贵州地区HIV/AIDS患者合并HCV感染情况及影响因素研究  

Status and Influencing Factors of HIV/AIDS Patients Co-infected with Hepatitis C Virus in Guizhou

作　　者：杨秀程 洪章萍 刘青 胡勇[1] 李杰[4] 杨兴林 YANG Xiucheng;HONG Zhangping;LIU Qing;HU Yong;LI Jie;YANG Xinglin(School of Public Health and Wellness,Guizhou Medical University,Guiyang 550025,China;Department of Infectious Disease Control,Aba Center for Disease Control and Prevention,Aba 624000,China;Department of Laboratory,Guiyang Medical Center for Public Health,Guiyang 550004,China;Office of Health Emergency,Meishan Center for Disease Control and Prevention,Meishan 620010,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,贵州省贵阳市550025 [2]四川省阿坝藏族羌族自治州疾病预防控制中心传染病管理所,624000 [3]贵州省贵阳市公共卫生救治中心检验科,550004 [4]四川省眉山市疾病预防控制中心卫生应急办公室,620010

出　　处：《中国全科医学》2022年第28期3531-3536,共6页Chinese General Practice

基　　金：贵阳市科技局计划项目(筑科合同[2018]1-40号)。

摘　　要：背景我国各地艾滋病病毒(HIV)感染/艾滋病(AIDS)患者合并丙型肝炎病毒(HCV)感染情况差异较大,HIV、HCV两种病毒合并感染可加快疾病临床进展,从而降低患者生存质量、加剧死亡的发生。目前针对贵州地区HIV/AIDS患者合并HCV感染的研究相对较少。目的了解贵州地区HIV/AIDS患者合并HCV感染情况,并分析其影响因素,从而为早期发现HIV/AIDS患者合并HCV感染提供诊疗依据。方法本研究纳入病例来源于2006年3月至2020年12月在贵阳市公共卫生救治中心接受抗病毒治疗(ART)的HIV/AIDS患者队列,最终纳入符合研究要求的患者3084例。收集患者的性别、年龄、民族、文化程度、职业、婚姻状况、感染途径、确诊年份、ART前的CD_(4)^(+)T淋巴细胞和抗-HCV水平。采用多因素Logistic回归分析HIV/AIDS患者合并HCV感染的影响因素。结果3084例HIV/AIDS患者中,合并HCV感染202例,合并感染率为6.55%。不同年龄、文化程度、职业、感染途径HIV/AIDS患者合并HCV感染率比较,差异有统计学意义(P<0.05);不同性别、民族、婚姻状况HIV/AIDS患者合并HCV感染率比较,差异无统计学意义(P>0.05);随着确诊年份的增长、CD_(4)^(+)T淋巴细胞水平的升高,HIV/AIDS患者合并HCV感染率呈下降趋势(P<0.05)。多因素Logistic回归分析结果显示,30~39、40~49岁HIV/AIDS患者合并HCV感染的风险高于≥50岁者〔OR(95%CI)分别为2.512(1.374,4.593)、2.802(1.521,5.163)〕,农民HIV/AIDS患者合并HCV感染的风险高于其他职业者〔OR(95%CI)=1.926(1.201,3.090)〕,感染途径为静脉吸毒HIV/AIDS患者合并HCV感染的风险高于男男同性传播者〔OR(95%CI)=39.038(17.559,86.790)〕,2006—2010、2011—2015年确诊HIV/AIDS患者合并HCV感染的风险高于2016—2020年确诊者〔OR(95%CI)分别为10.890(6.428,18.447)、4.613(2.928,7.269)〕,基线CD_(4)^(+)T淋巴细胞<200、200~350、351~499个/μl HIV/AIDS患者合并HCV感染的风险高于≥500个/μl者〔OBackground The status of patients with HIV/AIDS co-infected with HCV considerably varies in different parts of China.The co-infection of HIV and HCV accelerates the clinical progress of the disease,thereby reducing the patients'quality of life and exacerbating the occurrence of death.Currently,there are relatively few studies on patients with HIV/AIDS coinfected with HCV in Guizhou.Objective To analyze the status of patients with HIV/AIDS co-infected with HCV in Guizhou and its influencing factors and consequently provide basis for its early detection,diagnosis,and treatment.Methods The cases included in this study were a cohort of HIV/AIDS patients who received antiviral therapy(ART)in the public health rescue center of Guangzhou from March 2006 to December 2020.Finally,3084 patients who met the study requirements were included.Patients'sex,age,ethnicity,education level,occupation,marital status,route of infection,year of diagnosis,and CD_(4)^(+)T-lymphocytes before ART and anti HCV levels were collected.Multivariate Logistic regression model were used to identify influencing factors of patients with HIV/AIDS co-infected with HCV.Results Among the 3084 patients with HIV/AIDS,202 were co-infected with HCV,and the co-infection rate was 6.55%.There were significant differences in HCV infection rates among patients with HIV/AIDS of different age groups,education levels,occupations,route of infection(P<0.05).There were no significant differences in HCV infection rates among patients with HIV/AIDS by gender,ethnicity,and marital status(P>0.05).The prevalence of HCV infection among HIV/AIDS patients tended to decrease with increasing year of diagnosis and increasing levels of CD_(4)^(+)T lymphocytes(P<0.05).Multivariate Logistic regression analysis showed that the risk of HCV infection was higher among HIV/AIDS patients aged 30-39 and 40-49 years than among those≥50 years〔OR(95%CI)=2.512(1.374,4.593),2.802(1.521,5.163),respectively〕,and the risk of HCV infection was higher among HIV/AIDS farmers than among those

关 键 词：HIV感染 获得性免疫缺陷综合征 丙型肝炎病毒 丙型肝炎 影响因素分析 贵州 

分 类 号：R512.91[医药卫生—内科学] R373.21[医药卫生—临床医学]