Association between syphilis, antibodies to herpes simplex virus type 2, and recreational drug use and hepatitis B virus infection in the Women's Interagency HIV Study.
Association between syphilis, antibodies to herpes simplex virus type 2, and recreational drug use and hepatitis B virus infection in the Women's Interagency HIV Study.
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DOI：
10.1086/424879
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发表时间：
2004-11
期刊：
影响因子：
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通讯作者：
P. Tien;A. Kovacs;P. Bacchetti;A. French;M. Augenbraun;S. Cole;N. Hessol;J. Justman
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文献类型：
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作者：
P. Tien;A. Kovacs;P. Bacchetti;A. French;M. Augenbraun;S. Cole;N. Hessol;J. Justman
肝病是人类免疫缺陷病毒（HIV）感染妇女死亡的主要原因;然而，这一人群中B型肝炎病毒（HBV）感染的危险因素尚未得到很好的研究。方法：我们描述了在1994-95年和2001-02年期间参加妇女机构间HIV研究的2132名HIV感染妇女的横断面分析中HBV感染的血清阳性率和预测因素。任何检测结果为阳性的B型肝炎核心抗原抗体定义的感染;那些有疫苗免疫的血清学证据的妇女被排除在分析之外。女性被分为有注射毒品使用史（IDU）、有非注射毒品使用史（non-IDU）和无非法毒品使用史。结果：在1606名HIV感染者和526名未感染者中，分别有7%和12%的人出现疫苗免疫。在排除这些妇女后，1500名艾滋病毒感染者中有43%和461名艾滋病毒未感染妇女中有22%感染了HBV。静脉吸毒者、非静脉吸毒者和无非法药物使用者的HBV感染率不同（分别为76%、30%和17%; P<0.0001）。在IDU组中，HBV感染与单纯疱疹病毒2型（HSV-2）血清阳性密切相关（比值比[OR]，2.9; 95%置信区间[CI]，1.6-5.4），在非IDU组中，HBV感染与梅毒史密切相关（OR，2.7; 95% CI，1.4-5.0）。讨论我们发现，在我们的队列中，HBV感染的妇女和艾滋病毒感染的风险很高。HSV-2血清阳性和梅毒史似乎是HBV感染的重要相关因素。乙型肝炎病毒的性传播，特别是在有生殖器溃疡病史的人群中，应该成为所有高危人群教育的一个主要重点。
BACKGROUND Liver disease is a leading cause of death in human immunodeficiency virus (HIV)-infected women; however, risk factors for hepatitis b virus (hbv) infection in this population have not been well studied. METHODS We describe the seroprevalence and predictors of HBV infection in a cross-sectional analysis of 2132 women with and at risk for HIV infection enrolled in the Women's Interagency HIV Study during the periods 1994-95 and 2001-02. Any test result positive for antibody to hepatitis B core antigen defined infection; those women with serological evidence of vaccine immunity were excluded from analysis. Women were stratified into those with a history of injection drug use (IDU), those with a history of noninjection drug use (non-IDU), and those with no history of illicit drug use. RESULTS Of 1606 HIV-infected and 526 HIV-uninfected women, 7% and 12%, respectively, appeared to be vaccine immune. After exclusion of these women, 43% of 1500 HIV-infected and 22% of 461 HIV-uninfected women had HBV infection. HBV infection prevalence differed among the IDU, non-IDU, and no illicit drug use groups (76%, 30%, and 17%, respectively; P<.0001). HBV infection was strongly associated with herpes simplex virus 2 (HSV-2) seropositivity in the IDU group (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.6-5.4) and with a history of syphilis in the non-IDU group (OR, 2.7; 95% CI, 1.4-5.0). DISCUSSION We found a high prevalence of HBV infection in our cohort of women with and at risk for HIV infection. HSV-2 seropositivity and a history of syphilis appeared to be important correlates of HBV infection. Sexual transmission of HBV, particularly in those with a history of genital ulcer disease, should be a major focus of education in all high-risk groups.