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刚果民主共和国南基伍省儿童乙型和丙型肝炎病毒合并感染的流行情况及其与 HIV 感染的相关因素。

Prevalence of hepatitis B and C viral co-infection and associated factors with HIV infection in children in South Kivu, Democratic Republic of the Congo.

机构信息

Department of Paediatrics, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, DR, Congo.

Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, DR, Congo.

出版信息

BMC Infect Dis. 2023 Aug 14;23(1):531. doi: 10.1186/s12879-023-08474-8.

Abstract

BACKGROUND

The World Health Organization's (WHO) 2030 goal of eradicating Hepatitis B and C viruses must also include HIV co-infected children. However, data on the prevalence of this condition are lacking in the Democratic Republic of Congo (DRC), which is considered as one of the countries with high-prevalence of these viruses. The need to assess the extent of this co-infection in the children of this country is therefore important in order to capitalize on efforts to improve prevention and management of both infections.

METHODOLOGY

This is a comparative cross-sectional study conducted from February 04, 2015 to September 03, 2019 at 14 General Reference Hospitals with a pediatric HIV management programme in South Kivu province. The study compared the frequency of hepatitis B (HBV) and C (HCV) markers and factors associated with these two viruses in two equal groups: HIV-positive and HIV-negative children. The data were analyzed using the SPSS version 20.0 software and the significance level was set at p-value less than 0.05.

RESULTS

The study involved a total of 594 children, 297 of whom were HIV-positive and 297 negative. HBsAg was found in 8.7% of HIV-positive patients and 0.7% for HCV antibodies. On the other hand, among the HIV-negative patients, the proportion of HBsAg was 0.7% but no cases with anti-HCV antibodies were detected. HIV status increases by 14 times the risk of co-occurring with HBV [OR 14.1 (95% CI: 3.33-60.2); p < 0.001] and this risk is not apparent for HCV (p = 0.297). Multivariate logistic regression showed that history of jaundice in the family (aOR:4.19;95% CI: 2.12-11.59), recent hospitalization (aOR:10.7;95% CI: 6.69-17.2), surgery (aOR: 3.24;95% CI: 1.18-8.92), piercing (aOR: 4.26;95% CI: 1.70-10.7) and transfusion in the last 6 months (aOR: 2.69;95% CI: 1.55-4.67) were significantly associated with higher risk of being HBV- HIV co-infected.

CONCLUSION

This study investigated the importance of hepatitis viral co-infections in HIV-positive children in South Kivu. Particular attention should be paid to prevention and early detection of these co-infections in this population.

摘要

背景

世界卫生组织(WHO)2030 年消除乙型肝炎和丙型肝炎病毒的目标也必须包括 HIV 合并感染的儿童。然而,在被认为是这些病毒高发国家之一的刚果民主共和国(DRC),缺乏关于这种情况流行率的数据。因此,评估该国儿童中这种合并感染的程度非常重要,以便利用改善这两种感染的预防和管理的努力。

方法

这是一项在南基伍省 14 家具有儿科 HIV 管理项目的综合参考医院进行的比较性横断面研究。该研究比较了两组(HIV 阳性和 HIV 阴性儿童)乙型肝炎(HBV)和 C 型肝炎(HCV)标志物的频率以及与这两种病毒相关的因素。数据使用 SPSS 版本 20.0 软件进行分析,显著性水平设置为 p 值小于 0.05。

结果

该研究共涉及 594 名儿童,其中 297 名 HIV 阳性,297 名 HIV 阴性。HBsAg 在 8.7%的 HIV 阳性患者中发现,而 HCV 抗体在 0.7%的患者中发现。另一方面,在 HIV 阴性患者中,HBsAg 的比例为 0.7%,但未检测到抗 HCV 抗体。HIV 状况使 HBV 合并感染的风险增加 14 倍[OR 14.1(95%CI:3.33-60.2);p<0.001],而 HCV 合并感染的风险不明显(p=0.297)。多变量逻辑回归显示,家族性黄疸史(aOR:4.19;95%CI:2.12-11.59)、最近住院(aOR:10.7;95%CI:6.69-17.2)、手术(aOR:3.24;95%CI:1.18-8.92)、穿孔(aOR:4.26;95%CI:1.70-10.7)和 6 个月内输血(aOR:2.69;95%CI:1.55-4.67)与 HBV-HIV 合并感染的风险显著相关。

结论

本研究调查了南基伍省 HIV 阳性儿童中乙型肝炎病毒合并感染的重要性。特别应注意在该人群中预防和早期发现这些合并感染。

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