Human immunodeficiency virus and hepatitis C virus co-infection: epidemiology, natural history and the situation in China

Worldwide, the hepatitis C vires （HCV） and human immunodeficiency virus （HIV） pandemics poseserious threats to global health, currently infecting 130 million and 40 million people respectively. Of those infected with HW, an estimated 4-12 million are co-infected with HCV. Due to shared risk factors for transmission, co-infection with HIV and HCV is common in China. Liver disease was the second leading cause of death behind acquired imunodeficiency syndrome （AIDS） in co-infected patients. Several studies have confirmed that HIV co-infection accelerates the clinical course of chronic HCV infection and leads to an increased risk of cirrhosis, hepatocellular carcinoma, and decompensated liver disease.     

南宁市102例HIV/HCV共感染者HCV基因型特征分析

目的了解南宁市静脉注射吸毒人群(IDUs)中HIV/HCV共感染者HCV基因亚型流行情况。方法收集2012—2014年间南宁市静脉注射吸毒人员HIV/HCV共感染者血浆样本总共108份,设计特异性引物,通过巢式PCR对HCV NS5B区域长339 bp的片段进行扩增并测序,构建系统进化树对HCV进行基因分型。结果 108份血浆样本中巢式PCR成功扩增基因片段102份,系统进化分析显示检出4种HCV基因型含6种基因亚型,各基因亚型所占样本比例为6a 34.31%(35/102)、3b 33.33%(34/102)、1a 20.59%(21/102)、1b 6.87%(7/102)、3a 3.92%(4/102)和2a 0.98%(1/102)。在不同人口学特征时102份样本HCV基因型组成差异无统计学意义(P0.05)。结论南宁市IDUs人群HIV/HCV共感染者中至少存在6种HCV基因亚型流行,6a、3b和1a为主要流行亚型。     

人类免疫缺陷病毒与乙型肝炎病毒重叠感染的临床分析

目的提高对人类免疫缺陷病毒 (HIV)与乙型肝炎病毒 (HBV)重叠感染的认识。方法对赤道几内亚巴塔地区医院1999年 1月 - 2 0 0 0年 6月确诊的 4 6例HIV/HBV重叠感染进行分析。结果HIV/HBV重叠感染患者临床表现主要为 :长期发热 (5 3 4 % )、近期消瘦 (47 8% )、全身酸痛 (6 9 6 % )、浅表淋巴结肿大 (45 7% )、慢性腹泻 (2 3 9% )及瘙痒性皮炎 (13 0 % )。HB sAg、HBeAg双阳性为 5 2 2 % ;血清谷丙转氨酶轻微异常为 6 5 2 % ;病死率为 2 8 3%。结论临床医师应加强对HIV/HBV重叠感染诊断的警惕性 ,对高危人群应常规进行血清抗HIV抗体和HBV标志检测     

Hepatitis B virus/human immunodeficiency virus coinfection: interaction among human immunodeficiency virus infection, chronic hepatitis B virus infection, and host immunity

Objective  This review discusses progress in the studies of hepatitis B virus (HBV)/human immunodeficiency virus (HIV) coinfection and focuses on the interaction among HIV infection, chronic HBV infection, and host immunity.

Data sources  Data and studies published mainly from 2008 to 2011 were selected using PubMed.

Study selection  Original articles and critical reviews concerning HBV/HIV coinfection and HBV and HIV pathogenesis were selected.

Results  HIV may accelerate HBV progression by lowering CD4 count, weakening HBV-specific immunity, “enriching” HBV mutants, causing immune activation, etc. On the other hand, HBV may enhance HIV replication by activating HIV long terminal repeat (LTR) with X protein (HBX) and cause immune activation in synergy with HIV. Paradoxically, HBV may also inhibit HIV dissemination via dendritic cells.

Conclusions  The interaction among HIV, HBV, and host immunity remains poorly understood. Further research is warranted to elucidate the detailed molecular mechanisms and to translate these mechanisms into clinical practice.

