柬埔寨四个省份的 HIV/AIDS 感染者和孕妇中的丙型肝炎血清流行率：一项综合生物行为调查。

Hepatitis C seroprevalence among people living with HIV/AIDS and pregnant women in four provinces in Cambodia: an integrated bio-behavioral survey.

机构信息

University of Health Sciences, 73 Monivong Boulevard, Phnom Penh, 12201, Cambodia.

Ecole Doctorale de Santé Publique, Service de Santé Publique du GH Hôpitaux, Universitaires de Paris Sud, Université Paris-Saclay, Inserm CESP U1018, Paris, France.

出版信息

BMC Infect Dis. 2022 Feb 22;22(1):177. doi: 10.1186/s12879-022-07163-2.

DOI:10.1186/s12879-022-07163-2

PMID:35193496

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8862396/

Abstract

BACKGROUND

Understanding the extent of viral hepatitis burden in specific subgroups, such as pregnant women and people living with HIV/AIDS (PLWHA), and their geographic distribution is essential for evidence-informed policy and mobilizing resources for targeted treatment and prevention efforts. However, in Cambodia, the epidemiology of hepatitis C remains uncertain. We estimated the hepatitis C virus (HCV) burden and transmission risk factors among PLWHA and pregnant women attending antenatal care (ANC) in Cambodia.

METHODS

Between March and April 2016, we conducted a cross-sectional survey in four diverse geographical areas: the capital city of Phnom Penh and three provinces. We collected information on demographic characteristics and risk behaviors and performed HCV antibody (Anti-HCV) testing among pregnant women attending public ANC clinics and among those receiving HIV care at the hospitals. We computed the prevalence of HCV among the two population subsets and performed logistic regression analyses to identify risk factors associated with HCV antibody positivity.

RESULTS

Of 935 participants enrolled, 510 (54.6%) were pregnant women and 425 (45.4%) were PLWHA. Anti-HCV prevalence was significantly higher in PLWHA than in pregnant women (29/425, 6.8% vs 5/510, 0.9%, P < 0.001). Of the geographic regions, Preah Sihanouk province (Southwest) had the highest anti-HCV prevalence among PLWHA (12.0%, P = 0.031). There was no significant geographic difference in anti-HCV prevalence among pregnant women. In multivariable analyses (data subset to PLWHA), HCV infection was significantly associated with having a family member positive for HCV (OR = 7.6 [95% CI: 1.01-57.84], P = 0.048) and a history of intravenous medication injection in the last 5 years (OR = 7.1 [95% CI: 2.79-18.10], P < 0.001).

CONCLUSIONS

HCV infection is relatively common among Cambodian PLWHA, likely related to intravenous medication injection and intra-familial viral transmission. Systematic HCV testing and care among PLWHA (and possibly their family members) might be necessary. Setting up a surveillance system for HCV might also be beneficial for some geographical regions and populations.

摘要

背景

了解特定亚组（如孕妇和艾滋病毒/艾滋病感染者）的病毒性肝炎负担及其地理分布情况对于循证政策和为有针对性的治疗和预防工作调集资源至关重要。然而，在柬埔寨，丙型肝炎的流行病学情况仍不确定。我们评估了柬埔寨接受产前保健（ANC）的艾滋病毒感染者和孕妇中的丙型肝炎病毒（HCV）负担和传播风险因素。

方法

2016 年 3 月至 4 月期间，我们在四个不同地理区域（首都金边和三个省）进行了一项横断面调查。我们收集了人口统计学特征和风险行为的信息，并对在公立 ANC 诊所就诊的孕妇以及在医院接受艾滋病毒护理的孕妇进行了 HCV 抗体（Anti-HCV）检测。我们计算了这两个人群亚组中 HCV 的流行率，并进行了逻辑回归分析以确定与 HCV 抗体阳性相关的风险因素。

结果

935 名参与者中，510 名（54.6%）为孕妇，425 名（45.4%）为艾滋病毒感染者。艾滋病毒感染者中的抗-HCV 流行率明显高于孕妇（29/425，6.8%比 5/510，0.9%，P<0.001）。在所调查的地理区域中，Preah Sihanouk 省（西南部）艾滋病毒感染者中的抗-HCV 流行率最高（12.0%，P=0.031）。孕妇中的抗-HCV 流行率在不同地理区域间没有显著差异。在多变量分析（针对艾滋病毒感染者的数据集）中，HCV 感染与家庭成员 HCV 阳性（比值比[OR]7.6[95%置信区间：1.01-57.84]，P=0.048）和过去 5 年内静脉内药物注射史（OR 7.1[95%CI：2.79-18.10]，P<0.001）显著相关。