Abstract
Human immunodeficiency virus (HIV)-infected patients are at a 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 has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV–HBV, HIV–HCV, and HIV–syphilis co-infection. HBV–HCV, HCV–syphilis, HBV–syphilis, and HBV–HCV–syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643–82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328–1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382–0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.
Highlights
Human immunodeficiency virus (HIV) shares similar routes of transmission with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis), which include blood transfusion, sexual transmission, and mother-to-child transmission
Because of similar routes of transmission and risk factors, we speculate that HBV, HCV, and syphilis infection among HIV-positive individuals of this study were found late too, as even they were not aware of their infection status at all when they were diagnosed with HIV
We found that the positive rate of Hepatitis B surface antigen (HBsAg) for HIV-infected patients in Shaanxi Province was 11.7%, which was higher than the general population in either China or Shaanxi Province
Summary
Human immunodeficiency virus (HIV) shares similar routes of transmission with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis), which include blood transfusion, sexual transmission, and mother-to-child transmission. It is very common that HIV-positive individuals are co-infected with HBV, HCV, and syphilis. It is estimated that approximately 5–20% of HIV-positive individuals worldwide are infected with HBV [1], and 15–30% are simultaneously infected with HCV [2]. Syphilis has been widely spread among HIV-positive individuals in the last few years, especially in men who have sex with men (MSM) [3,4]. There is no doubt that the high rate of HBV, HCV, and syphilis among HIV-positive individuals has become a global public health problem [5,6]. Increasing morbidity and mortality have been observed in a growing number of co-infected cases, a single infection with any of the pathogens can cause serious health problems [7]
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