High incidence and persistence of hepatitis B virus infection in individuals receiving HIV care in KwaZulu-Natal, South Africa.
High incidence and persistence of hepatitis B virus infection in individuals receiving HIV care in KwaZulu-Natal, South Africa.
复制标题
南非夸祖鲁-纳塔尔接受HIV治疗的个体中B型肝炎病毒感染的高发病率和持续性
DOI：
10.1186/s12879-020-05575-6
复制
发表时间：
2020-11-16
影响因子：
3.7
通讯作者：
Mlisana K
中科院分区：
文献类型：
--
作者：
Msomi N;Naidoo K;Yende-Zuma N;Padayatchi N;Govender K;Singh JA;Abdool-Karim S;Abdool-Karim Q;Mlisana K
乙肝病毒、人类免疫缺陷病毒和结核病是南非常见的传染病。我们利用为艾滋病毒-结核病合并感染患者提供护理的机会，以更好地了解这些联合感染之间的关系，确定问题的严重性，并确定在南非夸祖鲁-纳塔尔患有和不患有结核病的艾滋病毒感染患者中感染乙肝病毒的危险因素。这项回顾队列分析是在2018年进行的。住院的艾滋病毒感染者也被纳入分析范围。对临床记录结果进行分析，以确定合并或不合并结核感染的HIV感染者的患病率、发病率、持久性以及与HBs Ag阳性相关的因素。共纳入4292例艾滋病毒感染者，平均年龄34.7 岁(SD：8.8)。根据HBs Ag阳性，基线时乙肝病毒感染率为8.5%(363/4292)[95%可信区间：7.7~9.3]，随访结束时为9.4%(95%可信区间：8.6~10.3%)。乙肝发病率为2.1/100人年(p-y)。男性患者发生乙肝病毒感染的风险是男性的两倍(HR2.11；95%CI：1.14-3.92)，而严重的免疫抑制与持续感染的风险增加两倍以上(调整后的风险比(RR)2.54；95%CI 1.06-6.14；p = 0.004)。此外，登记时的活动性结核病与发生乙肝病毒感染的风险增加两倍相关(AHR 2.38；95%CI：0.77-7.35)。在高乙肝病毒负担环境中提供艾滋病毒护理和治疗，错失了乙肝病毒筛查、免疫接种和护理提供的机会。
Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude of the problem, and identify risk factors for HBV infection in HIV infected patients with and without TB in KwaZulu-Natal, South Africa. This retrospective cohort analysis was undertaken in 2018. In-care HIV infected patients were included in the analysis. Results from clinical records were analysed to determine the prevalence, incidence, persistence and factors associated with HBsAg positivity in HIV-infected patients with or without TB co-infection. A total of 4292 HIV-infected patients with a mean age of 34.7 years (SD: 8.8) were included. Based on HBsAg positivity, the prevalence of HBV was 8.5% (363/4292) [95% confidence interval (CI): 7.7–9.3] at baseline and 9.4% (95%CI: 8.6–10.3%) at end of follow-up. The HBV incidence rate was 2.1/100 person-years (p-y). Risk of incident HBV infection was two-fold higher among male patients (HR 2.11; 95% CI: 1.14–3.92), while severe immunosuppression was associated with a greater than two-fold higher risk of persistent infection (adjusted risk ratio (RR) 2.54; 95% CI 1.06–6.14; p = 0.004. Additionally, active TB at enrolment was associated with a two-fold higher risk of incident HBV infection (aHR 2.38; 95% CI: 0.77–7.35). The provision of HIV care and treatment in high HBV burden settings provide a missed opportunity for HBV screening, immunization and care provision.
登录
查看更多内容
影响因子：
168.9
作者：
Schweitzer, Aparna;Horn, Johannes;Ott, Joerdis J.
通讯作者：
Ott, Joerdis J.
影响因子：
12.7
作者：
MacKellar, DA;Valleroy, LA;Janssen, RS
通讯作者：
Janssen, RS
影响因子：
5.5
作者：
Simani, Omphile E.;Leroux-Roels, Geert;Mphahlele, M. Jeffrey
通讯作者：
Mphahlele, M. Jeffrey
DOI：
10.1056/nejmoa0905848
发表时间：
2010-02-25
期刊：
The New England journal of medicine
影响因子：
--
作者：
Abdool Karim SS;Naidoo K;Grobler A;Padayatchi N;Baxter C;Gray A;Gengiah T;Nair G;Bamber S;Singh A;Khan M;Pienaar J;El-Sadr W;Friedland G;Abdool Karim Q
通讯作者：
Abdool Karim Q
影响因子：
8.8
作者：
Lavanchy, D.
通讯作者：
Lavanchy, D.