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Abstract：
BACKGROUND: The burden of hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis coinfections remains disproportionately high among people living with HIV/AIDS. Hubei province is located in central China, where there are distinct regional characteristics of the distribution of people living with HIV/AIDS acquired via diverse transmission routes and the AIDS epidemic itself.
OBJECTIVE: We aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission.
METHODS: From January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men.
RESULTS: Among 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission.
CONCLUSIONS: In people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.
OBJECTIVE: We aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission.
METHODS: From January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men.
RESULTS: Among 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission.
CONCLUSIONS: In people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.
摘要：
背景：乙型肝炎病毒（HBV）的负担，丙型肝炎病毒（HCV），在艾滋病毒/艾滋病感染者中，梅毒合并感染仍然不成比例。湖北省位于中国中部，通过不同传播途径获得的艾滋病毒/艾滋病感染者的分布和艾滋病流行本身具有明显的区域特征。
目的：我们旨在估计HBV的大小，HCV,或梅毒合并感染艾滋病毒/艾滋病患者的血液传播，其中包括以前的有偿献血者，受污染的血液接受者，和静脉吸毒者，以及性传播艾滋病毒感染者（包括异性恋者和男男性行为者）和母婴传播艾滋病毒者。
方法：从2010年1月至2020年12月，对HIV/AIDS患者进行了乙型肝炎表面抗原（HBsAg）检测，HCV抗体,和梅毒特异性抗体.阳性患者进一步检测HBV标志物，HBVDNA，和HCVRNA，并接受了快速血浆反应循环卡测试。所有艾滋病毒/艾滋病感染者首先被分为传播组(血液，性别,和母亲对孩子)；然后，通过血液传播的艾滋病毒感染者被分为以前的有偿献血者，受污染的血液接受者，和静脉吸毒者，而性传播HIV的人分为异性恋者和男男性行为者。
结果：在6623名艾滋病毒/艾滋病感染者中，前有偿献血者的慢性HCV感染率为80.3%(590/735)，73.3%(247/337)的静脉吸毒者，57.1％（444/777）在受污染的受血者中，19.4%(21/108)的艾滋病毒母婴传播者，8.1%(240/2975)的异性恋者，1.2%(21/1691)的男性与男性发生性关系。慢性HBV感染率在所有血液传播HIV传播人群中相似。然而,与异性恋者相比，与男性发生性关系的男性中慢性HBV感染率更高（213/1691，12.6％vs308/2975，10.4％;χ21=5.469;P=.02），尽管HBV暴露较少见（827/1691，48.9%vs1662/2975，55.9%；χ21=20.982；P<.001）。有趣的是,HBsAg和乙型肝炎e抗原（HBeAg）的组合被发现在11例患者与性别传播的HIV传播，但在血液传播的HIV传播人中有0人（11/196，5.6％vs0/521，0％；χ21=29.695，P<.001）。在患有性传播艾滋病毒的人中，梅毒滴度≥1:16和神经梅毒的患者比例分别为8.6%(105/1227)和7.8%(37/473),分别,而这些值在血液传播艾滋病毒的人群中为0。
结论：在艾滋病毒/艾滋病感染者中，HCV传播强度与血液或性接触的特定暴露方式显着相关。与男性发生性关系的男性中慢性HBV感染率高于任何其他人群。应注意通过性交感染艾滋病毒的艾滋病毒/艾滋病感染者中神经梅毒的高患病率。
目的：我们旨在估计HBV的大小，HCV,或梅毒合并感染艾滋病毒/艾滋病患者的血液传播，其中包括以前的有偿献血者，受污染的血液接受者，和静脉吸毒者，以及性传播艾滋病毒感染者（包括异性恋者和男男性行为者）和母婴传播艾滋病毒者。
方法：从2010年1月至2020年12月，对HIV/AIDS患者进行了乙型肝炎表面抗原（HBsAg）检测，HCV抗体,和梅毒特异性抗体.阳性患者进一步检测HBV标志物，HBVDNA，和HCVRNA，并接受了快速血浆反应循环卡测试。所有艾滋病毒/艾滋病感染者首先被分为传播组(血液，性别,和母亲对孩子)；然后，通过血液传播的艾滋病毒感染者被分为以前的有偿献血者，受污染的血液接受者，和静脉吸毒者，而性传播HIV的人分为异性恋者和男男性行为者。
结果：在6623名艾滋病毒/艾滋病感染者中，前有偿献血者的慢性HCV感染率为80.3%(590/735)，73.3%(247/337)的静脉吸毒者，57.1％（444/777）在受污染的受血者中，19.4%(21/108)的艾滋病毒母婴传播者，8.1%(240/2975)的异性恋者，1.2%(21/1691)的男性与男性发生性关系。慢性HBV感染率在所有血液传播HIV传播人群中相似。然而,与异性恋者相比，与男性发生性关系的男性中慢性HBV感染率更高（213/1691，12.6％vs308/2975，10.4％;χ21=5.469;P=.02），尽管HBV暴露较少见（827/1691，48.9%vs1662/2975，55.9%；χ21=20.982；P<.001）。有趣的是,HBsAg和乙型肝炎e抗原（HBeAg）的组合被发现在11例患者与性别传播的HIV传播，但在血液传播的HIV传播人中有0人（11/196，5.6％vs0/521，0％；χ21=29.695，P<.001）。在患有性传播艾滋病毒的人中，梅毒滴度≥1:16和神经梅毒的患者比例分别为8.6%(105/1227)和7.8%(37/473),分别,而这些值在血液传播艾滋病毒的人群中为0。
结论：在艾滋病毒/艾滋病感染者中，HCV传播强度与血液或性接触的特定暴露方式显着相关。与男性发生性关系的男性中慢性HBV感染率高于任何其他人群。应注意通过性交感染艾滋病毒的艾滋病毒/艾滋病感染者中神经梅毒的高患病率。
