Moorman Anne C, Bixler Danae, Teshale Eyasu H, Hofmeister Megan, Roberts Henry, Chapin-Bardales Johanna, Gupta Neil
Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2023 Jul 22:333549231181348. doi: 10.1177/00333549231181348.
The overlapping epidemics of hepatitis C virus (HCV) and HIV infection stem from underlying behaviors and health disparities among disproportionately affected populations, especially people who inject drugs (PWID). Characterizing the prevalence of HCV-HIV coinfection offers improved data to address these underlying determinants of health. We performed a literature search for articles that describe US populations, were published during 2005-2021, and summarized evidence of the prevalence of HCV infection in recent HIV clusters and outbreaks among PWID. In population- and community-based studies, HCV antibody prevalence among PWID with HIV ranged from 10.7% to 71.4%, depending on the setting and study design. HCV-HIV coinfection ranged from 70% to 94% among 5 larger HIV clusters or outbreaks among PWID during 2014-2021; where characterized, HCV diagnosis preceded HIV detection by a median of 4 to 5 years. Robust modernized surveillance is needed to support and measure the progress of city, state, and national activities for ending the HIV epidemic and eliminating hepatitis C. Developing and leveraging surveillance systems can identify missed opportunities for prevention, evaluate care, and build capacity for outbreak investigation. In addition, improved data on injection drug use are crucial to inform efforts for improved HCV and HIV testing, prevention, and treatment in settings that serve PWID. By providing data in a wholistic, integrated manner, public health surveillance programs can support efforts to overcome inefficiencies of disease-specific silos, accelerate delivery of preventive and clinical services, and address the excess disease burden and health disparities associated with HCV-HIV coinfection.
丙型肝炎病毒（HCV）和艾滋病毒感染的重叠流行源于受影响尤为严重的人群（特别是注射吸毒者）的潜在行为和健康差异。确定HCV-艾滋病毒合并感染的流行情况能提供更好的数据，以解决这些健康的潜在决定因素。我们对描述美国人群、在2005年至2021年期间发表的文章进行了文献检索，并总结了近期艾滋病毒聚集性感染和注射吸毒者中疫情期间HCV感染流行情况的证据。在基于人群和社区的研究中，感染艾滋病毒的注射吸毒者中HCV抗体流行率在10.7%至71.4%之间，具体取决于研究背景和设计。在2014年至2021年期间注射吸毒者中的5次较大规模艾滋病毒聚集性感染或疫情中，HCV-艾滋病毒合并感染率在70%至94%之间；在有特征描述的情况下，HCV诊断比艾滋病毒检测早4至5年。需要强大的现代化监测来支持和衡量城市、州和国家为终结艾滋病毒流行和消除丙型肝炎而开展的活动的进展。开发和利用监测系统可以发现预防方面错失的机会、评估医疗服务并建立疫情调查能力。此外，关于注射吸毒情况的更好数据对于为服务注射吸毒者的场所改进HCV和艾滋病毒检测、预防及治疗工作提供信息至关重要。通过以全面、综合的方式提供数据，公共卫生监测项目可以支持克服针对特定疾病的孤立工作的低效性、加快预防和临床服务的提供，并解决与HCV-艾滋病毒合并感染相关的额外疾病负担和健康差异问题。
