Status and Influencing Factors of HIV/AIDS Patients Co-infected with Hepatitis C Virus in Guizhou

Abstract

Background The status of patients with HIV/AIDS co-infected with HCV considerably varies in different parts of China. The co-infection of HIV and HCV accelerates the clinical progress of the disease, thereby reducing the patients' quality of life and exacerbating the occurrence of death. Currently, there are relatively few studies on patients with HIV/AIDS co-infected with HCV in Guizhou. Objective To analyze the status of patients with HIV/AIDS co-infected with HCV in Guizhou and its influencing factors and consequently provide basis for its early detection, diagnosis, and treatment. Methods The cases included in this study were a cohort of HIV/AIDS patients who received antiviral therapy (ART) in the public health rescue center of Guangzhou from March 2006 to December 2020. Finally, 3 084 patients who met the study requirements were included. Patients' sex, age, ethnicity, education level, occupation, marital status, route of infection, year of diagnosis, and CD4+ T-lymphocytes before ART and anti HCV levels were collected. Multivariate Logistic regression model were used to identify influencing factors of patients with HIV/AIDS co-infected with HCV. Results Among the 3 084 patients with HIV/AIDS, 202 were co-infected with HCV, and the co-infection rate was 6.55%. There were significant differences in HCV infection rates among patients with HIV/AIDS of different age groups, education levels, occupations, route of infection (P<0.05) . There were no significant differences in HCV infection rates among patients with HIV/AIDS by gender, ethnicity, and marital status (P>0.05) . The prevalence of HCV infection among HIV/AIDS patients tended to decrease with increasing year of diagnosis and increasing levels of CD4+ T lymphocytes (P<0.05) . Multivariate Logistic regression analysis showed that the risk of HCV infection was higher among HIV/AIDS patients aged 30-39 and 40-49 years than among those ≥50 years〔OR (95%CI) =2.512 (1.374, 4.593) , 2.802 (1.521, 5.163) , respectively〕, and the risk of HCV infection was higher among HIV/AIDS farmers than among those in other occupations〔OR (95%CI) =1.926 (1.201, 3.090) 〕. Route of infection of intravenous drug user was higher for HIV/AIDS patients with HCV infection than for MSM〔OR (95%CI) =39.038 (17.559, 86.790) 〕, and for HIV / AIDS patients diagnosed 2006—2010, 2011—2015, the risk of HCV infection was higher than that for those diagnosed 2016—2020〔OR (95%CI) =10.890 (6.428, 18.447) , 4.613 (2.928, 7.269) , respectively〕. Those with baseline CD4+ T lymphocytes <200, 200-350, 351-499/μl had higher risk of HCV infection among HIV/AIDS patients than those with baseline CD4+ T lymphocytes≥500/μl, respectively〔OR (95%CI) =7.120 (3.731, 13.589) , 3.614 (1.818, 7.184) , 2.795 (1.319, 5.922) 〕. Conclusion Although the strategy of "exhaustive treatment" for HIV/AIDS has decreased HCV infection rates among patients with HIV/AIDS in Guizhou, the status still need to be carefully monitored. Early HCV screening should be conducted for the HIV/AIDS population, focusing on individuals aged 30-49 years, intravenous drug users, farmers, and those with low CD4+ T-lymphocyte levels.

Keywords

• hiv infections|acquired immunodeficiency syndrome|hepatitis c virus|hepatitis c|root cause analysis|guizhou