 6a），每个聚类仅发生在一个城市，除了一个来自台北的 3a 序列与香港聚类在基因上密切相关外，没有重叠。