Epidemiological Characteristics And Clinical Features On HIV Co-infection With HBV And/or HCV

Objective:To explore the epidemiological characteristics and clinical features of HIV and co-infection with HBV and/or HCV in HIV/AIDS patients.Method:Gathering the epidemiological and clinical data of690cases with HIV/AIDS who had seen doctors in infectious diseases department of The First Affiliated Hospital of Kunming Medical University and The Third People’s Hospital of Kunming during April2009to April2013. The patients were divided into four groups as follows:HIV group, HIV/HBV group, HIV/HCV group and HIV/HBV/HCV group. All the patients in four groups were retrospectively analyzed for the epidemiological data and their clinical items including CD4+T lymphocyte count, CD8+T lymphocyte count, total protein, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, prothrombin time, HIV-RNA, HBV-DNA as well as HCV-RNA viral load.Result:1. There were304cases (44.06%) with HIV and386cases (55.94%) with AIDS in all the690cases. There were71cases (10.29%) with HIV/HBV,183cases (26.52%) with HIV/HCV and26cases (3.77%) with HIV/HBV/HCV. The rate of HIV/HCV co-infection (26.52%) was higher than the rate of HIV/HBV co-infection (10.29%).2. Of all the690cases with HIV/AIDS, male cases was518and female cases was172. The ratio male to female was3:1. The age was from3to82years old and their average age was41.05±13.06years old. Young adults (539) accounted for a large part (78.12%). They were mainly farmers and migrant workers the number of which was539(78.12%). Sexually transmitted way was the main transmitted way in HIV group, HIV/HBV group and HIV/HBV/HCV group, which respectively accounted for82.93%,84.50%and69.23%. Intravenous drug use was the main transmitted way in HIV/HCV group and accounted for62.84%. The differences among gender, age, occupation and way of transmission in the four groups were statistically significant (P<0.05).3. The incidence of opportunistic infections was as follows:tuberculosis, oral and esophageal fungal infections, bacterial pneumonia and pneumocystis pneumonia. The cases that co-infection with tuberculosis or fungi occupied a large part and respectively accounted for14.78%and14.35%. The incidence of tuberculosis, venereal disease and kaposi’s sarcoma had significant differences in the four groups (P<0.05), respectively dominated in HIV/HCV group, HIV/HBV/HCV group, HIV/HBV/HCV group. The differences in the incidence of other opportunistic infections and tumors was not statistically significant (P>0.05).4. HIV group had normal or mildly liver function damage. HIV/HBV, HIV/HCV, HIV/HBV/HCV group had mildly or moderate liver function damage. HIV/HBV, HIV/HCV and HIV/HBV/HCV group had higher liver function indicators than that of HIV group. HIV/HBV/HCV had the highest liver function indicators (P<0.05).5. Of all690cases, CD4+T lymphocyte count significantly decreased and CD8+T lymphocytes counts increased. The differences of T lymphocyte count in HIV, HIV/HBV and HIV/HCV was not statistically significant (P>0.05). HIV/HBV/HCV had lowest CD4+T lymphocyte count (P<0.05). In the four groups, HIV-RNA load level was significant different (P<0.05). HIV group had low HIV RNA level of replication. HIV/HBV, HIV/HCV group had low or moderate HIV-RNA level of replication. HIV/HBV/HCV had moderate or high HIV-RNA level of replication. HIV/HBV, HIV/HCV and HIV/HBV/HCV group had higher HIV-RNA load level than that of HIV group. 6. HBV-DNA load level and HCV-RNA load level of HIV/HBV/HCV group were respectively higher than HIV/HBV and HIV/HCV group (P<0.05).Conclusion:The male cases who were30-40years old occupied a large part in all case with HIV/AIDS. They were mainly farmers and migrant workers. Sexually transmitted way was the main transmitted way. Intravenous drug use was the main transmitted way in HIV/HCV group. Co-infection with HBV and/or HCV would increase the incidence of opportunistic infections and tumors. HIV group had normal or mildly liver function damage. HIV/HBV and HIV/HCV co-infection would aggravate the damage of the liver, especially in cases of HIV/HBV/HBV co-infection. HIV/HBV/HCV co-infection would aggravate the damage of cellular immunity. Co-infection with HBV and/or HCV would increase HIV-RNA load level. HIV/HBV/HCV co-infection would increase HBV-DNA and HCV-RNA load level.