Spontaneous viral clearance, viral load, and genotype distribution of hepatitis C virus (HCV) in HIV-infected patients with anti-HCV antibodies in Europe
Spontaneous viral clearance, viral load, and genotype distribution of hepatitis C virus (HCV) in HIV-infected patients with anti-HCV antibodies in Europe
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DOI：
10.1086/592171
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发表时间：
2008-11-01
影响因子：
6.4
通讯作者：
Lundgren, Jens
中科院分区：
文献类型：
--
作者：
Soriano, Vincent;Mocroft, Amanda;Lundgren, Jens
背景资料。在人类免疫缺陷病毒(HIV)感染者中，影响血清丙型肝炎病毒(HCVRNA)水平和基因分布的变量尚不清楚，也不是该人群暴露于丙型肝炎病毒后自发清除的决定因素。对EuroSIDA队列中所有保存样本的HIV感染的丙型肝炎病毒抗体(Ab)阳性患者进行血清丙型肝炎病毒RNA检测，并对有病毒血症的患者进行丙型肝炎病毒基因分型。用Logistic回归分析与自发丙型肝炎病毒清除和丙型肝炎病毒1型相关的变量。1940例丙型肝炎病毒抗体阳性患者中，血清丙型肝炎病毒核糖核酸阳性者1496例(77%)。注射吸毒者自发清除丙型肝炎病毒的可能性低于男同性恋者(20%比39%；调整后的优势比[AOR]，0.36[95%可信区间(CI)，0.24~0.53])，而乙肝表面抗原(HBs)阳性的患者比HBs Ag阴性的患者更有可能自发清除丙型肝炎病毒(43%比21%；AOR，2.91[95%CI，1.94-4.38])。在丙型肝炎病毒血症患者中，786例(53%)携带丙型肝炎病毒1型，53例(4%)携带丙型肝炎病毒2型，440例(29%)携带3型，217例(15%)携带4型。丙型肝炎病毒RNA水平越高，感染丙型肝炎病毒1型的几率越大(AOR，1.60/1log高[95%CI，1.36~1.88])。在EuroSIDA中，超过四分之三的艾滋病毒和丙型肝炎抗体阳性患者显示出活跃的丙型肝炎病毒复制。病毒血症在注射吸毒者中更常见，相反，在乙肝表面抗原阳性患者中较少见。在分析的丙型肝炎病毒血症患者中，53%的患者携带丙型肝炎病毒1型，该基因型与较高的血清丙型肝炎病毒核糖核酸水平相关。
Background. Variables influencing serum hepatitis C virus (HCV) RNA levels and genotype distribution in individuals with human immunodeficiency virus (HIV) infection are not well known, nor are factors determining spontaneous clearance after exposure to HCV in this population.Methods. All HCV antibody (Ab)-positive patients with HIV infection in the EuroSIDA cohort who had stored samples were tested for serum HCV RNA, and HCV genotyping was done for subjects with viremia. Logistic regression was used to identify variables associated with spontaneous HCV clearance and HCV genotype 1.Results. Of 1940 HCV Ab-positive patients, 1496 (77%) were serum HCV RNA positive. Injection drug users (IDUs) were less likely to have spontaneously cleared HCV than were homosexual men (20% vs. 39%; adjusted odds ratio [aOR], 0.36 [95% confidence interval {CI}, 0.24-0.53]), whereas patients positive for hepatitis B surface antigen (HBsAg) were more likely to have spontaneously cleared HCV than were those negative for HBsAg (43% vs. 21%; aOR, 2.91 [95% CI, 1.94-4.38]). Of patients with HCV viremia, 786 (53%) carried HCV genotype 1, and 53 (4%), 440 (29%), and 217 (15%) carried HCV genotype 2, 3, and 4, respectively. A greater HCV RNA level was associated with a greater chance of being infected with HCV genotype 1 (aOR, 1.60 per 1 log higher [95% CI, 1.36-1.88]).Conclusions. More than three-quarters of the HIV- and HCV Ab -positive patients in EuroSIDA showed active HCV replication. Viremia was more frequent in IDUs and, conversely, was less common in HBsAg-positive patients. Of the patients with HCV viremia analyzed, 53% were found to carry HCV genotype 1, and this genotype was associated with greater serum HCV RNA levels.