【摘要】 目的了解广西地区HIV感染人群HCV抗体阳性率的流行病学现状与特点。方法以2010年-2016年在广西7家医院就诊的HIV抗体阳性的广西籍患者为研究对象,收集患者基本人口学资料及HCV抗体检测结果、HIV/HCV共感染途径等资料。计数资料组间比较采用χ2检验方法或Fisher’s精确检验,采用Bonferroni法进行多个样本率的多重比较。因变量为二分类变量,采用二分类logistic回归模型进行单因素及多因素分析。结果共选取HIV抗体确证阳性患者6154例,其中HCV抗体阳性409例,阳性率为6. 65%[95%可信区间(CI):6. 03%～7. 27%],其中男性HCV抗体阳性率(7. 97%)高于女性(3. 57%),差异具有统计学意义(χ2=29. 294,P <0. 01); 18～44岁年龄段HCV抗体阳性率最高(10. 47%),45～59岁年龄段次之(5. 44%),均高于其他年龄段,两两分析比较差异均有统计学意义(P值均<0. 01);静脉吸毒人群HCV抗体阳性率最高(75. 12%),静脉吸毒+性接触次之(70. 00%),均高于其他感染途径,差异均有统计学意义(P值均<0. 01); HIV抗体和HCV抗体均为阳性的患者中,静脉吸毒所占比例高于其他感染途径,其中男性以静脉吸毒居多(72. 30%),女性则以性传播为主(57. 58%),2种人群在感染途径分布差异具有统计学意义(P <0. 01); 18～44岁年龄段患者静脉吸毒比例最高(71. 58%),其次为45～59岁年龄段(63. 27%),其比例远高于其他年龄段,两两分析比较提示其差异均有统计学意义(P值均<0. 01),60～80岁年龄段性接触传播比例高于其他年龄段,两两分析比较提示差异均有统计学意义(P值均<0. 01); logistic回归分析表明,HIV感染者中,静脉吸毒者合并HCV感染的危险性是其他途径感染者的60. 385倍(95%CI:7. 909～461. 017),静脉吸毒+性接触者合并HCV感染的危险性是其他途径感染者的46. 667倍(95%CI:4. 144～525. 501)(P值均<0. 01)。结论广西地区HIV感染人群HCV抗体阳性率维持在较高的流行病学水平,男性HCV抗体阳性率高于女性,青年人群HCV抗体阳性率高于其他年龄段;男性、中青年人群主要经静脉吸毒途径感染HIV和HCV,而女性、老年人群则主要经性接触途径感染HIV和HCV;静脉吸毒是HIV感染者合并HCV感染的独立危险因素。更多还原

【Abstract】 Objective To investigate the epidemiological status and features of anti-HCV positive rate among the HIV-infected population in Guangxi,China. Methods The patients from Guangxi who attended 7 hospitals in Guangxi form 2010 to 2016 and were confirmed with positive HIV antibody were enrolled as subjects. Their demographic data,anti-HCV test results,and route of HIV-HCV coinfection were collected. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups,and the Bonferroni method was used for multiple comparisons of sample rates. Since dependent variables were binary variables,the binary univariate and multivariate logistic regression analyses were performed. Results A total of 6154 patients with positive HIV antibody were enrolled,among whom 409(6. 65%; 95% confidence interval [CI]: 6. 03%-7. 27%) had positive HCV antibody. Male patients had a significantly higher anti-HCV positive rate than female patients(7. 97% vs 3. 57%,χ2= 29. 294,P < 0. 01). The age group of 18-44 years had the highest anti-HCV positive rate of 10. 47%,followed by the age group of 45-59 years(5. 44%),and these two groups had a significantly higher positive rate than the other age groups based on pairwise comparison(all P < 0. 01). Intravenous drug users had the highest anti-HCV positive rate of 75. 12%,followed by the intravenous drug users with sexual contact(70. 00%),and the patients with these two routes of infection had a significantly higher anti-HCV positive rate than those with other routes(all P < 0. 01). In the patients with positive HIV and HCV antibodies,intravenous drug users accounted for a higher proportion than the patients with other routes of infection; 72. 30% of the male patients were intravenous drug users,while 57. 58% of the female patients were infected via sexual transmission,and there was a significant difference in the distribution of the routes of infection between the male and female patients(P < 0. 01). The age group of 18-44 years had the highest proportion of intravenous drug users(71. 58%),followed by the age group of 45-59 years(63. 27%),and these twogroups had a significantly higher proportion than the other age groups based on pairwise comparison(all P < 0. 01). The age group of 60-80 years had a significantly higher proportion of patients with sexual transmission than the other age groups based on pairwise comparison(all P < 0. 01). The logistic regression analysis showed that for the patients with HIV infection,the risk of intravenous drug use and HCV infection was 60. 385 times(95% CI: 7. 909-461. 017) that of the other routes of infection,and the risk of intravenous drug use + sexual contact and HCV infection was 46. 667 times(95% CI: 4. 144-525. 501) that of the other routes of infection(P < 0. 01). Conclusion The anti-HCV positive rate remains high among the patients with HIV infection in Guangxi,and male patients have a higher anti-HCV positive rate than female patients. Young individuals have a higher anti-HCV positive rate than the other age groups. Among the male population and the young and middle-aged population,intravenous drug use is the main route of HIV/HCV infection,while in the female population and the elderly population,sexual contact is the main route of infection. Intravenous drug use is an independent risk factor for HIV-HCV coinfection.更多还原