Epidemiology And Influencing Factors Of HIV And HBV Co-Infected In Beijing

BackgroundAIDS,that is,acquired immunodeficiency syndrome,about 37 million people worldwide are infected by human immunodeficiency virus(Human immunodeficiency virus,HIV)currently.At the same time,about 400 million people suffer from chronic hepatitis B virus(hepatitis B virus,HBV)infection.Because HIV and HBV share a common route of infection,HIV and HBV are often co-infected.Patients with HIV/HBV co-infection are more likely to develop liver cirrhosis and hepatocellular carcinoma.It is an important issue in the prevention and control of infectious diseases.At present,the research on the prevalence and disease characteristics of HIV infection co-infected with HBV is rare,and there are few international studies to evaluate the functional cure of chronic HBV infection in patients with HIV/HBV co-infection.The study of HIV/HBV co-infection is of great significance for the prevention and control of the disease.Objective1.Calculating the prevalence of HIV/HBV co-infection in Beijing distract.2.Calculating the prevalence of HIV/HBV co-infection among newly diagnosed HIV infections from 2013 to 201 8 and analyze the trend of annual rate.3.Logistic regression model was used to analyze the correlation between clinical characteristics and co-infection in patients with HIV/HBV co-infection.4.Analyzing the HBsAg clearance rate and HBeAg antigen conversion rate of HIV/HBV co-infected patients under different ART regimens.Subjects and methods1.Subjects:patients with HIV infection were followed up and treated in Beijing HIV/AIDS designated treatment Hospital(Peking Union Medical College Hospital,Beijing Ditan Hospital and Beijing You' an Hospital)from 2001 to 2019.2.Research methods:1)Epidemiological investigation:We analysed retrospectively the clinical data of HIV infected persons in HIV/AIDS designated treatment hospitals in Beijing,including sex,age,marital status,route of infection,and the baseline results of tests for HBV replication(hepatitis B e antigen[HBeAg],antibody to HBeAg[anti-HBe],HBV DNA).2)Collection of blood samples and Laboratory tests:including liver chemistry tests(aspartate aminotransferase[AST],alanine aminotransferase[ALT]),T lymphocyte subsets,HIV virus load.Besides,we analyzed retrospectively the tests for hepatitis B in HIV patients diagnosed in the past few years,and to determine the annual prevalence of HIV/HBV co-infection and its trend in newly diagnosed HIV infection.3)Identifying the influencing factors of HIV/HBV co-infection in Beijing:stratified analysis was made according to the patient's age,sex,marital status,CD4+T cell count and antiviral treatment regimen to determine the impact of different factors on HIV/HBV co-infection.4)Evaluating the efficacy of different ART regimens in the treatment of chronic HBV infection in patients with HIV infection:according to the different anti-HBV drugs included in the ART regimen for HIV/HBV co-infection in the cohort,the patients were divided into two groups:single 3TC group and 3TC+TDF group.The results of HBsAg,HBeAg and HBV DNA load in different groups were collected or detected to determine the HBsAg clearance rate,HBeAg antigen conversion rate and HBV DNA inhibition rate of different ART regimens.5)Statistical analysis:After sorting out the data,SPSS(23.0)was used for statistical analysis.Results1.In the long-term follow-up of 13253 cases of HIV/AIDS infection,11572 patients were included in the study,of which 532 cases(4.60%)were co-infected with HIV/HBV.85.9%of the coinfected patients were young and middle-aged(28-48 years old)male,and the main route of infection was homosexual transmission(74.8%).2.From 2013 to 2018,the prevalence of HIV/HBV co-infection showed a fluctuating downward trend,with an average annual growth rate of 6.37%,4.55%,3.92%,4.68%,4.24%and 2.74%,respectively.3.The main influencing factor of HIV/HBV co-infection was age(28-48 years old vs<28 years old,OR=2.938,95%CI:1.300-6.640)and marriage(married versus unmarried,OR=1.259,95%CI:1.004-1.579).4.87.4%of the patients with co-infection received baseline treatment with two anti-HBV drugs,lamivudine(3TC)and tenofovir(TDF).During the follow-up,the HBeAg antigen loss rate and antigen conversion rate in the 3TC+TDF group were 46.4%and 39.3%respectively at 1 year of treatment.Compared with 3TC group,3TC+TDF group tends to have higher antigen conversion rate and higher virus inhibition rate.ConclusionThe prevalence of HIV/HBV co-infection in Beijing was 4.6%,slightly lower than the prevalence of national average of 12 provinces in 2013;the prevalence of the HIV/HBV co-infection showed a fluctuating downward trend from 2016 to 201 8.Among the many clinical risk factors investigated in this study,age(28-48 years old)and marriage had a higher risk of co-infection,and no correlation between other risk factors and co-infection was found.Compared with 3TC group,3TC+TDF group tends to have higher antigen conversion rate and higher virus inhibition rate.Attention should be paid to the high-risk population,early prevention and strengthening the monitoring of liver function.