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韩国慢性乙型肝炎及丙型肝炎病毒或人类免疫缺陷病毒合并感染的流行病学特征:一项基于韩国健康保险审查与评估服务数据库的全国性索赔研究

Epidemiologic Characteristics of Chronic Hepatitis B and Coinfections with Hepatitis C Virus or Human Immunodeficiency Virus in South Korea: A Nationwide Claims-Based Study Using the Korean Health Insurance Review and Assessment Service Database.

作者信息

Oh Hyunwoo, Sohn Won, Choi Na Ryung, Lee Hyo Young, Kim Yeonjae, Nam Seung Woo, Jeong Jae Yoon

机构信息

Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea.

Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea.

出版信息

Pathogens. 2025 Jul 19;14(7):715. doi: 10.3390/pathogens14070715.

Abstract

Coinfections with hepatitis C virus (HCV) or human immunodeficiency virus (HIV) among individuals with chronic hepatitis B (CHB) are associated with worse clinical outcomes but remain understudied due to their low prevalence and the sensitivity of associated data. This nationwide, cross-sectional study utilized claims data from the Korean Health Insurance Review and Assessment Service (2014-2021) to investigate the prevalence, comorbidities, treatment patterns, and liver-related complications among patients with HBV monoinfection, HBV/HIV, HBV/HCV, or triple coinfection. Among over 4.5 million patients with chronic hepatitis B, the prevalence of HIV and HCV coinfection ranged from 0.05 to 0.07% and 0.77 to 1.00%, respectively. Patients with HBV/HCV coinfection were older and had significantly higher rates of hypertension, diabetes, dyslipidemia, and major adverse liver outcomes, including hepatocellular carcinoma and liver transplantation, compared to other groups. HBV/HIV coinfection was more common in younger males and was associated with higher dyslipidemia. The use of HBV antivirals increased over time across all groups. These findings highlight the distinct clinical characteristics and unmet needs of coinfected populations, underscoring the importance of tailored screening and management strategies in HBV-endemic settings.

摘要

慢性乙型肝炎(CHB)患者中合并感染丙型肝炎病毒(HCV)或人类免疫缺陷病毒(HIV)与更差的临床结局相关,但由于其低患病率和相关数据的敏感性,仍未得到充分研究。这项全国性横断面研究利用韩国健康保险审查与评估服务机构(2014 - 2021年)的理赔数据,调查了单纯感染HBV、HBV/HIV、HBV/HCV或三重感染患者的患病率、合并症、治疗模式及肝脏相关并发症。在超过450万慢性乙型肝炎患者中,HIV和HCV合并感染的患病率分别为0.05%至0.07%和0.77%至1.00%。与其他组相比,HBV/HCV合并感染的患者年龄更大,高血压、糖尿病、血脂异常以及包括肝细胞癌和肝移植在内的主要肝脏不良结局的发生率显著更高。HBV/HIV合并感染在年轻男性中更为常见,且与更高的血脂异常相关。所有组中HBV抗病毒药物的使用随时间增加。这些发现凸显了合并感染人群独特的临床特征和未满足的需求,强调了在HBV流行地区制定针对性筛查和管理策略的重要性。

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