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Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study
INTRODUCTION: Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and diseas...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International AIDS Society
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793284/ https://www.ncbi.nlm.nih.gov/pubmed/26979535 http://dx.doi.org/10.7448/IAS.19.1.20659 |
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author | Xie, Jing Han, Yang Qiu, Zhifeng Li, Yijia Li, Yanling Song, Xiaojing Wang, Huanling Thio, Chloe L Li, Taisheng |
author_facet | Xie, Jing Han, Yang Qiu, Zhifeng Li, Yijia Li, Yanling Song, Xiaojing Wang, Huanling Thio, Chloe L Li, Taisheng |
author_sort | Xie, Jing |
collection | PubMed |
description | INTRODUCTION: Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and disease characteristics of HBV and HCV co-infection in HIV-positive patients across 12 provinces. METHODS: HIV-positive ART-naïve patients were recruited from two parent cohorts established during November 2008–January 2010 and August 2012–September 2014. Hepatitis B surface antigen (HBsAg), hepatitis B e antigen and HCV antibody (anti-HCV) status were retrieved from parent databases at the visit prior to ART initiation. HBV DNA was then determined in HBsAg+ patients. HCV RNA was quantified in anti-HCV+ patients. Aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 (FIB4) were calculated. Chi-square test, Kruskal–Wallis test and logistic regression were used for statistical analysis, as appropriate. RESULTS: Of 1944 HIV-positive patients, 186 (9.5%) were HIV–HBV co-infected and 161 (8.3%) were HIV–HCV co-infected. The highest HIV–HBV prevalence (14.5%) was in Eastern China while the highest HIV–HCV prevalence was in the Central region (28.2%). HIV–HBV patients had lower median CD4 + T cell count (205 cells/μL) than either HIV monoinfected (242 cells/μL, P=0.01) or HIV–HCV patients (274 cells/μL, P=0.001). Moderate-to-significant liver disease was present in >65% of the HIV–HCV, ~35% of the HIV–HBV and ~20% of the HIV monoinfected patients. Independent associations with moderate-to-significant liver disease based on APRI included HBV (Odds ratio, OR 2.37, P < 0.001), HCV (OR 9.64, P<0.001), CD4 count≤200 cells/μL (OR 2.55, P<0.001) and age ≥30 years (OR 1.80, P=0.001). CONCLUSIONS: HBV and HCV prevalence is high in HIV-positive Chinese and differs by geographic region. HBV and HCV co-infection and HIV monoinfection are risks for moderate-to-significant liver disease. Only HIV–HBV is associated with greater HIV-related immunosuppression. Incorporating screening and management of hepatitis virus infections into Chinese HIV programmes is needed. |
format | Online Article Text |
id | pubmed-4793284 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | International AIDS Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-47932842016-03-16 Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study Xie, Jing Han, Yang Qiu, Zhifeng Li, Yijia Li, Yanling Song, Xiaojing Wang, Huanling Thio, Chloe L Li, Taisheng J Int AIDS Soc Research Article INTRODUCTION: Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and disease characteristics of HBV and HCV co-infection in HIV-positive patients across 12 provinces. METHODS: HIV-positive ART-naïve patients were recruited from two parent cohorts established during November 2008–January 2010 and August 2012–September 2014. Hepatitis B surface antigen (HBsAg), hepatitis B e antigen and HCV antibody (anti-HCV) status were retrieved from parent databases at the visit prior to ART initiation. HBV DNA was then determined in HBsAg+ patients. HCV RNA was quantified in anti-HCV+ patients. Aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 (FIB4) were calculated. Chi-square test, Kruskal–Wallis test and logistic regression were used for statistical analysis, as appropriate. RESULTS: Of 1944 HIV-positive patients, 186 (9.5%) were HIV–HBV co-infected and 161 (8.3%) were HIV–HCV co-infected. The highest HIV–HBV prevalence (14.5%) was in Eastern China while the highest HIV–HCV prevalence was in the Central region (28.2%). HIV–HBV patients had lower median CD4 + T cell count (205 cells/μL) than either HIV monoinfected (242 cells/μL, P=0.01) or HIV–HCV patients (274 cells/μL, P=0.001). Moderate-to-significant liver disease was present in >65% of the HIV–HCV, ~35% of the HIV–HBV and ~20% of the HIV monoinfected patients. Independent associations with moderate-to-significant liver disease based on APRI included HBV (Odds ratio, OR 2.37, P < 0.001), HCV (OR 9.64, P<0.001), CD4 count≤200 cells/μL (OR 2.55, P<0.001) and age ≥30 years (OR 1.80, P=0.001). CONCLUSIONS: HBV and HCV prevalence is high in HIV-positive Chinese and differs by geographic region. HBV and HCV co-infection and HIV monoinfection are risks for moderate-to-significant liver disease. Only HIV–HBV is associated with greater HIV-related immunosuppression. Incorporating screening and management of hepatitis virus infections into Chinese HIV programmes is needed. International AIDS Society 2016-03-14 /pmc/articles/PMC4793284/ /pubmed/26979535 http://dx.doi.org/10.7448/IAS.19.1.20659 Text en © 2016 Xie J et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Xie, Jing Han, Yang Qiu, Zhifeng Li, Yijia Li, Yanling Song, Xiaojing Wang, Huanling Thio, Chloe L Li, Taisheng Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title | Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title_full | Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title_fullStr | Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title_full_unstemmed | Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title_short | Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study |
title_sort | prevalence of hepatitis b and c viruses in hiv-positive patients in china: a cross-sectional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793284/ https://www.ncbi.nlm.nih.gov/pubmed/26979535 http://dx.doi.org/10.7448/IAS.19.1.20659 |
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