Factors influencing hepatitis B virus infection risk among human immunodeficiency virus positive individuals in central urban areas of Ningbo city,a COX proportional risk model
Factors influencing hepatitis B virus infection risk among human immunodeficiency virus positive individuals in central urban areas of Ningbo city,a COX proportional risk model
李萍萍 1方瑶 1戴一添 1李宗宝 2叶莉霞3
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作者信息
1. 宁波市江北区疾病预防控制中心,浙江宁波 315020
2. 宁波市第二医院,浙江宁波 315000
3. 宁波市疾病预防控制中心,浙江宁波 315000
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摘要
目的 分析人类免疫缺陷病毒(Human immunodeficiency virus,HIV)阳性人群乙型肝炎病毒(Hepatitis B virus,HBV)感染发生风险及其影响因素.方法 通过国家艾滋病综合防治信息平台选择宁波市某医院2006-2022年确诊和管理的≥15岁且HBV血清标志物检测排除HBV感染的HIV阳性患者,随访至2023年6月31日,计算HBV感染发生率并采用多因素COX比例风险模型分析发生HBV感染的影响因素,计算风险比(Hazard ratio,HR)及其95％CI.结果 共纳入362例研究对象,平均确诊年龄为33.09±12.27岁,平均观察时间为5.02±3.71人年;观察期内发生HBV感染78例(21.55％),发生率为4.29(95％CI:3.40-5.32)/100人年.多因素COX比例风险模型分析显示,年龄30-49岁和≥50岁、CD4+与CD8+T细胞比值＜0.3、有梅毒感染史者HBV感染发生风险高[HR(95％CI):3.83(2.07-7.07)、5.46(2.71-11.02)、2.97(1.73-5.10)、2.27(1.39-3.70)],有乙型肝炎疫苗(Hepatitis B vaccine,HepB)接种史者 HBV 感染发生风险低[HR(95％CI):0.37(0.19-0.72)].结论 HIV阳性人群特别是确诊年龄大、CD4+与CD8+T细胞比值低、有梅毒感染史和无HepB接种史者HBV感染发生风险较高.建议加强HIV阳性人群HepB接种或抗HBV治疗.
Abstract
Objective To analyze the risk of hepatitis B virus(HBV)infection and factors influencing risk among human immunodeficiency virus(HIV)positive individuals.Methods We obtained data on HIV-positive individuals over 15 years of age from the National HIV/AIDS Prevention and Control Information Platform.All subjects were diagnosed and managed during 2006-2022 in a hospital of Ningbo city;all had initially tested negative for HBV infection based on screening for serum HBV markers.We followed subjects until 31 June 2023 to determine the incidence of HBV infection.We used a multivariate COX proportional risk model to identify factors influencing HBV infection and calculated hazard ratios(HR)and 95％confidence intervals(CI).Results A total of 362 subjects were included;the average age was 33.09±12.27 years and the average length of follow-up was 5.02±3.71 person-years;78 subjects(21.55％)became infected with HBV,yielding an incidence of 4.29(95％CI:3.40-5.32)per 100 person-years.Multivariate COX proportional risk model analysis showed that the incidence of HBV infection was highest among subjects who were 30-49 or ≥50 years old,whose baseline ratios of CD4+to CD8+T cell were less than 0.3,and who had a history of syphilis[HR(95％CI):3.83(2.07-7.07),5.46(2.71-11.02),2.97(1.73-5.10),and 2.27(1.39-3.70)];the incidence was lowest among subjects who had received hepatitis B vaccine(HepB)[HR(95％CI):0.37(0.19-0.72)].Conclusions HIV-positive individuals,particularly at older age,with a low ratio of CD4+to CD8+T cell,a history of syphilis,or who had not received HepB vaccination had a high risk of HBV infection.We recommend HepB vaccination or anti-HBV therapy for HIV-positive individuals.
关键词
人类免疫缺陷病毒/乙型肝炎病毒/感染/风险/影响因素
Key words
Human immunodeficiency virus/Hepatitis B virus/Infection/Risk/Influencing factor
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