有偿献血员中艾滋病病毒、乙型肝炎和丙型肝炎病毒感染状况的研究

目的 探讨有偿献血员艾滋病病毒(HIV)、丙型肝炎(丙肝)病毒(HCV)、乙型肝炎(乙肝)病毒(HBV)感染的特点。方法61份HIV阳性献血员及89份HIV阴性献血员的血清,经酶联免疫吸附试验(ELISA)检测HCV抗体(抗-HCV)及HBV血清学标志物,比较两组人群的HCV、HBV及HCV/HBV感染情况。结果HIV阳性献血员的抗-HCV阳性率为70.49％。乙肝病毒表面抗原(HBsAg)与抗体(抗-HBs)、乙肝病毒e抗原(HBeAg)与抗体(抗-HBe)、乙肝病毒核心抗体(抗-HBc)和HBV的阳性率分别为8.20％、29.51％、3.28％、44.26％、11.4896、47.54％;而HIV阴性献血员的抗-HCV阳性率为19.10％,HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc、HBV的阳性率分别为2.25％、38.20％、1.12％、47.19％、6.74％、47.19％。经统计学分析,两组人群的HCV、HCV/HBV感染率的差异有显著的统计学意义,而HBV血清学标志物则无显著性差异。结论 与HIV阴性献血员相比。HIV阳性献血员的HCV感染率很高,而HBV血清学标志物则无显著性差异。对献血员进行HBV检测而未检测HIV、HCV造成的选择偏倚,可能是中国中部一些省份HIV感染者HCV感染率高而HBV感染并不相应增高这一现象的原因之一。     

男男性行为者HIV感染队列中新发HBV感染的特点及影响因素

目的探讨北京MSM感染HIV过程中合并HBV新发感染情况及影响因素,为制定有效预防乙肝感染策略提供依据。方法以2006年10月至2014年11月,在北京佑安医院MSM高危人群随访队列中发现的HIV急性期感染者为研究对象,观察其在后续随访过程中合并HBV新发感染的情况并进行研究分析。利用SPSS 16.0进行统计分析。结果 192例HIV急性期感染者在平均随访1.4年后有14例发生了新发HBV感染,新发HBV感染的患者平均年龄为(35.4±9.1)岁,大于未感染者(32.3±8.7)(P=0.005)。14例中11例为急性自限性HBV感染,3例发展为慢性HBV感染。抗-HBs阴性人群HBV的新发感染率(18.0%)高于抗-HBs阳性的人群(2.3%)(χ~2=15.259,P0.001)。HBV感染后CD4细胞下降速率平均为每个月14个/μL(IQR:6,35.2),高于非HBV感染者6.9个/μL(IQR:5,12)(Z=10.56,P 0.001)。结论 HIV感染人群HBV新发感染率及慢性化的比例较高,对HIV阳性MSM应监测乙肝五项并积极接种乙肝疫苗以有效预防HIV感染人群合并新发HBV感染。     

佑安医院HIV/AIDS病人中HBV HCV及TP感染情况分析

目的分析佑安医院艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中,乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及梅毒螺旋体(TP)的共感染情况,为HIV的防控和综合治疗提供科学依据。方法回顾性分析2013年6月至2014年6月,在佑安医院艾滋病门诊接受艾滋病抗病毒治疗的1314例HIV/AIDS病人,调查抗病毒治疗基线时HBV、HCV及TP的共感染情况。结果1314例患者中,男性1255例(95.5%),女性59例(4.5%),平均年龄33.43岁(16~80岁)。其中1070例检测了抗TP,阳性率38.1%(408例);1164例检测了HBV感染标志物,HBsAg阳性率5.9%(69例),HBV标志物全阴性400例(34.4%);1161例检测了抗HCV,阳性率2.2%(25例)。经性途径感染HIV者TP共感染率高,分别有32.8%(368/1122)男男性行为者和22.9%(25/109)异性性行为者抗TP阳性。结论需要加强HIV感染者中HBV、HCV的筛查,以保证抗HIV治疗的顺利进行。经性途径感染HIV的患者中TP感染率较高,需积极干预。     

