High rate of seronegative HCV infection in HIV-positive patients
High rate of seronegative HCV infection in HIV-positive patients
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DOI：
10.3892/br.2013.188
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发表时间：
2014-01-01
影响因子：
2.3
通讯作者：
Lusida, Maria Inge
中科院分区：
文献类型：
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作者：
Juniastuti;Utsumi, Takako;Lusida, Maria Inge
人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）合并感染是一个重大的全球卫生问题。这两种病毒通过血液接触（主要是静脉注射毒品）传播的效率很高，而丙型肝炎病毒则不太容易通过性行为传播。抗体检测是HCV感染的主要筛查方法，尽管它可能不是HIV感染的最佳选择。本研究的目的是调查hiv阳性患者的HCV感染，有无可检测到的抗HCV抗体反应。从印度尼西亚泗水市hiv阳性患者中采集187份血浆样本，检测抗HCV [HCV酶免疫测定（EIA） 3.0]、HCV基因型。亚型[利用引物靶向部分NS5B/5' UTR进行逆转录聚合酶链反应（RT-PCR），然后进行测序]和HCV病毒载量（定量RT-PCR）。抗HCV阳性119例（63.6%），其中检出HCV RNA 73例（61.3%），HCV-1a为主要亚型（31.5%）。在68份抗HCV阴性样本中，26/68（38.2%）检测到HCV RNA，主要为HCV-3a亚型（50%）。高HCV病毒载量在HCV血清阳性患者中更为常见。检测到HCV RNA的HCV血清阳性样本主要来自hiv阳性的肠外传播（IVDU）患者（76.7%）；然而，HCV RNA检测的HCV血清阴性样本主要来自通过异性传播获得HCV的患者（61.5%）。总之，hiv阳性患者合并丙型肝炎病毒感染的风险很高，一些患者仍然是丙型肝炎病毒血清阴性。此外，通过性途径获得HCV的hiv阳性患者和通过肠外途径获得HCV的患者在HCV血清阳性和亚型上可能存在差异。
Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a significant global health problem. The two viruses are transmitted with high efficacy via blood-to-blood contact, mainly intravenous drug use (IVDU), whereas HCV is less easily transmitted sexually. Antibody testing is the main screening method for HCV infection, although it may not be the optimal option for HIV infection. The aim of this study was to investigate HCV infection in HIV-positive patients, with and without a detectable anti-HCV antibody response. A total of 187 plasma samples were obtained from HIV-positive patients in Surabaya, Indonesia and examined for anti-HCV [HCV enzyme immunoassay (EIA) 3.0], HCV genotype.subtype [reverse transcription- polymerase chain reaction (RT-PCR) using primers targeting a part of NS5B/5' UTR followed by sequencing] and HCV viral load (quantitative RT-PCR). A total of 119 patients (63.6%) were found to be anti-HCV-positive and, among these, HCV RNA was detected in 73 (61.3%), with HCV-1a as the predominant subtype (31.5%). Of the 68 anti-HCV-negative samples, HCV RNA was detected in 26/68 (38.2%) mostly as the HCV-3a subtype (50%). High HCV viral loads were more common among the HCV-seropositive patients. The HCV-seropositive samples with detected HCV RNA were mostly obtained from HIV-positive patients with parenteral transmission (IVDU) (76.7%); however, the HCV-seronegative samples with detected HCV RNA were mostly from patients who had acquired HCV through heterosexual transmission (61.5%). In conclusion, HIV-positive patients were at high risk of becoming co-infected with HCV and several remained HCV-seronegative. Furthermore, there may exist differences in HCV seropositivity and subtypes between HIV-positive patients who acquired HCV sexually and those who acquired HCV parenterally.