     

Epidemiology of Hepatitis B, C, D and G Viruses and Cytokine Levels among Intravenous Drug Users

Viral hepatitis presents a major global publichealth concern. HBV and HCV, in particular ,were the causative agents responsible for parenter-ally transmitted diseases[1 ,2]. IVDU represent aspecial subgroup of the population who oftenshared contaminated needles for intravenous drugsinjection[3].Opiate use was knownto alter i mmunefunction and had i mmunosuppressive effects thatmay modify T-lymphocyte subpopulations .IVDUwere subject to transmittable blood-borne patho-gens . The pathogens…     

广西部分地区人类免疫缺陷病毒感染者合并丙型肝炎病毒感染情况分析

目的 了解广西人类免疫缺陷病毒(HIV)感染者中HIV/丙型肝炎病毒(HCV)的混合感染率及其HCV RNA的阳性率,为今后HIV患者丙肝筛查及预防提供参考.方法 采用ELISA法检测HIV感染者血清中的丙肝病毒抗体,按结果分成抗-HCV(+)组和抗-HCV(-)组,再用巢式PCR法检测血清的HCV RNA,分析比较HCV RNA阳性率.结果 在300例HIV感染者中,有146例抗-HCV阳性,154例抗-HCV阴性;在抗-HCV阳性组中,HCV RNA的阳性率为78.08％(114/146);在抗-HCV阴性组中,HCV RNA阳性率为26.62％(41/154);ELISA法和巢式PCR法检测HCV感染的符合率为75.67％[(113+114)/300].结论 在广西的HIV感染者中HCV感染状况较严重.对HIV感染者进行丙肝筛查时,为减少漏诊率,建议采用PCR方法检测抗-HCV阴性血清中的HCV RNA.     

有偿献血员人类免疫缺陷病毒合并乙型、丙型肝炎病毒感染及生化指标分析

目的: 探讨有偿献血员中人类免疫缺陷病毒(HIV)合并乙型、丙型肝炎病毒(HCV、HBV)感染情况及其肝、肾功能指标的变化。方法: 选取125例曾有偿献血HIV感染者,进行HCV、HBV血清学标志物及肝、肾功能各项指标检测。结果: 125例中,合并HCV感染率为92.0%,合并HBV感染率为5.6%,合并HCV感染组AST、ALT与对照组和单纯HIV感染组差异均有统计学意义。HIV合并HCV、HBV感染组及单纯HIV感染组β₂微球蛋白与对照组差异有统计学意义,合并HCV组与单纯HIV感染组β₂微球蛋白差异有统计学意义(P < 0.01)。结论: HIV合并HCV可加重HIV患者的肝脏损害,对肾功能未造成影响,β₂微球蛋白升高可能是机体免疫过度活化的表现。     

人类免疫缺陷病毒合并乙型肝炎病毒感染患者高效抗反转录病毒治疗效果和肝脏损伤研究

目的 对人类免疫缺陷病毒(HIV)合并乙型肝炎病毒(HBV)感染患者高效抗反转录病毒治疗(HAART)的临床效果和伴随的肝脏损伤情况作出评价.方法 将患者按有无HBV合并感染分为HIV单纯感染组75例和HIV/HBV合并感染组69例,应用HAART方案治疗1年,对比观察患者血浆HIV载量,外周血CD4+T淋巴细胞计数、丙氨酸氨基转移酶等指标变化.结果 治疗前,HIV单纯感染组和HIV/HBV合并感染组的HIV载量均值分别为6.31和5.85 log10copies/mL,治疗12个月后,分别降低至2.90 log10 copies/mL(P＜0.05)和2.93log10 copies/mL(P＜0.05),两组HIV RNA抑制率分别为82.67％和92.75％.HIV单纯感染组和HIV/HBV合并感染组CD4+T细胞均值由治疗前的77.8个/μL和75.4个/μL,分别上升到221.4个/μL和214.3个/μL(P＜0.05).1年内HIV单纯感染组和HIV/HBV合并感染组的肝功能异常率分别为6.4％和19.7％ (P ＜0.05),但HAART期间无因发生严重肝脏损伤而停止治疗的患者.结论 应用HAART的HIV/HBV合并感染患者,短期内可以有效抑制HIV病毒复制,重建患者的免疫功能;HBV可能因促进HIV复制而加重肝损伤与免疫损伤,但并不影响HAART的效果.     

Prevalence of occult hepatitis B amongst Indian human immunodeficiency virus type 1 infected individuals—a pilot study

Background

The diagnosis of hepatitis B is routinely based on the detection of hepatitis B surface antigen (HBsAg) only. However, occult hepatitis B virus (HBV) infection (OBI), which is defined as infection with positive hepatitis B core antibody (anti-HBc) antibodies, positive DNA (deoxyribonucleic acid) PCR (polymerase chain reaction), and undetectable HBsAg, as well as anti-HBs antibodies in serum or plasma of HBV infected individuals, will remain undetected using this screening diagnostic approach of detecting HBsAg. The current study aims in studying the prevalence of the OBI amongst human immunodeficiency virus type 1 (HIV-1) infected individuals who have not been exposed to anti-retroviral therapy.

