Background
HIV-infected patients are at higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP), the agent causing syphilis, than the general population. The prevalence of HBV, HCV, and syphilis had geographic differences and varied from region to region among HIV-infected patients. The aim of this study was to investigate the epidemiological features and risk factors of HBV, HCV, and syphilis infection in HIV-infected individuals in Shaanxi Province, northwest China.
Methods
A retrospective study was conducted with HIV-infected patients from June 2011 to June 2016 in Shaanxi Province. Sociodemographic data was captured from the national HIV/AIDS information system in China. Serological tests and analysis of CD4+ T-cell count levels were performed using standard procedures. Besides, the HIV infection time and age were presumed by CD4+ T-cell count levels.
Results
The average time from HIV infection to diagnosis was (4.7±2.4) years, and the HIV infection time ≥3 years accounted for 66.8%. Of the discovery routes, voluntary counseling & testing (VCT) only accounted for 20.7%. Among 1018 HIV-infected patients, the prevalence of HBV, HCV, and syphilis was 11.0%, 11.1%, and 26.0%, respectively. HBV-HCV, HCV-syphilis, HBV-syphilis, and HBV-HCV-syphilis co-infection was 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective vaccination against HBV was as high as 30.2% in HIV-infected patients. Ethnicity (OR=29.257, 95%CI: 11.243-76.133) and HIV transmission routes (OR=149.368, 95%CI: 16.590-1 344.861) were the risk factors of HCV infection in HIV-infected patients. In the HIV-infected patients with the antibody of Treponema pallidum, the rate of homosexual transmission was so higher but heterosexual transmission is lower (OR=0.548 95% CI: 0.382-0.786), suggesting that homosexual transmission might be a risk factor for HIV-syphilis co-infection.
Conclusion
The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. In addition, a high prevalence of HBV, HCV, and syphilis co-infection could be observed, and like HIV infection, they might not understand their HBV, HCV and syphilis infection status. At last, the high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.