云南地区老挝籍留学生重要传染性疾病调查北大核心CSCD

目的调查云南地区老挝籍留学生传染病感染状况,为当地传染性疾病的防控措施提供依据。方法采集受检者血液采用ELISA法检测血清中的乙肝表面抗原(HBsAg)、丙肝(HCV)抗体和梅毒(TP)抗体和HIV抗体水平;采用免疫层析法检测登革热非结构蛋白1抗原(DENV-NS1)。结果共检测504例,其中HIV抗体阳性4例、TP抗体阳性1例、HBsAg阳性48例,阳性率分别为0.79%、0.19%和9.52%,HCV和DENV抗原均阴性。阳性者中,HBsAg和TP合并感染1例,HBsAg和HIV合并感染2例,HBsAg、抗-TP同时合并抗-HIV感染(抗-HIV/HBsAg/抗-TP)1例。感染者主要来自老挝的万象省、南塔省、琅勃拉邦省和波乔省,分别占27.08%、18.75%、14.58%和12.50%。结论云南省中老边境地区老挝籍留学生HBV、HIV感染率较高,建议加强对外籍人员HBV、HIV和TP等重要传染病的监测。     

云南地区老挝籍留学生重要传染性疾病调查

目的调查云南地区老挝籍留学生传染病感染状况,为当地传染性疾病的防控措施提供依据。方法采集受检者血液采用ELISA法检测血清中的乙肝表面抗原(HBsAg)、丙肝(HCV)抗体和梅毒(TP)抗体和HIV抗体水平;采用免疫层析法检测登革热非结构蛋白1抗原(DENV-NS1)。结果共检测504例,其中HIV抗体阳性4例、TP抗体阳性1例、HBsAg阳性48例,阳性率分别为0.79%、0.19%和9.52%,HCV和DENV抗原均阴性。阳性者中,HBsAg和TP合并感染1例,HBsAg和HIV合并感染2例,HBsAg、抗-TP同时合并抗-HIV感染(抗-HIV/HBsAg/抗-TP)1例。感染者主要来自老挝的万象省、南塔省、琅勃拉邦省和波乔省,分别占27.08%、18.75%、14.58%和12.50%。结论云南省中老边境地区老挝籍留学生HBV、HIV感染率较高,建议加强对外籍人员HBV、HIV和TP等重要传染病的监测。     

未抗病毒治疗人类免疫缺陷病毒感染者隐匿性乙型肝炎的调查及其临床特点

目的 观察未经抗病毒治疗(ART)的人类免疫缺陷病毒(HIV)感染者和普通人群隐匿性乙型肝炎流行状况,评估HIV感染者合并隐匿性乙型肝炎的临床特点.方法 通过酶联免疫分析法检测未经ART治疗的HIV感染者和普通人群血浆HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc水平,筛查出HBsAg阴性的HIV感染者(感染组)249例,健康体检者HBsAg阴性者121例(健康组),再采用罗氏COBASAmpliPrep/COBAS TaqManHBVTest,version2.0试剂盒检测外周血HBV DNA水平.统计分析用STATA 10软件处理本实验各组数据.用Fisher's精确概率检验、秩和检验.结果 感染组HBV DNA阳性者24例,隐匿性乙型肝炎占9.7％;健康组HBV DNA阳性者4例,隐匿性乙型肝炎占3.3％,两组比较,P=0.035,差异有统计学意义.感染组24例HBVDNA阳性者,HBV DNA载量最低者血中能测到,但在检测值水平以下,(即＜20 IU/ml),最高者3.22×105 IU/ml.大于100 IU/ml占37.5％(9/24),20 ～ 99 IU/ml占16.7％ (4/24),＜20IU/ml,但可测出HBV DNA占45.8％ (11/24).HIV感染者抗-HBc(+)/抗-HBs(+)组、抗-HBc(+)/抗-HBs(-)组、抗-HBc(-)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组DNA阳性率分别为7.3％ (8/110),20.8％ (11/53),14.3％ (3/21),3.1％(2/64),抗-HBc(+)/抗-HBs(-)组分别与抗-HBc(+)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组两组比较,P值分别为0.018和0.003,差异有统计学意义.四组间HBV DNA病毒载量比较,P=0.805,差异无统计学意义.感染组HBV DNA(+)组与HBV DNA(-)组比较,CD4计数(Z=1.902,P=0.0586)和ALT水平(Z=1.401,P=0.1611)差异无统计学意义.结论 在未经ART治疗HIV感染者中,隐匿性乙型肝炎高于普通人群,HIV感染者抗-HBc(+)/抗-HBs(-)组隐匿性乙型肝炎最高.     

