北京地区人类免疫缺陷病毒感染者合并乙型肝炎病毒感染的流行病学特征及影响因素分析

目的:分析北京市人类免疫缺陷病毒（HIV）感染者/艾滋病（AIDS）患者合并乙型肝炎病毒（HBV）感染的流行病学特征,并探索影响合并感染的相关因素。方法:对北京地区HIV/AIDS定点治疗医院（北京协和医院、北京地坛医院、北京佑安医院）长期随访的接受抗反转录病毒治疗（ART）的13 253例HIV感染者临床资料进行回顾...     

绍兴县吸毒人群HIV HBV HCV和梅毒感染状况的调查

绍兴县自1999年发现首例艾滋病病毒（HIV）感染者以来，近几年HIV感染者增长幅度惊人，HIV感染者主要集中在吸毒人群。为进一步了解绍兴县吸毒人群的HIV、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和梅毒的感染状况，吸毒方式和高危因素，于2005年对绍兴县戒毒所收容的吸毒人员开展调查，报告如下。     

HBV合并HCV或人类免疫缺陷病毒感染的抗病毒治疗进展

乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染是目前全球慢性肝病的主要原因,HBV合并人类免疫缺陷病毒(HIV)感染也较常见,全球4000万HIV感染者中10%并发慢性乙型肝炎(CHB).自从高效抗逆转录病毒治疗的推广,艾滋病相关原因的死亡已经减少,但由肝脏疾病造成的死亡却不断上升,逐渐成为HIV感染者发病和死亡的一个主要原因.     

绍兴县吸毒人群 HIV HBV HCV和梅毒感染状况的调查

绍兴县自1999年发现首例艾滋病病毒（HIV）感染者以来，近几年HIV感染者增长幅度惊人，HIV感染者主要集中在吸毒人群。为进一步了解绍兴县吸毒人群的HIV、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和梅毒的感染状况，吸毒方式和高危因素，于2005年对绍兴县戒毒所收容的吸毒人员开展调查，报告如下。     

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。     

HIV/HCV混合感染者的细胞凋亡机制

艾滋病病毒(HIV)和丙型肝炎病毒(HCV)的混合感染相当常见,两者混合感染后,疾病的进程、预后及治疗较单纯感染者均发生显著改变。近年来,有不少研究致力于混合感染者的发病机制,其中,细胞凋亡为一个重要的部分。文章就HIV、HCV单纯感染者和HIV/HCV混合感染者的肝细胞、免疫细胞的凋亡机制进行综述。     

豫南某县献血浆人群HIV HCV HBV感染情况调查分析

1995年4月,豫南某县在有偿献血浆人员中发现了首例艾滋病病毒(HIV)感染者。为了解豫南农村有偿献血浆人群中HIV、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)感染情况,2004年进行了此次调查。1对象与方法选择有偿献血浆人员较集中的9个乡,随机选取具有有偿献血浆史人员,并选择部分非     

425例HIV携带者重叠感染丙型肝炎状况调查分析

艾滋病病毒(HIV)与丙型肝炎病毒(HCV)具有相同的传播途径,两者均可经血液、性接触、母婴垂直传播途径感染。为了解HIV感染者的HCV感染状况,2005年10月对宛城区确认的HIV感染者进行调查,结果如下。1材料与方法对全区所有已经确认进行管理的HIV感染者进行登记调查,常规消毒后采集     

HIV/HCV重叠感染者疾病进展及病毒间相互作用机制的研究进展

自1981年美国首次从男同性恋患者中报道艾滋病(AIDS)以来,相同症状的患者不断被发现,该疾病也以其惊人的速度在世界范围内传播开来。由于丙型肝炎病毒(HCV)与艾滋病病毒(HIV)有相同的传播途径,使HCV在HIV感染者中得到广泛的传播。据报道,全球HCV感染者中大约6%～10%合并HIV感染,HIV感染者中大约有30%合并HCV感染。因此HIV/HCV重叠感染成为AIDS最关注的领域之一。现对HIV/HCV重叠感染者疾病进展及病毒间在人体内相互作用机制的最新研究进展综述如下。     

