| Objective To analyze the epidemiological situation and feature of HCV infection among HIV-infected individuals in Guangxi.Methods The patients who confirmed with HIV infection from 2010 to 2016 and practiced medicine in hospitals of Guangxi Zhuang autonomous region were enrolled in the study. The data of basic demographic data and clinical information including HCV anti-body, HIV and HCV-infected routes and more about them were collected. And then the data was used for statistical and epidemiological analysis of HCV infection among HIV-infected individuals from Guangxi. What’s more, we collected serum of 40 anti-HCV-negative patients from the HIV-infected individuals for detecting high sensitive HCV RNA.Results 1. A total of 6154 HIV-positive cases were enrolled, of which 3154 contained full information including routes of infection. Anti-HCV antibody was present in 6.65%(409/6154) (95%CI:6.03%-7.27%) among the 6154 patients.2. The positive rate of anti-HCV antibody was 8.02%(345/4304) in males and 3.46%(64/1850) in females among the 6154 patients. Obviously, male was higher than female in the positive rate, and the difference between them was statistically significant (P<0.01).3. All of the cases could be divided into five groups according to the age, including～17y,18～44y,45～59y,60-89y and 90y-. The positive rate of anti-HCV antibody was 0.00%(0/12), 10.47%(283/2703),5.44%(104/1913),1.44%(22/1524) and 0.00%(0/2), respectively. It showed that it was highest in the group of 18-43y, and the differences between it and others were statistically significant (P<0.01).4. All of the 3514 patients infected with HTV/HCV by intravenous drug uses (IDUs), sexual contact, both intravenous drug uses and sexual contact, other routs (including mother-to-child transmission, transfusion and dental treatment in private clinics) or unknown modes of transmission. The positive rate of anti-HCV antibody in the routes mentioned above was 75.12%(157/209), 2.53%(81/3202),70.00%(7/10),4.76%(1/21) and 4.17%(3/72), respectively. There was no statistical significance between the group of intravenous drug uses and both intravenous drug uses and sexual contact in the rate (P>0.01). But the rates of them were higher than that in other groups and the differences were statistically significant (P<0.01).5. Of 409 patients, including 343 men and 66 women, who showed positive for both HTV-antibody and HCV-antibody, the percentage in the groups infected by IDUs, sexual contact, both IDUs and sexual contact, other ways and unknown modes of transmission respectively was 66.99%(274/409),29.83%(122/409),1.96%(8/409),0.24%(1/409) and 0.98%(4/409). The most of them infected by IDUs apparently. (1). In the 343 men, the proportion of the patients infected through IDUs, sexual contact, both IDUs and sexual contact, other ways and unknown modes of transmission was 72.30%(248/343),24.49%(84/343),2.33%(8/343) and 0.87%(3/343), respectively. And the proportion was 39.39%(26/66),57.58%(38/66), 1.52%(1/66) and 1.52%(1/66), respectively, among the 66 women. It showed that the males were infected primarily through IDUs while most of the femals were infected through sex contract, and the differences of distribution of routes for them were statistically significant(P< 0.01). (2). The patients could be divided into five groups by age as mentioned above. None under 18y or over 89y. The proportion of the patients infected through IDUs, sexual contact, both IUDs and sexual contact, other ways and unknown modes of transmission was 71.58%(209/292),23.97%(70/292),2.74%(8/292),0.34%(1/292) and 1.37%(4/292) in the 292 patients aged between 18y and 44y. In 98 patients aged between 45y and 59y, all of them infected by IDUs and sexual contact, and the proportion was 63.27%(62/98) and 36.73%(36/98), respectively, and 15.79%(3/19) and 84.21%(16/19), respectively in the 19 patients aged between 60y and 89y. It indicated that the percentage of both of the patients aged 18y～44y and 45y～59y infected by IDUs were higher than those aged 60y-89y, and the percentage of the patients aged 60y-89y infected through sex was higher than those aged 18y-44y and 45y～59y. The differences were statistically significant(P<0.01).4. Univariate and multivariate logistic regression analysis were applied in the analysis. By univariate logistic regression analyses, routes of infection, but not gender or age, was selected as a risk factor for HCV infection among HTV-infected individuals. Multivariate logistic regression analysis revealed that the routes of IDUs (AOR= 60.385,95%CI:7.909-461.017, P=0.000) and both IDUs and sexual contact (AOR=46.667,95%CI: 4.144-525.501, P=0.002) were significant factor for HCV infection.5. The HCV RNA could not be detectable in the serum of 40 anti-HCV-negative patients who got HTV infection.Conclusions 1. The positive rate of anti-HCV antibody among HIV-infected patients was 6.65%(95%CI:6.03%～7.27%) in Guangxi.2. Most patients infected with HCV through IDUs among HIV-infected individuals in Guangxi. The positive rate was highest for males in gender and for the youth in age, both of whom infected with HCV by IDUs mainly, as well as the middle-aged patients. But most females and the elderly infected with HCV via sex contract among HIV-infected individuals.3. IDUs were independent risk factors for infecting with HCV among HIV-infected patients.4. We would not miss HCV-infected patients probably if screening for HCV only depending on anti-HCV antibody among HIV infected patients. |
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