儿童无症状HBV感染者抗-HBs的抗独特型抗体检测的意义

抗-HBs 是 HBV 感染的唯一保护性抗体。部分 HBV 感染者却迟迟不产生抗-HBs,其原因引起了许多作者的重视。Troisi和 Irshad 氏等在 HBV 感染者的血清中检测出抗-HBs 的抗独特型抗体(anti-Id)。这种抗体可通过免疫网络调节机制抑制抗-HBs 产生。本文旨在进一步探讨无症状 HBV 感染者血清 anti-Id 的出现规律及其意义。     

HIV感染献血者并发感染HBV、HCV及梅毒调查分析

目的:了解曲靖市无偿献血人群中艾滋病病毒(HIV)感染者并发感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和梅毒的状况。方法:应用酶联免疫吸附试验(ELISA),对HIV感染献血者检测HBsAg、抗-HCV、抗-TP。结果:133例HIV感染献血者中,HBV感染率为1.5%,HCV感染率为10.5%,梅毒感染率为7.5%。结论:曲靖市HIV感染的献血者中,并发HCV和梅毒感染率高,而并发HBV感染率较低。     

人类免疫缺陷病毒感染者合并隐匿性乙型肝炎病毒感染的现状调查

目的 调查分析上海地区HIV感染者中隐匿性HBV感染的流行现状.方法 对上海市公共卫生临床中心就诊的HIV感染者在尚未接受抗病毒治疗前采集血标本,检测HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc,抗-HCV,CD4+T细胞计数,使用巢式PCR法检测HBV S区.结果 105例(男92例,女13例)HBsAg阴性的HIV感染者中32例(男27例,女5例)HBV DNA阳性;16～30岁年龄组22例,其中5例HBV DNA阳性,31～49岁年龄组44例,其中15例HBV DNA阳性,50～75岁年龄组39例,其中12例HBV DNA阳性;32例中有27例至少一项HBV血清学标志物阳性,5例均阴性.47例合并HCV感染者中有14例HBV DNA阳性,阳性率29.8%;58例未合并HCV感染的HIV感染者中18例HBV DNA阳性,阳性率为31.0%.CD4+T细胞计数平均值145.1个/μ(4～623个/μ1),75例CD4+T细胞<200个/μ1的患者中有26例HBV DNA阳性,约占34.7%,30例CD4+T细胞>200/μ1患者中有6例HBV DNA阳性,阳性率为20.0%.以上各项之间两两相比差异均无统计学意义.结论 HIV感染者中存在隐匿性HBV感染,且与HIV感染者性别、年龄、HBV标志物、是否合并HCV感染及CD4+T细胞计数无明显相关.     

深圳市初治HIV感染者合并HBV感染率及特征分析

目的了解深圳市初治HIV感染者合并HBV感染率、特征及HBV易感率。方法以2015—2018年深圳市第三人民医院收治的未接受过抗反转录病毒治疗的成年HIV感染者作为研究对象,收集其基本特征和临床资料,分析纳入对象合并HBV的感染率、合并感染者特征及HBV易感率。结果共纳入4666例初治HIV感染者,合并HBV感染率为10.46%(488/4666);合并感染率随年龄升高、CD4细胞计数的降低和WHO HIV临床分期的加重均呈现逐渐增高的趋势(P均<0.05)。不同HBV DNA水平分组间HIV RNA的差异以及不同HIV RNA水平分组间HBV DNA的差异均无统计学意义(P均>0.05)。HIV/HBV共感染者以HBeAg阴性所占比例较高(76.2%),但HBeAg阳性者ALT异常率高于HBeAg阴性者(31.03%vs.15.86%,P<0.05)。深圳市HIV感染者HBV易感率为24.73%(1154/4666),女性高于男性(31.56%vs.24.16%,P<0.05),15~24岁在各年龄组中最高,为29.00%(P<0.05)。结论深圳市初治HIV感染者合并HBV感染率和HBV易感率均较高。年龄较大和病程较重的HIV感染者合并HBV感染率最高。建议对HIV感染者常规进行治疗前HBV的筛查、临床状态的评估及用药后的监测。对乙型肝炎(乙肝)五项检测均为阴性的HBV易感者建议接种乙肝疫苗。     