北京地区人类免疫缺陷病毒感染者合并乙型肝炎病毒感染的流行病学特征及影响因素分析

目的分析北京市人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者合并乙型肝炎病毒(HBV)感染的流行病学特征,并探索影响合并感染的相关因素。方法对北京地区HIV/AIDS定点治疗医院(北京协和医院、北京地坛医院、北京佑安医院)长期随访的接受抗反转录病毒治疗(ART)的13 253例HIV感染者临床资料进行回顾性分析。结果排除未进行HBV标志物检测的患者1 681例, 共有11 572例HIV感染者纳入研究,其中HIV合并HBV感染的患者532例(4.6%),主要为青壮年(28～48岁)男性,占 85.9%,感染途径以同性性传播为主(74.8%)。87.4%的合并感染患者基线治疗接受了包含拉米夫定(3TC)、替诺福韦(TDF)两种抗HBV药物的治疗。2013—2018年,HIV合并HBV感染的年新增感染率呈波动性下降的趋势,年均增长率分别为 6.37%、4.55%、3.92%、4.68%、4.24%和2.74%。HIV合并HBV感染的主要影响因素为年龄(28～48岁比<28岁,OR=2.807, 95%CI 1.241～6.345)以及婚姻状况(已婚比未婚,OR=1.259,...     

Prevalence of hepatitis B and C in HIV-infected patients: a meta-analysis

BACKGROUND: Hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share similar routes of transmission by sexual intercourse or drug use by parenteral injection, so coinfection is common. This study aimed to determine the prevalence of coinfection with either HCV or HBV in patients infected with HIV. DATA SOURCES: A meta-analysis was performed to quantify HBV coinfection with HCV in HIV patients. Published studies in the English and Chinese language medical literature invol...     

TT virus infection in Italy: prevalence and genotypes in healthy subjects, viral liver diseases and asymptomatic infections by parenterally transmitted viruses

This study was aimed to evaluate TT virus prevalence in subjects with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections in patients affected by hepatitis of unknown origin (non-A–non-E hepatitis) and in healthy subjects who had not been exposed to HBV, HCV and HIV. A total of 317 subjects were tested; 40 were HBsAg asymptomatic carriers, 57 subjects were anti-HCV positive (45 without chronic hepatitis and 12 with HCV-related chronic hepatitis), and 27 had chronic non-A–non-E hepatitis. Fifty-seven subjects were intravenous drug users (IVDUs) (52 with HCV or/and HIV infections), seven patients underwent a liver transplant for fulminant hepatitis and 137 were healthy subjects from the general population. Overall, TTV-DNA was detected in 62 subjects (19.6%): in 17.9% of the HBsAg carriers, in 14% of the anti-HCV-positive patients (in 8.3% and in 15.5% of patients with and without chronic hepatitis, respectively), in 22.2% of non-A–non-E hepatitis patients, in 22.8% of IVDUs, in 57.1% of fulminant hepatitis patients. TTV-DNA was also found in 20.4% healthy subjects. The prevalence in the different subgroups was not statistically different. The genotypes were identified in 40 of the 62 (64.5%) TTV-DNA positive samples: genotype 1a in 17.5%, 1b in 27.5%, genotype 2 in 27.5%, genotype 3 in 15.0%, genotype 4 in 5.0% and genotype 5 in 7.5%; the genotype distribution in the subsets of patients was not significantly different. In conclusion, this study showed that TTV infection is common in Italy; it is widespread throughout the entire population and five genotypes are present in Sardinia. Our results further dismiss the role of TTV as cofactor in influencing the clinical course of infections with other hepatitis viruses as well as the role of HIV in enhancing TTV transmission and replication.     

Nosocomial outbreak of multiple bloodborne viral infections.

In resource-limited countries, nosocomial transmission of bloodborne pathogens is a major public health concern. After a major outbreak of human immunodeficiency virus (HIV) infection in approximately 400 children in 1998 in Libya, we tested HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) markers in 148 children and collected epidemiological data in a subgroup of 37 children and 46 parents. HIV infection was detected in all children but one, with HCV or HBV coinfection in 47% and 33%, respectively. Vertical transmission was ruled out by analysis of parents' serology. The children visited the same hospital 1-6 times; at each visit, invasive procedures with potential blood transmission of virus were performed. HIV and HCV genotypic analyses identified a HIV monophyletic group, whereas 4 clusters of HCV sequences were identified. To our knowledge, this is the largest documented outbreak of nosocomial HIV transmission.     