Method

Estimation of HBsAg, anti-HBs, and anti-HBc total antibody status amongst 100 HIV-1 infected study participants was carried out using enzyme-linked immunosorbent assay (ELISA) kits. Detection of HBV-DNA was carried out by in-house qualitative PCR. CD4 + T lymphocyte counts were analysed using Becton Dickinson's (BD) FACSCount™ system.

Results

The median age of the HIV-1 infected study population was 35 years (range: 22–67), with the gender distribution being 53 males and 47 females. The mean CD4 T lymphocyte count of the study participants was 210/mm³. Overall, serological evidence of HBV infection was observed in 28% of the HIV-1 infected study participants. There was 5% seropositivity for HBsAg, of which 2% were additionally positive for HBV-DNA-PCR. “Anti-HBc alone” status was seen in 18% of study participants, this being statistically higher in those with CD4 T lymphocyte counts < 200/mm³. While there was a single specimen with co-positivity for anti-HBc total antibodies and HBV-DNA, 5% of the in the study population exhibited anti-HBs antibodies positivity, with one sample exhibiting dual positivity for HBsAg and anti-HBs antibodies.

Conclusion

Occult HBV infections may contribute to chronic liver damage, and associ-ated reactivation amongst immunocompromised individuals, HIV-1 in-fected being a subset of them. “Anti-HBc” testing followed by HBV-DNA detection by PCR can be utilised for such populations to detect OBIs. Early detection of hepatitis B viraemia will be important for deciding the antiviral therapeutic protocol so as to avoid evolution of antiviral resistance in the circulating HBV strains in HIV-1 infected individuals harbouring OBIs.     

南宁市静脉注射吸毒人群HIV-1基因亚型及耐药性分析

目的 了解南宁市静脉注射吸毒人群（IDUs）中HIV-1流行基因亚型及其耐药性,为辖区艾滋病防治策略制定提供科学依据。方法 收集2017年南宁市静脉注射吸毒人员HIV感染者血浆样本总共68份,提取病毒核糖核酸(RNA),通过巢式PCR对HIV pol基因片段进行扩增测序,构建系统进化树进行基因分型,并将序列提交至美国斯坦福大学HIV耐药数据库分析,利用pol基因测序结果分析HIV-1亚型和耐药性情况。结果 68份血浆样本中巢式PCR成功扩增基因片段62份,系统进化分析显示检出3种HIV-1重组基因亚型, CRF_01-AE亚型占72.6% (45/62)、CRF_07-BC亚型占12.9% (8/62)、CRF_08-BC亚型占14.5% (9/62) ,CRF01_AE 型为主要流行亚型。χ²检验分析显示在性别、年龄、民族、婚姻4个人口学特征中62份样本HIV-1亚型组成差异无统计学意义（P>0.05）。62份样本中3例CRF_08-BC亚型发现T69S耐药突变,1例CRF_01-AE亚型发现L210W突变,1例CRF_07-BC亚型发现A71V突变。结论 南宁市IDUs人群HIV-1感染者中至少存在3种HIV-1基因亚型流行,CRF_01-AE重组型为优势流行株,研究中出现的耐药突变位点为低度耐药突变位点,应密切监视其流行趋势。     

重组病毒法:一种快速检测HIV药物敏感性方法

目的建立一种快速检测所有HIV病毒株药物敏感性的新方法(重组病毒法)。方法用逆转录-聚合酶链法(RT-PCR)扩增HIV/AIDS患者血浆中的HIVRNA,得到全长HIV逆转录酶(RT)的编码序列,然后与无感染性的前病毒克隆pHIV△RTBstEⅡ经过同源重组产生活的、具有诱导合胞体(SI)表型的重组HIV,再用HelaCD4 细胞蚀斑减少法检测HIV对核苷类药物的敏感性。结果用这种方法检测了7株不同表型的HIV,重组病毒与原始HIV病毒具有相同的基因型,药物敏感性结果与标准化外周血单个核细胞(PBMC)培养法的结果相同。结论重组病毒法是一种快速、准确检测所有表型HIV病毒株的药物敏感性方法。     