河北省HIV-1感染者中HCV和HBV合并感染状况调查

目的了解河北省艾滋病病毒Ⅰ型(HIV-1)感染者中,丙型肝炎病毒(HCV)、乙型肝炎(乙肝)病毒(HBV)的感染状况。方法采集了HIV-1感染者的抗凝全血样品,进行了HCV抗体和乙肝病毒表面抗原(HBsAg)的检测。结果 147例HIV-1感染者中,HCV感染率为17.7%(26/147),HBV感染率为15.0%(22/147),HCV/HBV混合感染率为3.4%(5/147)。在HIV-1感染者中,HCV的感染率在注射吸毒感染者中为100%(6/6),血液途径感染者中为73.3%(11/15),性感染者中为6.3%(7/111),不同感染途径间的差异有统计学意义(P<0.001);女性高于男性(P=0.002);低文化程度的感染者中感染率较高,文化程度方面差异有统计学意义(P<0.01)。在HIV-1感染者中,HBV的感染率小年龄组较高(P<0.05)。结论在HIV感染人群中,有较高的HCV和HBV感染率。     

HBV and HIV co-infection:Impact on liver pathobiology and therapeutic approaches

The consequences of hepatitis B virus(HBV) and human immunodeficiency virus(HIV) co-infection on progression of severe liver diseases is a serious public health issue,worldwide. In the co-infection cases,about 90% of HIV-infected population is seropositive for HBV where approximately 5%-40% individuals are chronically infected. In HIV co-infected individuals,liverrelated mortality is estimated over 17 times higher than those with HBV mono-infection. The spectrum of HIVinduced liver diseases includes hepatitis,steatohepatitis,endothelialitis,necrosis,granulomatosis,cirrhosis andcarcinoma. Moreover,HIV co-infection significantly alters the natural history of hepatitis B,and therefore complicates the disease management. Though several studies have demonstrated impact of HIV proteins on hepatocyte biology,only a few data is available on interactions between HBV and HIV proteins. Thus,the clinical spectrum as well as the complexity of the co-infection offers challenging fronts to study the underlying molecular mechanisms,and to design effective therapeutic strategies.     

194例HIV阳性孕妇HBV HCV及梅毒合并感染状况分析

目的了解广西艾滋病病毒(HIV)阳性孕妇合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒状况,为医疗部门及相关部门采取有效的措施,实施母婴阻断、提高人口素质提供科学的依据。方法对广西贺州、柳州、南宁和横县发现的194名HIV阳性孕妇的HBV、HCV及梅毒合并感染状况进行检测分析。结果在调查的194名HIV阳性孕妇中,HIV/HCV、HIV/HBV和HIV/梅毒合并感染率分别为14.14%、9.42%和5.24%。2.62%和1.05%的妇女分别有HIV/HBV/HCV和HIV/HCV/梅毒混合感染,吸毒是HIV/HCV合并感染的危险因素,HIV/HBV合并感染存在地区差异。结论研究地区HIV阳性孕妇的HBV、HCV及梅毒感染率显著高于普通孕妇,应早期发现并采取有效的干预措施以预防母婴垂直传播。     

Prevalence of occult hepatitis B & C in HIV patients infected through sexual transmission.

