Factors associated with seronegative chronic hepatitis C virus infection in HIV infection
Factors associated with seronegative chronic hepatitis C virus infection in HIV infection
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DOI：
10.1086/511038
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发表时间：
2007-02-15
影响因子：
11.8
通讯作者：
Tien, Phyllis C.
中科院分区：
文献类型：
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作者：
Chamie, Gabriel;Bonacini, Maurizio;Tien, Phyllis C.
背景慢性血清阴性丙型肝炎病毒（HCV）感染定义为HCV抗体（抗HCV）阴性，但感染人类免疫缺陷病毒（HIV）的个体中出现HCV RNA阳性。然而，相关因素并没有很好地建立，因为报告的病例数少。来自4个队列的HIV感染受试者的多变量逻辑回归分析（Tien等人，2006; Bonacini等人，2001;乔治等人，2002;以及Hall等人，2004）确定了与抗HCV阴性受试者中HCV RNA阳性相关的因素。采用HCV酶免疫分析2.0检测抗-HCV。在1174例抗HCV阴性的HIV感染受试者中，血清阴性HCV感染的患病率为3.2%（95%置信区间[CI]，2.2%-4.3%）。抗HCV阴性受试者中，注射吸毒史（IDU; OR，5.8; 95%CI，2.7-12.8）、较高的丙氨酸氨基转移酶（ALT）水平（OR，2.0/倍; 95%CI，1.3-3.2）和CD 4细胞计数< 200个细胞/μ L（OR，2.3; 95%CI，1.1-4.8）与HCV RNA阳性相关。在有IDU史且CD 4细胞计数< 200个/μ L或ALT水平高于正常上限的人群中，血清阴性HCV感染率为24%（95%CI，13%~ 39%）。在HCV酶免疫测定2.0阴性的情况下，HIV感染患者中可检测到的HCV RNA较低，但高于HIV未感染患者中报告的患病率。我们的研究结果表明，HCVRNA检测应在抗-HCV阴性的HIV感染患者中进行，特别是那些有IDU病史和CD 4细胞计数< 200个细胞/μ L或ALT水平异常的患者。
Background. Chronic seronegative hepatitis C virus (HCV) infection is defined as being HCV antibody (anti-HCV) negative, but HCV RNA positivity occurs in individuals infected with human immunodeficiency virus (HIV). However, associated factors are not well established because of the small number of reported cases.Methods. Multivariate logistic regression analysis of HIV-infected subjects from 4 cohorts ( Tien et al.,2006; Bonacini et al., 2001; George et al., 2002; and Hall et al., 2004) determined factors associated with HCV RNA positivity in anti-HCV-negative subjects. HCV enzyme immunoassay 2.0 was used to determine anti-HCV status.Results. Among 1174 anti-HCV-negative, HIV-infected subjects, the prevalence of seronegative HCV infection was 3.2% (95% confidence interval [CI], 2.2%-4.3%). History of injection drug use (IDU; OR, 5.8; 95% CI, 2.7-12.8), higher alanine aminotransferase (ALT) level ( OR, 2.0 per doubling; 95% CI, 1.3-3.2), and CD4 cell count < 200 cells/mu L (OR, 2.3; 95% CI, 1.1-4.8) were associated with HCV RNA positivity in anti-HCV-negative subjects. Among those with a history of IDU who had either a CD4 cell count < 200 cells/mu L or an ALT level greater than the upper limit of normal, the prevalence of seronegative HCV infection was 24% (95% CI, 13%-39%).Conclusions. Detectable HCV RNA in the context of a negative HCV enzyme immunoassay 2.0 result in HIV-infected patients is low, but higher than the reported prevalence in HIV-uninfected patients. Our findings suggest that HCVRNA testing should be performed in anti-HCV-negative, HIV-infected patients, especially those with a history of IDU and either a CD4 cell count < 200 cells/mu L or an abnormal ALT level.