Hepatocellular carcinoma, human immunodeficiency virus and viral hepatitis in the HAART era

The incidence of hepatocellular carcinoma （HCC） in patients with human immunodeficiency virus （HIV） is rising. HCC in HIV almost invariably occurs in the context of hepatitis C virus （HCV） or hepatitis B virus （HBV） co-infection and, on account of shared modes of transmission, this occurs in more than 33% and 10% of patients with HIV worldwide respectively. It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy （HAART） era, wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop. Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy, which in HIV co-infection presents unique challenges. Once HCC develops, there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies, including liver transplantation.     

Hepatocellular carcinoma, human immunodeficiency virus and viral hepatitis in the HAART era

The incidence of hepatocellular carcinoma (HCC) in patients with human immunodeficiency virus (HIV) is rising. HCC in HIV almost invariably occurs in the context of hepatitis C virus (HCV) or hepatitis B virus (HBV) co-infection and, on account of shared modes of transmission, this occurs in more than 33% and 10% of patients with HIV worldwide respectively. It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy (HAART) era, wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop. Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy, which in HIV co-infection presents unique challenges. Once HCC develops, there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies, including liver transplantation.     

吸毒与丙型肝炎病毒、人类免疫缺陷病毒及梅毒螺旋体感染的相关性研究

目的调查吸毒人群中丙型肝炎病毒（HCV）、人类免疫缺陷病毒（HIV）和梅毒螺旋体（TP）感染的情况,以便采取有效防治措施。方法对强制戒毒的313例吸毒者进行集群抽样调查,受检者除进行一般临床分析和有关功能检查外,重点检测其HCV、HIV及rrP的感染强度。HCV及HIV检测采用ELISA法,TP检测采用TP颗粒凝胶（TPPA）法。结果313例吸毒者中HCV、HIV及TP阳性者分别为267、19、18例,感染率分别为85．3％、6．1％、5．8％。其中HCV＋TP、HCV＋H1V两种阳性并存者感染率为4．2％、5．8％,未发现HIV＋rrP感染同时存在。但在本组中可见TP阳性率在青少年组不论男女明显高于其他年龄组,其男、女组阳性率分别为17．9％、11．9％。结论吸毒者是HCV、HIV、TP感染的高危人群,青少年中的TP感染者也可能成为HIV／艾滋病（AIDS）的高危人群。     

Hepatitis delta virus propagation enabled by hepatitis C virus—Scientifically intriguing,but is it relevant to clinical practice?

In vitro cell culture experiments and animal models have demonstrated that hepatitis delta virus (HDV) can theoretically propagate being enveloped by human pathogenic viruses other than hepatitis B virus (HBV), namely hepatitis C virus (HCV) and dengue virus. However, the clinical relevance of these findings and whether HDV replication occurs in real‐world hepatitis B surface antigen (HBsAg)–negative HCV patient cohorts remain unknown. To this aim, we analysed 323 HCV‐RNA–positive and HBsAg‐negative sera for the presence of HDV‐RNA and anti‐HDV antibodies (anti‐HDV). All 323 (100%) samples were negative for HDV‐RNA. Interestingly, 8/316 samples tested positive for anti‐HDV. The HBV serology of these eight patients showed a positive result for HBV core antibodies (anti‐HBc) indicating a seroconversion of an acute HBV infection in the past. None of the anti‐HBc–negative patients were positive for anti‐HDV. Our results indicate a distinctly low probability of replicative HDV infection in HCV mono‐infected patients in Germany. Current German clinical guidelines rightly recommend performing HDV screening only in HBsAg‐positive patients. However, larger studies on this subject should be performed in regions that are endemic for chronic HBV/HDV as well as HCV infections.     

Clinical significance of“anti-HBc alone” in human immunodeficiency virus-positive patients

