JMIR Publications

ABSTRACT

Background:

According to the WHO report of 2020, 37.6 million people were infected with human immunodeficiency virus (HIV) infection globally[1]. Hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis are the three most common infections among people living with HIV/AIDS (PLWHA) all over the world sharing similar transmission routes including sexual, blood contact, and mother-to-child transmission[2-5]. Worldwide, HBV infection accounts for about 248 million chronic infections, and HCV for an estimated 110 million[5]. The ever-increasing burden of these infections has become a growing concern [6]. The burden of HIV, HBV, and HCV infections remains disproportionately high in sub-Saharan Africa[7-12]. The prevalence of HBV, HCV and syphilis co-infections in PLWHA were 8-12.2% [7-9], 33-80% [10,11] and 40.5% [12], respectively. Hubei province is located in the central part of China, where the AIDS epidemic has distinct regional characteristics. In the 1990s, poor, rural farmers sold plasma to unscrupulous blood collectors under unsanitary conditions, causing HIV transmission in paid plasma donors and contaminant blood recipients[13-15]. Later, as the result of imported cases, epidemic of AIDS gradually began to spread among intravenous drug users, heterosexual population and men who have sex with men (MSM). Although the epidemic of HIV, HBV, HCV and syphilis is well known among prisoners [16], blood donors [17], parturients [18] and even among inpatients [19], the prevalence of HBV, HCV and syphilis co-infections among PLWHA in central China has not been widely investigated. Therefore, this cross-sectional study aimed to estimate the differences of magnitude of HBV, HCV and syphilis co-infections among PLWHA in different high-risk behaviors population.

Objective:

To estimate the differences of magnitude of HBV, HCV and syphilis co-infections among people living with HIV/AIDS(PLWHA) in different high-risk behaviors population.

Methods:

Demographic and clinical information including HBsAg, anti-HCV and syphilis antibody were collected from the "HIS system among PLWHA. Further HBV marker detection, HCV RNA or syphilis titer were detected when necessary. All the PLWHA were grouped by the routes of HIV acquisition first and further by sources of people.

Results:

Among 6623 PLWHA, rates of chronic HCV infection were 80.27% (590/735) in paid plasma donors, 73.29% (247/337) in intravenous drug users, 57.14% (444/777) in contaminated blood recipients, 19.44% (21/108) in mother-to-child transmission population, 8.07% (240/2975) in heterosexual transmission population(HTP) and 1.24% (21/1691) in men who have sex with men(MSM). Chronic HBV infection rates were similar among HIV blood-borne transmission population(BBTP). However, compared to HTP, chronic HBV infection rate was greater (12.60% vs 10.35%, P=0.019) but HBV exposure was less common in MSM (48.91% vs 55.87%, P<0.001). Interesting, a combination pattern of merely HBsAg and HBeAg antigens was found in 11 patients in HIV sex-borne transmission population(SBTP), but none in HIV BBTP(X2=4.203, P=0.040). In HIV SBTP, the proportion of patients had syphilis titer ≥1:16 and neurosyphilis were 8.56% (105/1227) and 7.82% (37/473), respectively, whereas none was found in BBTP.

Conclusions:

In PLWHA, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among MSM was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in PLWHA acquired HIV by sexual contact.