加纳布阿宏地区感染 HIV-1 和未感染 HIV 的孕妇中的乙型肝炎和丙型肝炎感染。
Hepatitis B and C infections in HIV-1 and non-HIV infected pregnant women in the Brong-Ahafo Region, Ghana.
机构信息
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
出版信息
PLoS One. 2019 Jul 19;14(7):e0219922. doi: 10.1371/journal.pone.0219922. eCollection 2019.
BACKGROUND
Hepatitis B (HBV) or hepatitis C (HCV) virus co-infections in HIV are alarming during pregnancy due to the risk of vertical transmission and the eventual adverse effects on neonates. This study was conducted to ascertain the sero-prevalence of HIV/HBV and HIV/HCV co-infections, evaluate the effect of the co-infections on the immunological and virological characteristics and assess the association between some demographic and lifestyle characteristics and risk of HBV, HCV, HIV/HBV and HIV/HCV co-infections among pregnant women living in the Brong-Ahafo Region of Ghana.
METHODS
This comparative cross-sectional study was conducted at the anti-retroviral therapy (ART) clinics of the St. Elizabeth Hospital and the Holy Family Hospital, Brong-Ahafo Region, Ghana. A total of 248 consecutive consenting pregnant Ghanaian women, 148 diagnosed with HIV [HIV (+)] and 100 who were HIV negative [HIV (-)], were recruited. Validated questionnaire was used to obtain demographic and lifestyle data. Venous blood samples were obtained and HCV status, HBV profile, CD4+ T cell count, and HIV-1 RNA load were determined.
RESULTS
The sero-prevalence of HIV (+) /HBV, HIV (+) /HCV, HIV (-)/HBV, and HIV (-)/HCV infections were 22 (14.9%), 6 (4.1%), 10 (10.0%), and 12 (12.0%) respectively. HIV-1 viral load was not significantly different between HIV/HBV, HIV/HCV co-infection and HIV mono-infection. However, CD4+ T lymphocyte count (364 vs 512 vs 514 cells/μl; p = 0.0009) was significantly lower in HIV/HBV co-infection compared to HIV/HCV and HIV mono-infection respectively. There was no significant association between demographic and lifestyle characteristics and risk of HBV and HCV infections in HIV positive and negative subjects except for late diagnosis of HIV and history of sharing razors blades and pins, where increased odds of HIV (+) /HBV and HIV (-)/HBV infection were observed.
CONCLUSIONS
The prevalence of HIV (+)/HBV (14.9%), HIV (+)/HCV (4.1%), HIV (-)/HBV (10.0%), and HIV (-)/HCV (12.0%) are high among pregnant women in the Brong Ahafo Region of Ghana. HIV/HBV is associated with reduced CD4+ T lymphocyte count but not HIV-1 viral load. Early diagnosis of HIV and intensification of routine antenatal HBV and HCV are essential to abate the risk of maternal to child transmission.
背景
乙型肝炎（HBV）或丙型肝炎（HCV）病毒合并感染在怀孕期间令人担忧，因为存在垂直传播的风险，以及对新生儿的最终不利影响。本研究旨在确定 HIV/HBV 和 HIV/HCV 合并感染的血清流行率，评估合并感染对免疫和病毒学特征的影响，并评估一些人口统计学和生活方式特征与 HBV、HCV、HIV/HBV 和 HIV/HCV 合并感染在加纳布隆阿哈福地区孕妇中的相关性。
方法
这是一项在加纳布隆阿哈福地区圣伊丽莎白医院和圣家族医院的抗逆转录病毒治疗（ART）诊所进行的比较性横断面研究。共招募了 248 名连续同意的加纳孕妇，其中 148 名被诊断为 HIV [HIV (+)]，100 名 HIV 阴性 [HIV (-)]。使用经过验证的问卷获得人口统计学和生活方式数据。采集静脉血样，确定 HCV 状态、HBV 概况、CD4+T 细胞计数和 HIV-1 RNA 载量。
结果
HIV (+)/HBV、HIV (+)/HCV、HIV (-)/HBV 和 HIV (-)/HCV 感染的血清流行率分别为 22 例（14.9%）、6 例（4.1%）、10 例（10.0%）和 12 例（12.0%）。HIV-1 病毒载量在 HIV/HBV、HIV/HCV 合并感染和 HIV 单感染之间没有显著差异。然而，与 HIV/HCV 和 HIV 单感染相比，HIV/HBV 合并感染的 CD4+T 淋巴细胞计数（364 对 512 对 514 个细胞/μl；p=0.0009）显著降低。除了 HIV 的晚期诊断和共用剃刀刀片和别针的历史外，在 HIV 阳性和阴性受试者中，人口统计学和生活方式特征与 HBV 和 HCV 感染的风险之间没有显著关联，在这些特征中，观察到 HIV (+)/HBV 和 HIV (-)/HBV 感染的几率增加。
结论
在加纳布隆阿哈福地区的孕妇中，HIV (+)/HBV（14.9%）、HIV (+)/HCV（4.1%）、HIV (-)/HBV（10.0%）和 HIV (-)/HCV（12.0%）的流行率很高。HIV/HBV 与 CD4+T 淋巴细胞计数降低有关，但与 HIV-1 病毒载量无关。早期诊断 HIV 并加强常规产前 HBV 和 HCV 检测对于降低母婴传播风险至关重要。
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