| Background:Human Immunodeficiency Virus(HIV) is still spreading all over the world at present, and the patients with HIV/AIDS are increasing constantly. At the same time, in our country, the morbidity of viral hepatitis is maintained a high level, especially the hepatitis B virus (HBV) infection, which lists the top position in the world. As the spread of HIV and HBV with the similar pathway, the patients with HIV co-infected with HBV (HIV/HBV) are rising sharply. With the wide use of the effective antiretroviral drugs, there are obvious decrease with the aspects of the HIV-related complications and mortality of tumors. However, in recent years, many studies have shown that the morbidity and mortality of HIV/HBV related to liver diseases are obviously in a rising trend, so end-stage liver disease became one of the leading causes of death in patient with HIV/HBV. For the sake of preventing HIV/HBV at early time and reducing infection rate treatment rate and mortality, it is indispensable means for us to analysis the epidemiology and clinical characteristics of HIV/HBV.Objective:To analyze the epidemiology and clinical characteristics of HIV/HBV, and provide significant clues and evidence for the prevention and treatment of HIV/HBV at early time. Methods:Collected the clinic data of 5937 patients’ cases, who suffered from HIV/AIDS in the infectious department of the first affiliated hospital of Kunming medical university and infectious disease specialist hospital of Yunnan province from January in 2009 to December in 2014. Divided into pure HIV infection group (5537 cases) and HIV co-infected with HBV (HIV/HBV) group (400 cases), the epidemiological data of two groups and clinical data were retrospectively analyzed. Epidemiological data contains the distribution of time、space and person between the two groups; Clinical data is composed of CD4+ T lymphocyte count、 CD8+ T lymphocyte count、alanine aminotransferase (ALT)、aspartate aminotransferase (AST)、HBV serological immune makers、HBV-DNA loads, etc. Using SPSS for Windows 17.0 statistics software package to compile the experimental and clinical data statistics and analyze if there is any difference between the two groups.Result:1、5937 cases of patients with HIV/AIDS,5537 patients(93.26%) with pure HIV infection, 400 patients(6.74%) with HIV co-infected with HBV(HIV/HBV).2、In 5937 cases of HIV/AIDS patients,4437 of whom (74.73%) are male and 1500 (25.27%) are female, the ratio of the male to female is about 2.96:1; 4156 of pure HIV infection group(75.06%)were male and 1381(24.94%)were female, however, in HIV/HBV group,281 cases (70.25%) are men and 119(29.75%) are women, and the difference between the two group’s gender distribution was statistically significant (P< 0.05).3、In 5937 cases of HIV/AIDS patients, age range is from 3 to 88 years old, their mean age of whom are 40.73±14.57 years old, mainly young adults. Patients with HIV/HBV positive rate varied in different age stages, who are mainly ranged from 31 to 50 years old (257 cases, 7.56%), respectively,147 cases(7.54%) in 31～40 years old, and 110 cases (7.60%) in 41～ 50 years old. All different age stages had different HIV/HBV positive rates, and the difference was statistically significant (P< 0.05). Compared with the age stage about 61～70 years old,21～30 age stage,31～40 age stage,41～50 age stage,51～60 age stage, the difference are statistically significant (P< 0.05). Compared with any two age stages in rest, there has no statistical significance(P>0.05).4、In 5937 cases of HIV/AIDS patients, they were mainly farmers and migrant workers (3375 cases,56.85%); there were 1970 cases (35.58%) of farmers in pure HIV infection group,1142 cases were migrant workers (20.62%); there were 162 cases (40.5%) of farmers in HIV/HBV group and 101 cases were migrant workers (25.25%), and the difference between the two groups’occupational distribution was statistically significant (P< 0.05).5、In 5937 cases of HIV/AIDS patients, the transmission route are mainly through sexual transmission and intravenous drugs use.In pure HIV infection group, there are 3955 cases (71.42%) patient through sexual transmission,1120 cases (20.23%) through intravenous drug use; In HIV/HBV group, there are 318 cases (79.5%) patient through sexual transmission,64 patients (16.0%) through intravenous drugs use, and the difference between the two groups’ transmission route distribution was statistically significant (P< 0.05). Different HIV/HBV positive