2006-2018 年新加坡 HIV 感染男性中的丙型肝炎病毒感染：发病率及相关因素。

Hepatitis C virus infection in HIV-infected men in Singapore, 2006-2018: incidence and associated factors.

机构信息

National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore; and Corresponding author. Email:

Department of Infectious Diseases, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore.

出版信息

Sex Health. 2021 Jul;18(3):221-231. doi: 10.1071/SH20197.

DOI:10.1071/SH20197

PMID:34148565

Abstract

UNLABELLED

Background The epidemiology of hepatitis C virus (HCV) infection in people living with HIV has been evolving, with increasing evidence of permucosal (sexual) transmission identified predominantly in HIV-positive men who have sex with men (MSM). The aim of this study was to estimate the incidence rate and elucidate epidemiological factors associated with HCV infection among HIV-infected men in Singapore from 2006 to 2018.

METHODS

A retrospective cohort study was conducted using a clinical database maintained by the Clinical HIV Program at the National Centre for Infectious Diseases, Singapore. Factors associated with incident HCV infections were identified using Cox proportional hazards regression analyses.

RESULTS

Among 1348 HIV-infected male patients who were HCV seronegative at baseline, 64 (4.7%) subsequently tested positive for HCV, giving an incidence of 0.88 per 100 person-years of follow-up (PYFU) (95% confidence interval (CI) 0.69-1.13). The incidence rate of HCV seroconversion increased from 0.33 (95% CI 0.12-0.71) per 100 PYFU in 2010-2012 to 1.93 (95% CI 1.36-2.67) in 2016-2018. Independent factors associated with incident HCV infection were younger age groups at HIV diagnosis versus ≥45 years, HIV acquisition via MSM or via both sexual contact and intravenous drug use versus heterosexual transmission, HIV diagnosis in later periods versus 2006-2009, and recent syphilis acquisition.

CONCLUSIONS

An increasing trend of incident HCV infection was seen in HIV-infected men, particularly for MSM. Preventive and behavioural interventions should be targeted at HIV-infected individuals engaged in high-risk sexual behaviour.

摘要

背景

丙型肝炎病毒（HCV）在感染艾滋病毒的人群中的流行病学一直在演变，越来越多的证据表明，主要在艾滋病毒阳性的男男性行为者（MSM）中存在经黏膜（性）传播。本研究旨在估计 2006 年至 2018 年期间新加坡感染艾滋病毒的男性中 HCV 感染的发病率，并阐明与 HCV 感染相关的流行病学因素。

方法

采用新加坡国家传染病中心临床 HIV 项目维护的临床数据库进行回顾性队列研究。使用 Cox 比例风险回归分析确定与 HCV 感染相关的因素。

结果

在 1348 名基线 HCV 血清阴性的 HIV 感染男性患者中，有 64 名（4.7%）随后 HCV 血清学检测呈阳性，随访期间 HCV 感染的发生率为 0.88/100 人年（95%置信区间[CI]0.69-1.13）。HCV 血清转换的发生率从 2010-2012 年的 0.33（95%CI0.12-0.71）/100 人年增加到 2016-2018 年的 1.93（95%CI1.36-2.67）。与 HCV 感染相关的独立因素是 HIV 诊断时的年龄较小（<45 岁），而不是≥45 岁，HIV 感染是通过 MSM 还是通过性接触和静脉吸毒获得，而不是异性传播，HIV 诊断是在较晚的时期而不是 2006-2009 年，以及最近获得梅毒。