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HIV 感染者合并丙型肝炎病毒感染:男男性行为者和非男男性行为者的流行病学差异。

Hepatitis C Co-infection in People Living With HIV-Epidemiologic Differences Between Men Who Have Sex With Men MSM and Non-MSM.

机构信息

Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.

Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong, Hong Kong SAR, China.

出版信息

Front Public Health. 2022 Jun 3;10:925600. doi: 10.3389/fpubh.2022.925600. eCollection 2022.

Abstract

People living with human immunodeficiency virus (PLHIV) constitute a unique group at higher risk of hepatitis C virus (HCV) co-infection. In light of the diverse profiles of PLHIV, we differentiated between men who have sex with men (MSM) and non-MSM in the characterization of the epidemiologic features of HIV/HCV co-infection. Clinical data of HCV co-infection patients from the HIV specialist clinic in Hong Kong were retrospectively collected in conjunction with their HIV subtypes and HCV genotypes. Logistic regression models were used to identify factors associated with HIV/HCV co-infection in MSM. Survival analysis was performed to compare the time lag between HIV and HCV diagnoses between two groups. Latent class analysis was conducted to describe the features of different classes of co-infections. Four classes of HIV/HCV co-infections were identified: local MSM acquiring HCV after HIV diagnosis, local MSM with HIV/HCV co-diagnoses, local non-MSM, and non-local non-MSM. Accounting for over half of the co-infections, MSM were more likely to be younger, local residents, and associated with HCV genotype 3, compared to genotypes 1 and 6 in non-MSM. Overall, MSM had higher odds of achieving HIV viral suppression and co-diagnosing with a sexually transmitted infection at HCV diagnosis, and having a longer time lag between HIV and HCV diagnoses. Drug injection accounted for a majority of non-MSM HCV infection. There were distinctive epidemiologic differences between MSM and non-MSM co-infected with HIV and HCV, the characteristics of which could inform intervention strategies for achieving HCV micro-elimination.

摘要

人类免疫缺陷病毒 (HIV) 感染者 (PLHIV) 构成了一个具有更高丙型肝炎病毒 (HCV) 合并感染风险的独特群体。鉴于 HIV 感染者的多样化特征,我们在描述 HIV/HCV 合并感染的流行病学特征时,将男男性行为者 (MSM) 和非 MSM 区分开来。我们回顾性地收集了香港 HIV 专科诊所 HCV 合并感染患者的临床数据,并结合他们的 HIV 亚型和 HCV 基因型进行了分析。使用逻辑回归模型来确定 MSM 中与 HIV/HCV 合并感染相关的因素。进行生存分析以比较两组之间 HIV 和 HCV 诊断之间的时间滞后。进行潜在类别分析以描述不同合并感染类别的特征。确定了四种 HIV/HCV 合并感染类型:在 HIV 诊断后感染 HCV 的本地 MSM、HIV/HCV 同时诊断的本地 MSM、本地非 MSM 和非本地非 MSM。合并感染中超过一半是 MSM,与非 MSM 相比,他们更年轻、是本地居民,并且与 HCV 基因型 3 相关,而非基因型 1 和 6。总体而言,MSM 更有可能在 HCV 诊断时实现 HIV 病毒抑制和合并诊断性传播感染,并且 HIV 和 HCV 诊断之间的时间滞后更长。药物注射是大多数非 MSM HCV 感染的原因。MSM 和 HIV/HCV 合并感染的非 MSM 之间存在明显的流行病学差异,这些特征可以为实现 HCV 微消除的干预策略提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34c3/9204175/3c56f6bdc78c/fpubh-10-925600-g0001.jpg

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