北京地区人类免疫缺陷病毒感染者合并乙型肝炎病毒感染的流行病学特征及影响因素分析  

Epidemiology and influencing factors of human immunodeficiency virus and hepatitis B virus co-infected patients in Beijing

作　　者：李艺 张黎[1] 肖江 姜太一[4] 刘正印[1] Li Yi;Zhang Li;Xiao Jiang;Jiang Taiyi;Liu Zhengyin(Department of Infectious Disease,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate School,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100005,China;Center for Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Center for Infectious Diseases,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院感染内科,100730 [2]中国医学科学院北京协和医学院研究生院,100005 [3]首都医科大学附属北京地坛医院感染病中心,100015 [4]首都医科大学附属北京佑安医院感染病中心,100069

出　　处：《中华内科杂志》2021年第3期233-238,共6页Chinese Journal of Internal Medicine

基　　金：北京市科学技术委员会HIV/HBV共感染研究(D161100000416004)。

摘　　要：目的分析北京市人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者合并乙型肝炎病毒(HBV)感染的流行病学特征,并探索影响合并感染的相关因素。方法对北京地区HIV/AIDS定点治疗医院(北京协和医院、北京地坛医院、北京佑安医院)长期随访的接受抗反转录病毒治疗(ART)的13253例HIV感染者临床资料进行回顾性分析。结果排除未进行HBV标志物检测的患者1681例,共有11572例HIV感染者纳入研究,其中HIV合并HBV感染的患者532例(4.6%),主要为青壮年(28~48岁)男性,占85.9%,感染途径以同性性传播为主(74.8%)。87.4%的合并感染患者基线治疗接受了包含拉米夫定(3TC)、替诺福韦(TDF)两种抗HBV药物的治疗。2013—2018年,HIV合并HBV感染的年新增感染率呈波动性下降的趋势,年均增长率分别为6.37%、4.55%、3.92%、4.68%、4.24%和2.74%。HIV合并HBV感染的主要影响因素为年龄(28~48岁比<28岁,OR=2.807,95%CI 1.241~6.345)以及婚姻状况(已婚比未婚,OR=1.259,95%CI 1.004~1.579)。结论北京地区HIV合并HBV感染率为4.6%;2013—2018年HIV合并HBV的年新增合并感染率呈下降趋势。青壮年(28~48岁)已婚HIV感染者合并HBV感染的风险较高。Objective To analyze the epidemiological characteristics of human immunodeficiency virus(HIV)and hepatitis B virus(HBV)co-infected patients in Beijing and investigate the associated factors.Methods The clinical data of patients with HIV infection who were treated in HIV/AIDS designated hospitals(Peking Union Medical College Hospital,Beijing Ditan Hospital and Beijing Youan Hospital)were retrospectively analyzed.Results A total of 11572 patients were finally included in the study,among whom 532 patients(4.6%)were co-infected with HIV and HBV.Most of the co-infected patients were young male adults(28~48 years old),accounting for 85.9%.The main transmission route was homosexual behavior(74.8%).There were 87.4%co-infected patients treated with two anti-HBV drugs,including lamivudine(3TC)and tenofovir(TDF).From 2013 to 2018,the annual prevalence of HIV and HBV co-infection decreased gradually,with the rate of 6.37%,4.55%,3.92%,4.68%,4.24%and 2.74%,respectively.In our study,The main influencing factors of HIV and HBV co-infection were age older than 28 years old versus<28 years old(OR=2.807,95%CI 1.241-6.345)and marriage status(married versus unmarried,OR=1.259,95%CI 1.004-1.579).Conclusions The proportion of HBV infection in HIV-infected patients is 4.60%(532)in our cohort.From 2013 to 2018,the prevalence of HIV and HBV co-infection in Beijing shows a decreasing trend.The risk of co-infection is higher in married young adults(28~48 years old).

关 键 词：HIV感染 肝炎病毒 乙型 合并感染 

分 类 号：R512.91[医药卫生—内科学] R512.62[医药卫生—临床医学] R181.3