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在埃塞俄比亚亚的斯亚贝巴的政府医院中,HBsAg 阳性产妇中 HIV 或 HCV 的合并感染及其相关因素:一项横断面研究。

Co-infection of HIV or HCV among HBsAg positive delivering mothers and its associated factors in governmental hospitals in Addis Ababa, Ethiopia: A cross-sectional study.

机构信息

Aklilu Lemma Institute of Pathobiology, Addis Ababa Universty, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2022 Aug 26;17(8):e0273300. doi: 10.1371/journal.pone.0273300. eCollection 2022.

Abstract

BACKGROUND

Blood borne viral infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency virus (HIV) cause substantial mortality and morbidity worldwide. Viral hepatitis during pregnancy is closely related to high risks of maternal and neonatal complications. In Ethiopia, only a little information is available on co-infection of HCV or HIV among Hepatitis B surface Antigen (HBsAg) positive pregnant mothers. Thus, the study aimed to determine HIV or HCV co-infection and associated risk factors among HBsAg positive delivering mothers.

METHOD

A health facility-based cross-sectional study was conducted in five governmental hospitals in Addis Ababa among 265 HBsAg positive delivering mothers in the year 2019 and 2020. A purposive sampling technique was used to select the study participants. Structured questionnaires and laboratory test results were used to collect the data. SPSS version 20 software was used to enter and analyze the data. Multivariable logistic regression was used to identify independent predictors of HIV or HCV co-infections.

RESULTS

Of the HBsAg positive delivering mothers, 9 (3.4%) and 3 (1.1%) were co-infected with HIV and HCV, respectively. None of them were with triplex infection. All of the socio-demographic characteristics were not significantly associated with both HIV and HCV co-infections. Mothers who had a history of sexually transmitted diseases (STDs) were 9.3 times more likely to have HBV-HIV co-infection (AOR = 9.3; 95% CI: 1.84-47.1). Mothers who had multiple sexual partners were 5.96 times more likely to have HIV co-infection (AOR = 5.96; 95% CI: 1.074-33.104). The odds of having HBV-HIV co-infection were 5.5 times higher among mothers who had a history of sharing shavers, razors, and earrings (AOR = 5.5;95% CI: 1.014-29.69). HCV co-infection was not significantly associated with any of the potential risk factors.

CONCLUSION

This dual infection rate of HBsAg positive delivering mother with HIV or HCV indicates that a substantial number of infants born in Ethiopia are at high risk of mother-to-child transmission (MTCT) of HBV, HIV, and HCV. Thus, all pregnant mothers need to be screened for HBV, HCV, and HIV during antenatal care, and also need implementation of prevention mechanisms of MTCT of these viral infections.

摘要

背景

乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)等血源性病毒感染在全球范围内导致了大量的死亡率和发病率。妊娠期间的病毒性肝炎与母婴并发症的高风险密切相关。在埃塞俄比亚,只有很少的信息可用于了解 HBsAg 阳性孕妇中 HCV 或 HIV 的合并感染情况。因此,本研究旨在确定 HBsAg 阳性产妇中 HIV 或 HCV 的合并感染情况以及相关的危险因素。

方法

2019 年至 2020 年,在埃塞俄比亚亚的斯亚贝巴的五家政府医院进行了一项基于卫生机构的横断面研究,共纳入 265 名 HBsAg 阳性产妇。采用目的抽样技术选择研究对象。使用结构化问卷和实验室检测结果收集数据。使用 SPSS 版本 20 软件输入和分析数据。采用多变量逻辑回归分析确定 HIV 或 HCV 合并感染的独立预测因素。

结果

在 HBsAg 阳性产妇中,有 9 名(3.4%)和 3 名(1.1%)分别合并感染了 HIV 和 HCV,均未出现三重感染。所有社会人口学特征与 HIV 和 HCV 合并感染均无显著相关性。有性传播疾病(STDs)史的母亲发生 HBV-HIV 合并感染的可能性是无病史母亲的 9.3 倍(AOR=9.3;95%CI:1.84-47.1)。有多个性伴侣的母亲发生 HIV 合并感染的可能性是无多个性伴侣母亲的 5.96 倍(AOR=5.96;95%CI:1.074-33.104)。有共用剃须刀、刮胡刀和耳环史的母亲发生 HBV-HIV 合并感染的可能性是无此类行为的母亲的 5.5 倍(AOR=5.5;95%CI:1.014-29.69)。HCV 合并感染与任何潜在危险因素均无显著相关性。

结论

本研究中 HBsAg 阳性产妇 HIV 或 HCV 的双重感染率表明,在埃塞俄比亚出生的大量婴儿有感染乙型肝炎病毒、HIV 和 HCV 的母婴垂直传播(MTCT)的高风险。因此,所有孕妇在产前保健期间都需要接受 HBV、HCV 和 HIV 的筛查,并且还需要实施这些病毒感染的 MTCT 预防机制。

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