BACKGROUND: Prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) markers including active and occult infection has not been described in diverse cohorts among HIV-infected patients in India. Earlier studies have explained the role of HBV/HCV co-infection in cohorts of injection drug users (IDUs) but the sexual co-transmission of HBV/ HCV is not completely understood. OBJECTIVE: The objective of this study was to assess the prevalence of occult HBV & HCV infection in HIV positive sexually acquired transmission risk group. MATERIALS AND METHODS: 58 sexually acquired HIV positive patients were taken up for the study of occult HBV/HCV co-infection. Data on demographics, sexual behaviour, sexually transmitted diseases (STD), medical history, laboratory tests viz., serum ALT and CD4 count were recorded. HBV serology included HBsAg, anti HBs, IgG anti HBc and HBV DNA (PCR). HCV serology included anti HCV & HCV RNA (RT-PCR). RESULTS: Occult HBV infection (HBV DNA) was observed in 12.2% (7/58 with HBsAg -ve and IgG anti HBc +ve subjects) while an overall prevalence of HBV DNA was 13.7% (12% occult & 1.7% in HBsAg+ve patients). Out of 58 HIV positive patients 29.3% demonstrated reactivity for any marker of past or current HBV infection. (HBsAg 1.7%, anti HBs 10.3% anti HBc IgG 17.2%). 4/58 (6.8%) revealed anti HCV positivity along with HCV RNA positivity by RT-PCR while 6/58 (10.3%) individuals revealed an occult HCV infection (anti HCV negative). The overall HCV RNA prevalence was 17.2%. 2 out of 58 (3.4%) individuals were positive for occult infection of both HBV DNA & HCV RNA (Triple infection HIV/HBV/ HCV). The HBV/HCV co-infected group (n = 18) showed a significantly high ALT (114.3 + 12.3 U/I) & low CD4 count (202.5 + 33.7 cells/mm3). The percent prevalence of HBV/ HCV co-infection was higher in the illiterate group, in men less than 30 years of age, and in those who were married and exhibited polygamous activity. CONCLUSIONS: The study demonstrated that in HIV infected patients testing only serological viral markers like HBsAg, antiHBcIgG & anti HCV, fails to identify the true prevalence of co-infection with HBV & HCV. Qualitative PCR for HBV DNA & HCV RNA detects co-infection in patients who are negative for serological markers. Also, in subjects who had only a sexual risk factor for parenterally transmitted infections, HIV may enhance the sexual transmission of HBV and HCV.     

Frequency of HIV and HCV Co-Infections in Chronic HBV Patients Referred to Taleghani Hospital, Tehran, Iran from 2006 to 2010

Background

Co-infection with hepatitis C virus (HCV) and/or human immunodeficiency virus (HIV) in patients with chronic hepatitis B virus (HBV) infection can alter the course of the disease.

Objectives

In this study, we investigated the frequency of HIV and/or HCV co-infection in chronic HBV patients and related risk factors in acquiring the HCV and or HIV co-infectionit.

Patients and Methods

We studied 264 chronic HBV patients who visited the Gastrointestinal and Liver Ward of the Taleghani Hospital, Tehran, Iran between 2006 and 2010. Demographic information and records of possible risky behavior were obtained. Antibodies against HBV, HCV, and HIV, levels of alanine transaminase (ALT) and aspartate transaminase (AST), and conversion from hepatitis B e antigen (HBeAg) to hepatitis B e antibody (HBeAb) were evaluated.

Results

Of 264 patients with chronic HBV in this study, 184 patients (70%) were men and 78 patients (30%) were women. Only 1 patient (0.37%) was positive for anti-HIV antibody, whereas 12 patients (4.54%) were positive for anti-HCV antibody. None of the patients had co-infection with all 3 viruses (HBV, HIV, and HCV).

Conclusions

This study demonstrated that the prevalence of HCV is higher than that of HIV in chronic HBV patients. Since HCV or HIV co-infection affects the therapeutic outcome in chronic HBV patients, testing for HIV and HCV is recommended, especially for patients with a history of risky behavior.     

