Tassachew Yayehyirad, Abebe Tamrat, Belyhun Yeshambel, Teffera Tezazu, Shewaye Abate Bane, Desalegn Hailemichael, Andualem Henok, Kinfu Abiy, Mulu Andargachew, Mihret Adane, Howe Rawleigh, Aseffa Abraham
Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.
Hepat Med. 2022 May 13;14:67-77. doi: 10.2147/HMER.S365443. eCollection 2022.
The efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however, mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV.
The study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver disease (CLD) patients in Ethiopia.
Three hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC) (n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV testing algorithm was employed to screen HIV infection.
Regardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were co-infected with HBV (HBsAgHBcAb) and HCV (anti-HCV HCV-RNA), respectively, and 86.7% (13/15) exhibited a marker of HBV exposure (total HBcAb). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than non-HCC patients [8.6% (11/128) vs 1.8 (4/217), =0.005 and 3.9% (5/128) vs 0.9% (2/217), =0.1]. The rate of HIV mono-infection was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients.
The frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in people living with HIV.
高效使用抗逆转录病毒药物已显著降低了与艾滋病相关的发病率和死亡率；然而，在艾滋病毒感染者中，非艾滋病相关终末期肝病导致的死亡率正在上升。
本研究旨在确定埃塞俄比亚慢性肝病（CLD）患者中艾滋病毒及其与乙肝病毒和丙肝病毒合并感染的患病率。
本研究纳入了345例CLD患者，分为两组：肝细胞癌（HCC）组（n = 128）和非HCC组（n = 217）。非HCC组包括晚期肝病患者（n = 98）和慢性肝炎患者（n = 119）。采用酶免疫测定法测定乙肝病毒和丙肝病毒感染标志物。此外，采用一系列快速艾滋病毒检测算法筛查艾滋病毒感染。
无论肝病处于何种阶段，艾滋病毒的总体感染率为4.3%（15/345），艾滋病毒/乙肝病毒和艾滋病毒/丙肝病毒合并感染率分别为2%（7/345）和0.3%（1/345）。在所有艾滋病毒感染患者（n = 15）中，分别有46.7%（7/15）和6.7%（1/15）合并感染乙肝病毒（HBsAgHBcAb）和丙肝病毒（抗-HCV HCV-RNA），86.7%（13/15）表现出乙肝病毒暴露标志物（总HBcAb）。总体而言，HCC患者中艾滋病毒及其与乙肝病毒合并感染的频率比非HCC患者更明显[8.6%（11/128）对1.8%（4/217），P = 0.005；3.9%（5/128）对0.9%（2/217），P = 0.1]。HCC患者和非HCC患者中艾滋病毒单一感染率分别为3.9%（5/128）和0.9%（2/217）。
艾滋病毒及其与乙肝病毒/丙肝病毒合并感染率随肝病严重程度呈上升趋势。因此，对所有艾滋病毒阳性患者进行乙肝病毒和丙肝病毒感染筛查，对所有CLD患者进行艾滋病毒感染筛查，并采取必要的预防措施，将是预防艾滋病毒感染者中CLD进展和肝病相关死亡的重要策略。
