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肯尼亚HIV-1感染患者中乙型肝炎和丙型肝炎合并感染的患病率及相关因素

Prevalence and Factors Associated With Hepatitis B and C Co-Infection Among HIV-1-Infected Patients in Kenya.

作者信息

Maina Duncan Ndegwa, Nyerere Andrew Kimanga, Gicho Ruth Wambui, Mwangi Joseph Maina, Lihana Raphael Wekesa

机构信息

College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.

Kenya Medical Research Institute, Nairobi, Kenya.

出版信息

East Afr Health Res J. 2017;1(2):73-79. doi: 10.24248/EAHRJ-D-16-00334. Epub 2017 Jul 1.

Abstract

BACKGROUND

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the most chronic viral infections worldwide. Co-infections with HBV and HCV have become increasingly common among people living with HIV, resulting in a growing public health concern. The primary aim of our study was to determine the prevalence of HBV and HCV and their associated factors among HIV-1-infected patients attending the Ngong Sub-County Hospital comprehensive care clinic.

METHODS

After providing consent, a 5 mL blood sample was collected from each study participant visiting the comprehensive care clinic. The blood was screened for hepatitis B surface antigen and HCV antibodies using chemiluminescence immunoassay test according to the manufacturer's instructions. The CD4 T-cell counts were determined using FACSCalibre machine, while HIV-1 viral load was determined using the Abbott m2000rt System according to the manufacturer's instructions. A questionnaire was used to collect sociodemographic information and data on factors associated with HBV and HCV co-infections.

RESULTS

One hundred and ninety HIV-1-infected patients participated in this study: 150 (78.9%) women and 40 (21.1%) men. In the overall study population, the prevalence of HBV co-infection was 5.8% (95% CI, 2.6%-8.9%) and of HCV co-infection was 4.2% (95% CI, 1.6%-7.4%). However, no individual was co-infected with all 3 viruses. HCV was associated with antiretroviral treatment (OR 0.2; 95% CI, 0.0-0.8; =.036), while HBV showed a significant association with condom usage (OR 0.3; 95% CI, 0.1-0.9; P=.039) and median viral load.

CONCLUSION

A high prevalence of HIV/HBV and HIV/HCV co-infection was reported in this study, suggesting that HIV-infected patients should be routinely screened for HBV and HCV infections, and preventive and control measures should be put in place that include public education on HBV and HCV infections.

摘要

背景

乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)是全球最常见的慢性病毒感染之一。HBV和HCV合并感染在艾滋病毒感染者中越来越普遍,这引起了越来越多的公共卫生关注。我们研究的主要目的是确定在恩贡县医院综合护理诊所就诊的HIV-1感染患者中HBV和HCV的流行率及其相关因素。

方法

在获得同意后,从每位前往综合护理诊所的研究参与者采集5毫升血液样本。根据制造商的说明,使用化学发光免疫分析法对血液进行乙型肝炎表面抗原和HCV抗体筛查。使用FACSCalibre机器测定CD4 T细胞计数,同时根据制造商的说明使用雅培m2000rt系统测定HIV-1病毒载量。使用问卷收集社会人口统计学信息以及与HBV和HCV合并感染相关因素的数据。

结果

190名HIV-1感染患者参与了本研究:150名(78.9%)女性和40名(21.1%)男性。在整个研究人群中,HBV合并感染的患病率为5.8%(95%置信区间,2.6%-8.9%),HCV合并感染的患病率为4.2%(95%置信区间,1.6%-7.4%)。然而,没有个体同时感染这三种病毒。HCV与抗逆转录病毒治疗相关(比值比0.2;95%置信区间,0.0-0.8;P=0.036),而HBV与避孕套使用(比值比0.3;95%置信区间,0.1-0.9;P=0.039)和病毒载量中位数显著相关。

结论

本研究报告了HIV/HBV和HIV/HCV合并感染的高患病率,这表明应对HIV感染患者进行常规的HBV和HCV感染筛查,并应采取预防和控制措施,包括对HBV和HCV感染进行公众教育。

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