Alanine aminotransferase levels are not significantly elevated in patients with HIV/HBV co-infection and lamivudine resistance

In hepatitis B virus (HBV) monoinfection, alanine aminotransferase (ALT) levels are linearly correlated with HBV DNA levels and lamivudine resistance. In human immunodeficiency virus (HIV)/HBV co-infection, little is known about the association between ALT, HBV DNA, and lamivudine resistance. We assessed HBV DNA, lamivudine resistance and ALT levels in 45 time points in 11 patients with HIV/HBV co-infection during lamivudine-containing antiretroviral therapy. High HBV DNA levels (>10(6) copies/mL) and lamivudine resistance developed in 45% and 91% of patients, respectively. However, ALT levels were not elevated in the setting of high HBV DNA levels (mean ALT, 48 IU/mL) or lamivudine resistance (mean ALT, 44 IU/mL). HBV viraemia and lamivudine resistance during extended lamivudine-containing antiretroviral therapy are common in HIV/HBV co-infection, occurring in the absence of significant ALT elevations. In HIV/HBV co-infection, measurement of HBV DNA and HBV resistance mutations may identify HBV virological failure before biochemical changes and should be routinely used in the management of HIV/HBV co-infection.     

Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: a call for further investigation.

A growing body of evidence indicates that human immunodeficiency virus (HIV)-positive individuals are more likely to be infected with hepatitis B virus (HBV) than HIV-negative individuals, possibly as a result of shared risk factors. There is also evidence that HIV-positive individuals who are subsequently infected with HBV are more likely to become HBV chronic carriers, have a high HBV replication rate, and remain hepatitis Be antigen positive for a much longer period. In addition, it is evident that immunosuppression brought about by HIV infection may cause reactivation or reinfection in those previously exposed to HBV. Furthermore, HIV infection exacerbates liver disease in HBV co-infected individuals, and there is an even greater risk of liver disease when HIV and HBV co-infected patients are treated with highly active anti-retroviral therapy (HAART). Complicating matters further, there have been several reports linking HIV infection to 'sero-silent' HBV infections, which presents serious problems for diagnosis, prevention, and control. In sub-Saharan Africa, where both HIV and HBV are endemic, little is known about the burden of co-infection and the interaction between these two viruses. This paper reviews studies that have investigated HIV and HBV co-infection in sub-Saharan Africa, against a backdrop of what is currently known about the interactions between these two viruses.     

Prevalence of hepatitis B virus infection in Japanese patients with HIV.

Patients with HIV infection are frequently infected with hepatitis viruses, which are presently the major cause of mortality in HIV-infected patients after the widespread use of highly active antiretrovirus therapy. We previously reported that approximately 20% of HIV-positive Japanese patients were also infected with hepatitis C virus (HCV). Hepatitis B virus (HBV) infection may also be an impediment to a good course of treatment for HIV-infected patients, because of recurrent liver injuries and a common effectiveness of some anti-HIV drugs on HBV replication. However, the status of co-infection with HIV and HBV in Japan is unclear. We conducted a nationwide survey to determine the prevalence of HIV-HBV co-infection by distributing a questionnaire to the hospitals belonging to the HIV/AIDS Network of Japan. Among the 5998patients reported to be HIV positive, 377 (6.4%) were positive for the hepatitis B surface antigen. Homosexual men accounted for two-thirds (70.8%) of the HIV-HBV co-infected patients, distinct from HIV-HCV co-infection in Japan in which most of the HIV-HCV co-infected patients were recipients of blood products. One-third of HIV-HBV co-infected patients had elevated serum alanine aminotransferase levels at least once during the 1-year observation period. In conclusion, some HIV-infected Japanese patients also have HBV infection and liver disease. A detailed analysis of the progression and activity of liver disease in co-infected patients is needed.     

Molecular characterization of occult and overt hepatitis B (HBV) infection in an HIV-infected person with reactivation of HBV after antiretroviral treatment interruption

Introduction  

Occult HBV infection is characterized by the absence of surface antigenemia and the presence of potentially infectious hepatitis B virus (HBV)-DNA present in liver, serum, or both. Reactivation of chronic HBV infection in the presence of the HBV surface antigen (HBsAg) is a well-known complication in immunocompromised individuals under cytotoxic chemotherapy or in HIV-infected individuals when nucleos(t)ide analogs effective against HIV/HBV are discontinued. However, little is known on the possibility of such a complication in HIV-infected persons with HBV-core antibody (anti-HBc) as the sole serological marker of past HBV infection.