Coinfection with HIV and hepatitis C virus among injection drug users in southern China
Coinfection with HIV and hepatitis C virus among injection drug users in southern China
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DOI：
10.1086/429491
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发表时间：
2005-07-01
影响因子：
11.8
通讯作者：
Yu, XF
中科院分区：
文献类型：
--
作者：
Garten, RJ;Zhang, JB;Yu, XF
背景：我们试图在中国广西的注射吸毒者（IDUs）中检测人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）的合并感染情况。
方法：建立了一个注射吸毒者纵向队列（547名受试者）以研究血液传播感染的危险因素。每次随访时，参与者完成调查问卷，内容包括人口统计学特征、吸毒模式和性行为。采集血液样本并分析HIV和HCV的存在及基因型。
结果：17.6%的注射吸毒者存在HIV和HCV合并感染。95.1%的HIV阳性和70.4%的HIV阴性海洛因使用者感染了HCV。HCV阳性和HCV阴性海洛因使用者中HIV的患病率分别为23.4%和3.6%。多变量逻辑回归分析显示，过去6个月的性活动以及注射吸毒的持续时间与HIV和HCV合并感染显著相关。主要的循环HCV基因型包括6a（38%）、3b（37%）和1a（19%），而基因型6e（4%）、3a（2%）和1b（1%）仅在少数注射吸毒者中存在。每个研究地点都存在多种HCV基因型，且不按HIV状态或亚型区分。
结论：HCV在中国南方的注射吸毒者中高度流行。在广西，HIV感染是经肠道外和性传播的结果，因此，所有注射吸毒者都有很高的HIV和HCV合并感染风险。对HCV的分子追踪可能比HIV亚型分析更能敏感地预测HIV - 1疫情未来的传播。这项研究强调，如果中国不实施注射预防和初级药物滥用防治项目，HIV和HCV合并感染的程度和影响只会增加。
Background. We sought to examine coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among injection drug users (IDUs) in Guangxi, China.Methods. A longitudinal cohort of IDUs ( 547 subjects) was established to study risk factors for bloodborne infections. At each visit, participants completed questionnaires defining demographic characteristics, patterns of drug use, and sexual behaviors. Blood samples were collected and analyzed for the presence and genotype of HIV and HCV.Results. Coinfection with HIV and HCV was found in 17.6 % of the IDUs. HCV was present in 95.1 % of HIV-positive and 70.4 % of HIV-negative heroin users. The prevalence of HIV in HCV-positive and HCV-negative heroin users was 23.4 % and 3.6 %, respectively. Multivariate logistic regression analysis revealed that sexual activity during the past 6 months and duration of injection drug use were significantly associated with coinfection with HIV and HCV. The main circulating HCV genotypes included 6a (38 %), 3b (37 %), and 1a (19 %), whereas genotypes 6e (4 %), 3a (2 %), and 1b (1 %) were present in only a few IDUs. Multiple HCV genotypes were present at each study site and did not segregate by HIV status or subtype.Conclusions. HCV is highly prevalent in IDUs throughout southern China. In Guangxi, HIV infections are the result of parenteral and sexual transmission, and, therefore, all IDUs are at high risk of coinfection with HIV and HCV. Molecular tracking of HCV may be a more sensitive predictor of the future spread of the HIV-1 epidemic than is HIV subtyping. This study emphasizes that, without implementation of injection prevention and primary substance abuse programs in China, the extent and effect of coinfection with HIV and HCV will only increase.