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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...

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Autores principales: Xie, Jing, Han, Yang, Qiu, Zhifeng, Li, Yijia, Li, Yanling, Song, Xiaojing, Wang, Huanling, Thio, Chloe L, Li, Taisheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International AIDS Society 2016
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.
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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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