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Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study.

ABSTRACT: Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and disease characteristics of HBV and HCV co-infection in HIV-positive patients across 12 provinces.HIV-positive ART-naïve patients were recruited from two parent cohorts established during November 2008-January 2010 and August 2012-September 2014. Hepatitis B surface antigen (HBsAg), hepatitis B e antigen and HCV antibody (anti-HCV) status were retrieved from parent databases at the visit prior to ART initiation. HBV DNA was then determined in HBsAg+ patients. HCV RNA was quantified in anti-HCV+ patients. Aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 (FIB4) were calculated. Chi-square test, Kruskal-Wallis test and logistic regression were used for statistical analysis, as appropriate.Of 1944 HIV-positive patients, 186 (9.5%) were HIV-HBV co-infected and 161 (8.3%) were HIV-HCV co-infected. The highest HIV-HBV prevalence (14.5%) was in Eastern China while the highest HIV-HCV prevalence was in the Central region (28.2%). HIV-HBV patients had lower median CD4 + T cell count (205 cells/?L) than either HIV monoinfected (242 cells/?L, P = 0.01) or HIV-HCV patients (274 cells/?L, P = 0.001). Moderate-to-significant liver disease was present in > 65% of the HIV-HCV, ~ 35% of the HIV-HBV and ~ 20% of the HIV monoinfected patients. Independent associations with moderate-to-significant liver disease based on APRI included HBV (Odds ratio, OR 2.37, P < 0.001), HCV (OR 9.64, P < 0.001), CD4 count ? 200 cells/?L (OR 2.55, P < 0.001) and age ? 30 years (OR 1.80, P = 0.001).HBV and HCV prevalence is high in HIV-positive Chinese and differs by geographic region. HBV and HCV co-infection and HIV monoinfection are risks for moderate-to-significant liver disease. Only HIV-HBV is associated with greater HIV-related immunosuppression. Incorporating screening and management of hepatitis virus infections into Chinese HIV programmes is needed.

SUBMITTER: Xie J

PROVIDER: S-EPMC4793284 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study.

Xie Jing J Han Yang Y Qiu Zhifeng Z Li Yijia Y Li Yanling Y Song Xiaojing X Wang Huanling H Thio Chloe L CL Li Taisheng T

Journal of the International AIDS Society 20160314 1

<h4>Introduction</h4>Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and disease characteristics of HBV and HCV co-infection in HIV-positive patients across 12 provinces.<h4>Methods</h4>HIV-positive ART-naïve patients were recruited from two parent cohorts established dur ...[more]

PMID: 26979535

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Project description:BackgroundThe prevalence of human immunodeficiency virus (HIV) varies markedly among different risk groups in China, spreading fromhigh-risk populations to the general population. Indeed, China is in a critical period of HIV/acquired immunodeficiency syndrome (AIDS) prevention and control; however, data regarding HIV testing, infection and coinfection among infertile couples are lacking. This study aimed to estimate the HIV/AIDS prevalence to identify risk factors among infertile couples in Hunan, China.MethodsA cross-sectional hospital-based study was conducted to evaluate the prevalence of HIV/other infections (hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium (MG) infections) among 338,432 infertile individuals in Hunan, China, from 2012 to 2018. We calculated linear trends in prevalence using bivariate linear regression.ResultsThe overall prevalence rates of HIV, chlamydia, gonorrhea, MG, syphilis, and HBV and HCV antibody positivity in this study were 0.04%, 1.73%, 0.05%, 2.60%, 2.15%, 12.01% and 0.56%, respectively. The predominant infection was HBV, followed by MG, syphilis, and chlamydia. Only 1.13% of the participants (382/338432) reported sexually transmitted disease (STD) signs and symptoms suggesting genital tract infection. However, from 2012-2018, the variation in HIV prevalence was not significant (β = 0.000, PTREND = 0.907). The characteristics of the HIV-infected infertile population have not shifted dramatically, with women accounting for 32.56% of HIV cases in China. Overall, 87.60% of HIV-infected individuals have a relatively low education. In total, 37.98% of HIV-positive patients engage in high-risk behaviors.ConclusionsThis study expands upon existing knowledge of HIV prevalence in the infertile Chinese population. However, much work is needed to achieve popularization of prevention knowledge and change concept. Routine HIV screening is urgently needed for all adults with high-risk behaviors.