AIM: To determine the prevalence and clinical relevance of isolated antibodies to hepatitis B core antigen as the only marker of infection ("anti-HBc alone") among human immunodeficiency virus (HIV) type-1 infected patients. Occult hepatitis B infection frequency was also evaluated.METHODS: Three hundred and forty eight histories from 2388 HIV-positive patients were randomly reviewed. Patients with serological markers of hepatitis B virus (HBV) infection were classified into three groups: past hepatitis, "anti-HBc alone" and chronic hepatitis. Determination of DNA from HBV, and RNA and genotype from hepatitis C virus (HCV) were performed on "anti-HBc alone" patients.RESULTS: One hundred and eighty seven (53.7%) HIV-positive patients had markers of HBV infection: 118 past infection (63.1%), 14 chronic hepatitis (7.5%) and 55 "anti-HBc alone" (29.4%). Younger age [2.3-fold higher per every 10 years younger; 95% confidence intervals (CI) 1.33-4.00] and antibodies to HCV infection [odds ratio (OR) 2.87; 95% CI 1.10-7.48] were factors independently associated with the "anti-HBc alone" pattern. No differences in liver disease frequency were detected between both groups.Serum levels of anti-HBs were not associated with HCV infection (nor viral replication or HCV genotype), or with HIV replication or CD4 level. No "anti-HBc alone" patient tested positive for HBV DNA.CONCLUSION: "Anti-HBc alone" prevalence in HIVpositive patients was similar to previously reported data and was associated with a younger age and with antibodies to HCV infection. In clinical practice, HBV DNA determination should be performed only in those patients with clinical or analytical signs of liver injury.     

Impact of comorbidities on the severity of chronic hepatitis B at presentation

AIM: To evaluate the clinical relevance of each cofactor on clinical presentation of chronic hepatitis B.METHODS: Out of 1366 hepatitis B surface antigen (HBsAg) positive subjects consecutively observed in 79 Italian hospitals, 53 (4.3%) showed as the only cofactor hepatitis D virus (HDV) infection [hepatitis B virus (HBV)/HDV group], 130 (9.5%) hepatitis C virus (HCV) (group HBV/HCV), 6 (0.4%) human immunodeficiency virus (HIV) (group HBV/HIV), 138 (10.2%) alcohol abuse (group HBV/alcohol); 109 (8.0%) subjects had at least two cofactors and 924 were in the cofactor-free (CF) group.RESULTS: Compared with patients in group CF those in group HBV/alcohol were older and more frequently had cirrhosis (P < 0.001), those in group HBV/HDV were younger (P < 0.001), more frequently resided in the south of the country and had cirrhosis (P <0.001), those in group HBV/HCV were older (P < 0.001) and more frequently had cirrhosis (P < 0.001). These cofactors were all independent predictors of liver cirrhosis in HBsAg positive patients. Multivariate analysis showed that an older age [odds ratio (OR) 1.06, 95% CI: 1.05-1.08], alcohol abuse with more than 8 drinks daily (OR 2.89, 95% CI: 1.81-4.62) and anti-HDV positivity (OR 3.48, 95% CI: 2.16-5.58) are all independently associated with liver cirrhosis. This association was found also for anti-HCV positivity in univariate analysis, but it was no longer associated (OR 1.23, 95% CI: 0.84-1.80) at multivariate analysis.CONCLUSION: Older age, HDV infection and alcohol abuse are the major determinants of severe liver disease in chronic HBV infection, while HCV replication plays a lesser role in the severity of hepatic damage.     

Epidemiological survey of Japanese children infected with hepatitis B and C viruses

Aim: The lack of a nationwide survey on hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Japan led us to investigate the epidemiological profiles of these infections among Japanese children. Methods: We conducted a questionnaire survey of children (<20 years of age) infected with either HBV (n = 136) or HCV (n = 114), who visited 636 pediatric institutions in Japan from 2003 through 2005. Most HBV‐infected subjects (94%) were born in 1986 or after when a nationwide immunization program for infants born to HBe antigen‐positive carriers was initiated. The transmission routes were divided into five groups: maternal, horizontal (subdivided into intrafamilial, iatrogenic and other horizontal), and unknown transmission. Results: Comparison of subjects born in 1990 or after and those born in 1989 or before, when anti‐HBc and anti‐HCV (c100‐3) screening tests of blood donors began, showed a shift in the relative proportions of maternal, intrafamilial, iatrogenic, other horizontal, and unknown transmission from 52%, 19%, 4%, 7% and 19% to 70%, 14%, 6%, 1% and 9%, respectively, for HBV, which was statistically insignificant (P = 0.120), and from 14%, 0%, 76%, 4% and 7% to 89%, 2%, 4%, 0% and 5%, respectively, for HCV, which was statistically significant (P < 0.001). HBV horizontal transmission did not decrease in proportion. No transfusion‐acquired HCV infection was reported in subjects born in 1993 or after. Conclusion: Maternal transmission is a prominent source of HCV infection among Japanese children. The implementation of measures to prevent HBV horizontal infection is also essential, and the present system of selective vaccination should be expanded to universal vaccination.