深圳市初治HIV感染者合并HBV感染率及特征分析  

Prevalence and characteristics of HBV infection among treatment-naive HIV-infected individuals in Shenzhen

作　　者：刘甲野 孙丽琴[1] 周泱[1] 何云[1] 王嗣予 张纪元 徐六妹[1] 张路坤[1] 赵方[1] 郑祎 王辉[1] 王福生 LIU Jia-ye;SUN Li-qin;ZHOU Yang;HE Yun;WANG Si-yu;ZHANG Ji-yuan;XU Liu-mei;ZHANG Lu-kun;ZHAO Fang;ZHENG Yi;WANG Hui;WANG Fu-sheng(First Department of Infectious Disease,Shenzhen Third People’s Hospital,518000,China)

机构地区：[1]深圳市第三人民医院感染一科,518000 [2]中国人民解放军总医院第五医学中心感染性疾病诊疗与研究中心,北京100039

出　　处：《传染病信息》2020年第2期112-118,共7页Infectious Disease Information

基　　金：深圳市“医疗卫生三名工程”王福生院士团队(SZSM201612014);陈志伟教授团队(SZSM201512029)。

摘　　要：目的了解深圳市初治HIV感染者合并HBV感染率、特征及HBV易感率。方法以2015—2018年深圳市第三人民医院收治的未接受过抗反转录病毒治疗的成年HIV感染者作为研究对象,收集其基本特征和临床资料,分析纳入对象合并HBV的感染率、合并感染者特征及HBV易感率。结果共纳入4666例初治HIV感染者,合并HBV感染率为10.46%(488/4666);合并感染率随年龄升高、CD4细胞计数的降低和WHO HIV临床分期的加重均呈现逐渐增高的趋势(P均<0.05)。不同HBV DNA水平分组间HIV RNA的差异以及不同HIV RNA水平分组间HBV DNA的差异均无统计学意义(P均>0.05)。HIV/HBV共感染者以HBeAg阴性所占比例较高(76.2%),但HBeAg阳性者ALT异常率高于HBeAg阴性者(31.03%vs.15.86%,P<0.05)。深圳市HIV感染者HBV易感率为24.73%(1154/4666),女性高于男性(31.56%vs.24.16%,P<0.05),15~24岁在各年龄组中最高,为29.00%(P<0.05)。结论深圳市初治HIV感染者合并HBV感染率和HBV易感率均较高。年龄较大和病程较重的HIV感染者合并HBV感染率最高。建议对HIV感染者常规进行治疗前HBV的筛查、临床状态的评估及用药后的监测。对乙型肝炎(乙肝)五项检测均为阴性的HBV易感者建议接种乙肝疫苗。Objective To explore the prevalence and characteristics of HBV infection and the susceptibility rate of HBV among treatment-naive HIV-infected individuals in Shenzhen,China.Methods Antiretroviral therapy-naive HIV-infected adults who were treated in Shenzhen Third People’s Hospital from 2015 to 2018 were enrolled in the study.Their general data and clinical information were collected.The prevalence and characteristics of HBV infection and the susceptibility rate of HBV in HIV-infected individuals were investigated.Results A total of 4666 treatment-naive HIV-infected individuals were enrolled in this study.Among them,10.46%(488/4666)had HBV co-infection.The higher prevalence of HIV/HBV co-infection was observed in the elderly,patients with lower CD4 count or at advanced stage of WHO HIV clinical staging(P<0.05).No significant difference was observed on the HIV RNA load among different HBV DNA level groups,and on the HBV DNA load among different HIV RNA level groups(P>0.05).The proportion of HIV/HBV co-infected patients with HBeAg negative results was relatively higher(76.2%),however,the proportion of abnormal ALT was higher in HBeAg positive patients than that in HBeAg negative patients(31.03%vs.15.86%,P<0.05).Among the HIV-infected individuals in Shenzhen,the HBV susceptibility rate was 24.73%(1154/4666),and it was higher in female than that in male(31.56%vs.24.16%,P<0.05).Patients aged 15-24 years old had the highest rate of HBV susceptibility,accounting for 29.00%(P<0.05).Conclusions The prevalence of HBV co-infection and the susceptibility rate of HBV in treatment-naive HIV-infected individuals are relatively higher in Shenzhen,China.The prevalence of HBV co-infection reaches the peak in the elderly and patients at advanced stage.Routine screening of HBV before treatment,clinical condition assessment,and monitoring after treatment in HIV-infected individuals are suggested.Hepatitis B vaccination is recommended for HBV susceptible patients with negative results for hepatitis B five-item test.

关 键 词：人类免疫缺陷病毒 乙型肝炎病毒 共感染率 易感 

分 类 号：R512.91[医药卫生—内科学] R512.6[医药卫生—临床医学]