Project description:BACKGROUND:To date, most previous studies of frailty among hospitalized elderly Chinese patients have been conducted based on small samples, which cannot represent the elderly patient population. The aim of this study was to identify the prevalence of and risk factors for frailty among elderly patients in China. STUDY DESIGN AND SETTING:This cross-sectional study surveyed 9996 elderly patients from 6 tertiary-level hospitals in China. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. A mixed-effects Poisson regression model was used to analyse the factors associated with frailty among elderly patients. RESULTS:The mean age of all subjects was 72.47?±?5.77?years. The prevalence rate of frailty in this study was 18.02%. After adjustments were made for the confounding effect of the clustering of hospital wards, a mixed-effects Poisson regression model showed that the associated factors of frailty included the following: age (OR: 1.016, 95% CI: 1.012-1.020), BMI?<?18.5 (OR: 1.248, 95% CI: 1.171-1.330), female gender (OR: 1.058, 95% CI: 1.004-1.115), ethnic minority (OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department (OR: 1.104, 95% CI: 1.030-1.184), transit from another hospital (OR: 1.159, 95% CI: 1.049-1.279), former alcohol use (OR: 1.094, 95% CI: 1.022-1.171), fall history in the past 12?months (OR: 1.257, 95% CI: 1.194-1.323), vision dysfunction (OR: 1.144, 95% CI: 1.080-1.211), cognition impairment (OR: 1.182, 95% CI: 1.130-1.237), sleeping dysfunction (OR: 1.215, 95% CI: 1.215-1.318), urinary dysfunction (OR: 1.175, 95% CI: 1.104-1.251), and defecation dysfunction (OR: 1.286, 95% CI: 1.217-1.358). The results also showed some of the following protective effects: BMI?>?28 (OR: 0.897, 95% CI: 0.856-0.940); higher education level, including middle school (OR: 0.915, 95% CI: 0.857, 0.977) and diploma and above (OR: 0.891, 95% CI: 0.821, 0.966); and current alcohol use (OR: 0.869, 95% CI: 0.815, 0.927). CONCLUSION:We identified a relatively high prevalence of frailty among elderly patients, and there are several associated factors among the population derived from this investigation of a large-scale, multicentre, nationally representative Chinese elderly inpatient population. TRIAL REGISTRATION:Chinese Clinical Trial Registry, ChiCTR1800017682, registered 09 August 2018.

Project description:IntroductionAs part of the integration of refugees into Rwanda's national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting.MethodsRapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors.ResultsOf the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25-54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32).ConclusionSero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.

Project description:OBJECTIVES:Prevention of unplanned pregnancy is a crucial aspect of preventing mother-to-child HIV transmission. There are few data investigating how HIV status and use of antiretroviral therapy (ART) may influence pregnancy planning in high HIV burden settings. Our objective was to examine the prevalence and determinants of unplanned pregnancy among HIV-positive and HIV-negative women in Cape Town, South Africa. DESIGN:Cross-sectional analysis. SETTINGS:Single primary-level antenatal care clinic in Cape Town, South Africa. PARTICIPANTS:HIV-positive and HIV-negative pregnant women, booking for antenatal care from March 2013 to August 2015, were included. MAIN OUTCOME MEASURES:Unplanned pregnancy was measured at the first antenatal care visit using the London Measure of Unplanned Pregnancy (LMUP). Analyses examined LMUP scores across four groups of participants defined by their HIV status, awareness of their HIV status prior to the current pregnancy and/or whether they were using antiretroviral therapy (ART) prior to the current pregnancy. RESULTS:Among 2105 pregnant women (1512 HIV positive; 593 HIV negative), median age was 28 years, 43% were married/cohabiting and 20% were nulliparous. Levels of unplanned pregnancy were significantly higher in HIV-positive versus HIV-negative women (50% vs 33%, p<0.001); and highest in women who were known HIV positive but not on ART (53%). After adjusting for age, parity and marital status, unplanned pregnancy was most common among women newly diagnosed and women who were known HIV positive but not on ART (compared with HIV-negative women, adjusted OR (aOR): 1.43; 95% CI 1.05 to 1.94 and aOR: 1.57; 95%?CI 1.13 to 2.15, respectively). Increased parity and younger age (<24 years) were also associated with unplanned pregnancy (aOR: 1.42; 95%?CI 1.25 to 1.60 and aOR: 1.83; 95%?CI 1.23 to 2.74, respectively). CONCLUSIONS:We observed high levels of unplanned pregnancy among HIV-positive women, particularly among those not on ART, suggesting ongoing missed opportunities for improved family planning and counselling services for HIV-positive women.

Project description:ObjectiveHypertension (HTN) is an important public health issue worldwide, associated with the rapid economic development and urbanisation over the last decades. This is especially the case in Shenzhen, which has benefited greatly from the reform and opening-up policies. However, there is limited information on the epidemiology of HTN in this region. This study was designed to investigate the prevalence, awareness, treatment and control of HTN and the associated factors among adult residents in Shenzhen, China.DesignPopulation-based, cross-sectional study.ParticipantsThrough the multistage stratified random sampling method, a representative sample of 10 043 urban population aged ≥18 years were selected. Three consecutive blood pressure (BP) readings were measured after resting for a 5 min seat by trained staff and HTN was defined as mean systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported current use of antihypertensive drugs. Participants were interviewed using a structured questionnaire. Anthropometric details, BP, blood and urine samples were also collected.Primary outcome measurePrevalence of HTN.ResultsOverall, the weighted prevalence of HTN among residents in Shenzhen was 19.2% (95% CI 18.5 to 20.0). Among patients with HTN, 55.0% (95% CI 52.9 to 57.1) were aware of their condition and 44.9% (95% CI 42.8 to 47.1) were taking antihypertensive medications, but only 21.7% (95% CI 20.0 to 23.5) achieved BP control. Among those who knew their HTN, 81.7% (95% CI 79.3 to 83.8) were under treatment and 48.3% (95% CI 45.1 to 51.5) were controlled among those with treated HTN. Male, older age, lower educational level, overweight and obesity, family history of HTN, tobacco smoking, alcohol intake, diabetes mellitus, dyslipidaemia and high uric acid were associated with HTN.ConclusionsHTN is a major public health concern in Shenzhen, which has low awareness, treatment and control rates, and is associated with several risk factors. Effective multifaceted implementation strategies are highly needed to combat the emerging burden of HTN.

Dataset Information

Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study.

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Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study.

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