rate varied in different transmission route, and the difference was statistically significant(P< 0.05). Compared with sexual transmission route respectively, intravenous drug use、blood spread and mother to infant transmission route had a significant statistically difference(P< 0.05), and compared with any two transmission way, there has no statistical significance(P>0.05).6、Pure HIV infection group’s patients mostly had a normal liver function. However, compared with pure HIV infection group,in HIV/HBV group,the degree of the damaged liver function were mostly ranges from low to mild, among those patients,there were 243 case with abnormal liver function.the liver function index in HIV/HBV group was higher than the pure HIV infection group,the difference between two group’s liver function index was statistically significant (P< 0.05).7、Among the 5937 cases of HIV/AIDS patients, CD4+ T lymphocyte counts decreased obviously, while CD8+ T lymphocyte counts rose reversely. The difference between the two group’s the degree of CD4+ T lymphocyte count decrease and CD8+ T lymphocyte count increase was statistically significant (P< 0.01).8. Among the 5937 cases of HIV/AIDS patients,3265 cases(54.99%) with anti-HBs negative, 2272cases(38.27%) with anti-HBs positive;400 cases(6.74%) with HBsAg positive, 97case(24.25%) with HBeAg positive in HBsAg positive cases,238 case (59.5%) with anti-HBe positive,376 case(94%) with anti-HBc positive.The HBV-DNA positive rate in HBeAg positive group significantly higher than the HBeAg negative group, and the HBV-DNA positive rate is 77.32% and 18.48% respectively, and the difference was statistically significant (P< 0.05).9、Among 5937 cases of HIV/AIDS patients, the clinical manifestations appeared more complex and diverse, which were mainly manifested as fever (1908 cases,32.14%), emaciation and fatigue (1314 cases,22.13%),followed by were cough and hawking(918 cases,15.46%),Oral leukoplakia and sore throat(686 cases,11.55%), headache and dizziness(443 cases,7.46%), shortness of breath and difficulty breathing(428 cases,7.21%), abdominal pain and diarrhea(382 cases,6.43%), swollen lymph nodes(268 cases,4.52%);among them,there were 1774 cases (32.04%) with fever in pure HIV infection group,1220 cases (22.03%) with emaciation and fatigue;however,in HIV/HBV group,there were 134 cases (33.50%) with fever,94 cases (23.50%) with emaciation and fatigue.10-. Among 5937 cases of HIV/AIDS patients, there were 2441 cases exsisted variable opportunistic infections,2272 cases in pure HIV infecton group,169 cases in HIV/HBV group.Among these 2272 cases in pure HIV infecton group,bacterial pneumonia happened in 1214 cases (21.93%), lymphoma happened in 21 cases (0.38%),pneumocystis pneumonia happened in 317 cases (5.73%), oral fungal infection happened in 462 cases (8.34%), tuberculosis (TB) happened in 428 cases (7.73%), herpes zoster happened in 341 cases (6.16%), cryptococcus infection happened in 228 cases (4.12%), carlyle marney thin blue mould infection happened in 176 cases (3.18%), Among these 169 cases in HIV/HBV group,bacterial pneumonia happened in 61 cases (15.25%), lymphoma happened in 5 cases (1.25%),pneumocystis pneumonia happened in 31 cases (7.75%), oral fungal infection happened in 35 cases (8.75%), tuberculosis (TB) happened in 25 cases (6.25%), herpes zoster happened in 25 cases (6.25%), cryptococcus infection happened in 21 cases (5.25%), carlyle marney thin blue mould infection happened in 13 cases (3.25%), the difference of the morbidity of bacterial pneumonia and lymphoma between the pure HIV infection group and HIV/HBV group was statistically significant (P< 0.01).Conclusion:1、In this research,there were 400 cases with HIV co-infected with HBV,it is lower than the related reports which have been published at domestic and overseas.2、Patients with HIV/AIDS or co-infected with HBV mostly were male,and aged from 31 years old to 50 years old,mainy were farmers and migrant workers,transmitted mainly through sexual transmission,besides, when HIV/AIDS co-infected with HBV,it will increase the liver damage and the body’s immune injury.3、Among patients with HIV/HBV,HBeAg serological marker can be used as one of the symbols of HBV replicated actively, but the HBV-DNA loads must be monitored in order to guide the clinical diagnosis and treatment.4、HIV/AIDS merged HBV infection can increase the opportunistic infections and tumors. |
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