江苏省2005~2008年吸毒人群艾滋病病毒哨点监测结果分析

目的:通过对2005～2008年江苏省吸毒人群艾滋病病毒(HIV)哨点监测结果的分析,了解该人群艾滋病感染状况及高危行为状况变化趋势,评价近年对吸毒人群的干预效果。方法:采用SPSS11.5统计软件对2005～2008年江苏省7个吸毒人群艾滋病哨点监测数据进行统计分析。结果:吸毒人群中艾滋病病毒抗体(HIV抗体)阳性率为0.7%,丙肝(HCV)阳性率为34.04%。注射吸毒率逐年呈下降趋势且有统计学差异(χ2=156.66,P<0.01);注射吸毒且共用针具者与注射吸毒但不共用针具者艾滋病感染状况有统计学差别(χ2=18.173,P<0.01);发生商业性行为时从不使用安全套的比例有逐年下降趋势(χ2=11.67,P<0.01)。此外,注射吸毒者HCV感染率与非注射吸毒者HCV感染率有统计学差异(χ2=708.945,P<0.01)。结论:在吸毒人群中普遍存在艾滋病、HCV等血源传染性疾病流行的风险,加强对吸毒人群的监测和防病知识宣传教育及行为干预,有利于控制诸如艾滋病、HCV等血源性疾病的传播和蔓延。     

Hepatitis G viral RNA co-infection in plasma and peripheral blood mononuclear cells in patients with hepatitis C

Hepatitis G virus( HGV) is identified as a mem-ber of Flaviviridae family and is a single chain( )RNA virus.The transmission route of HGV is sameas that of hepatitis C virus( HCV) ,mainly thoughthe approaches of blood product use and intravenousinjection.Thus,HCV- HGV co- infection becomespossible.There has been domestic report about de-tecting HGV RNA in serum of hepatitis C,but notdetecting it in peripheral blood mononuclear cells( PBMCs) simultaneously.Therefore,some patients…     

青少年人类免疫缺陷病毒感染的影响因素

获得性免疫缺陷综合征（AIDS）,即艾滋病,是由人类免疫缺陷病毒（HIV）感染引起的一种严重的传染病。目前,HIV感染呈低龄化流行趋势,青少年已成为HIV的易感群体。静脉注射吸毒和性行为是青少年感染HIV的主要途径。吸毒和性行为的发生受多种个人及环境因素的影响。文章就青少年HIV感染现状及影响因素进行综述。     

青少年人类免疫缺陷病毒感染的影响因素

获得性免疫缺陷综合征(AIDS),即艾滋病,是由人类免疫缺陷病毒(HIV)感染引起的一种严重的传染病.目前,HIV感染呈低龄化流行趋势,青少年已成为HIV的易感群体.静脉注射吸毒和性行为是青少年感染HIV的主要途径.吸毒和性行为的发生受多种个人及环境因素的影响.文章就青少年HIV感染现状及影响因素进行综述.     

人类免疫缺陷病毒阴性病人Jiroveci氏肺孢子菌感染

对人类免疫缺陷病毒阴性病人Jiroveci氏肺孢子菌（基诺威茨肺孢菌或基瓦肺孢菌）感染的流行病学、临床表现、诊断、治疗和预防进行了简要回顾。     

Human immunodeficiency virus infection in diabetic intravenous drug users

OBJECTIVE.--To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. DESIGN.--Cross-sectional survey in a cohort of IV drug users. SETTING.--Community-based study clinic. SUBJECTS.--The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. OUTCOME MEASURES.--The HIV seroprevalence among IV drug users with and without a history of diabetes. RESULTS.--Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P = .03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. CONCLUSION.--Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.     

HIV和肝炎病毒混合感染的临床分析

目的 :观察HIV和肝炎病毒混合感染的流行病学特点。方法 :对本院 2 48例因并发症而住院治疗的AIDS病人中 10 3例HIV和肝炎病毒混合感染情况进行流行病学分析。结果 :10 3例HIV和肝炎病毒混合感染病例中HIV/HCV混合感染 95例 ,HIV/HBV混合感染 5例 ,HIV/HBV、HCV混合感染 3例 ,各占 3 8 0 0 %、2 0 0 %和 1.2 0 %。输血途径感染 68例 ,单采血浆感染 15例 ,母婴传播途径感染 7例 ,性传播途径感染 5例 ,各占混合感染病例的 71.60 %、15 .80 %、7.45 %和 5 .2 6%。结论 :HIV/HCV混合感染人数和比例远远多于HIV/HBV、HIV与HBV、HCV混合感染人数和比例 ,大多数病人以输血途径和单采血浆途径感染。