韩国某单一中心丙型肝炎病毒和人类免疫缺陷病毒合并感染患者的临床特征和治疗结局。

Clinical Characteristics and Treatment Outcomes of Patients with Hepatitis C Virus and Human Immunodeficiency Virus Coinfection: Experience at a Single Center in Korea.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.

Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.

出版信息

J Korean Med Sci. 2021 Nov 29;36(46):e308. doi: 10.3346/jkms.2021.36.e308.

DOI:10.3346/jkms.2021.36.e308

PMID:34845874

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8629715/

Abstract

BACKGROUND

Because of the very low incidence of human immunodeficiency virus (HIV) coinfection in Korea, data on hepatitis C virus (HCV)/HIV coinfection are limited. This study aimed to investigate the clinical characteristics and treatment outcomes of patients with HCV/HIV coinfection in Korea.

METHODS

We performed a retrospective cohort study of all HCV-monoinfected and HCV/HIV-coinfected patients treated with antivirals at National Medical Center in Seoul, Korea, between January 2009 and March 2020.

RESULTS

We enrolled 220 HCV-monoinfected and 23 HCV/HIV-coinfected patients treated with antivirals. The HCV/HIV-coinfected patients were younger (HCV vs. HCV/HIV: 57.3 ± 11.3 vs. 40.7 ± 10.1 years, < 0.001) and had a higher proportion of men (HCV vs. HCV/HIV: 54.5% [n = 120] vs. 91.3% [n = 21], < 0.001) than the HCV-monoinfected patients. Genotype 1b and 2 were most common in both HCV monoinfection and HCV/HIV coinfection groups. HCV-monoinfected patients had a higher incidence of genotype 1b and 2 than HCV/HIV-coinfected patients (HCV vs. HCV/HIV: 95.4% [n = 210] vs. 73.9% [n = 17], < 0.001), while the HCV/HIV-coinfected patients had genotype 1a (HCV vs. HCV/HIV: 1.8% [n = 4] vs. 21.7% [n = 5], < 0.001). The fibrosis-4 index was significantly lower in the HCV/HIV-coinfected patients than in the HCV-monoinfected patients (HCV vs. HCV/HIV: 3.81 ± 3.38 vs. 1.66 ± 1.10, < 0.001). Among the direct-acting antivirals (DAA)-treated patients, the sustained viral response (SVR) rate did not differ significantly between both groups (HCV vs. HCV/HIV: 94.9% [93/99] vs. 90.9% [10/11], = 0.480).

CONCLUSION

In Korea, the HCV/HIV-coinfected patients who received antiviral treatment were younger, had higher proportion of men and incidence of genotype 1a, and had less advanced fibrosis than the HCV-monoinfected patients. In actual clinical settings, HCV/HIV-coinfected patients show excellent SVR to DAA treatment, similar to HCV-monoinfected patients.

摘要

背景

由于韩国人类免疫缺陷病毒（HIV）合并感染的发生率非常低，因此有关丙型肝炎病毒（HCV）/HIV 合并感染的数据有限。本研究旨在调查韩国 HCV/HIV 合并感染患者的临床特征和治疗结局。

方法

我们对 2009 年 1 月至 2020 年 3 月期间在首尔国立医疗中心接受抗病毒治疗的所有 HCV 单感染和 HCV/HIV 合并感染患者进行了回顾性队列研究。

结果

我们纳入了 220 例 HCV 单感染和 23 例 HCV/HIV 合并感染接受抗病毒治疗的患者。HCV/HIV 合并感染患者较 HCV 单感染患者年轻（HCV 组 vs. HCV/HIV 组：57.3 ± 11.3 岁 vs. 40.7 ± 10.1 岁，<0.001），男性比例更高（HCV 组 vs. HCV/HIV 组：54.5%[n=120] vs. 91.3%[n=21]，<0.001）。1b 和 2 型是 HCV 单感染和 HCV/HIV 合并感染组中最常见的基因型。HCV 单感染患者的 1b 和 2 型基因型发生率高于 HCV/HIV 合并感染患者（HCV 组 vs. HCV/HIV 组：95.4%[n=210] vs. 73.9%[n=17]，<0.001），而 HCV/HIV 合并感染患者的 1a 型基因型发生率较高（HCV 组 vs. HCV/HIV 组：1.8%[n=4] vs. 21.7%[n=5]，<0.001）。与 HCV 单感染患者相比，HCV/HIV 合并感染患者的纤维化 4 指数显著降低（HCV 组 vs. HCV/HIV 组：3.81 ± 3.38 vs. 1.66 ± 1.10，<0.001）。在接受直接作用抗病毒药物（DAA）治疗的患者中，两组的持续病毒学应答（SVR）率无显著差异（HCV 组 vs. HCV/HIV 组：94.9%[93/99] vs. 90.9%[10/11]，=0.480）。