The Impact of Social Factors on Human Immunodeficiency Virus and Hepatitis C Virus Co-Infection in a Minority Region of Si-Chuan, the People's Republic of China: A Population-Based Survey and Testing Study

Abstract

BackgroundWhile many human immunodeficiency virus (HIV) studies have been performed in Liangshan, most were focused only on HIV infection and based on a sampling survey. In order to fully understand HIV and hepatitis C virus (HCV) prevalence and related risk factors in this region, this study implemented in 2009, included a survey, physical examination, HIV and HCV test in two towns.MethodsAll residents in two towns of the Butuo county were provided a physical examination and blood tests for HIV and HCV, and then followed by an interview for questionnaire.ResultsIn total, 10,104 residents (92.4%) were enrolled and 9,179 blood samples were collected for HIV and HCV testing, 6,072 were from individuals >14 years old. The rates of HIV, HCV, and HIV/HCV co-infection were 11.4%, 14.0%, and 7.7%, respectively for >14-year-old residents. The 25–34 yr age group had the highest prevalence of HIV, HCV, and HIV/HCV co-infections, reaching 24.4%, 26.2% and 16.0%, respectively. Overall, males had a much higher prevalence of all infections than females (HIV: 16.3% vs. 6.8%, HCV: 24.6% vs. 3.9%, HIV/HCV co-infected: 14.7% vs. 1.1%, respectively; P = 0.000). Approximately half of intravenous drug users tested positive for HIV (48.7%) and 68.4% tested positive for HCV. Logistic regression analysis showed that five factors were significantly associated with HIV and HCV infection: gender (odds ratio [OR] = 5.8), education (OR = 2.29); occupation (student as reference; farmer: OR = 5.02, migrant worker: OR = 6.12); drug abuse (OR = 18.0); and multiple sexual partners (OR = 2.92). Knowledge of HIV was not associated with infection.ConclusionHIV and HCV prevalence in the Liangshan region is very serious and drug use, multiple sexual partners, and low education levels were the three main risk factors. The government should focus on improving education and personal health awareness while enhancing drug control programs.

Genotypic distribution and hepatic fibrosis among HIV/HCV co-infected individuals in Southern China: a retrospective cross-sectional study

“…We were also not able to collect information on alcohol use, herbal use, duration of HCV infection, insulin resistance, HIV viral load, and use of hepatotoxic drugs including ART dosing and duration. Despite the bias introduced, we believe our findings demonstrating a strong association between HIV/HCV co-infection with IDU and lower education status is valid given similar findings in previously published epidemiological research, particularly in China [ 55 , 56 ]. Lastly, we did not obtain liver biopsies or transient elastography.…”

Differences in clinical features of HIV/HCV co-infected individuals compared with HCV mono-infected individuals in Southern Thailand

“…Third, some demographic data such as educational status could not be obtained and may have lead to some bias. Regardless of these potential limitations, we believe that our nding of strong associations between HIV/HCV co-infection with IVDU and MSM is valid, given similar ndings in previously published epidemiological research (24,25). In addition, this was a cross-sectional retrospective study which limited our ability to examine disease duration, which may be important as our mono-infection group was signi cantly older than the coinfection group which could indicate a longer disease duration leading to more severe hepatic brosis in mono-infected individuals.…”

Zidovudine- versus Tenofovir-Based Antiretroviral Therapy for the Initial Treatment of HIV Infection in the Ethnic Minority Region of Liangshan Prefecture, Sichuan Province, China

“…[4][5][6][7][8][9][10] In 2010, areas of the Liangshan Prefecture located in Sichuan Province had an 11% prevalence of HIV among adults, making this the highest prevalence region in China. 11 In a pilot project starting in 2011, our center located in Liangshan Prefecture, replaced ZDV with TDF as part of the preferred HAART regimen for treatment-naive HIV-infected patients. This permitted us to conduct a comparison of TDF-versus ZDV-based HAART in antiretroviral naive HIV-infected individuals in a high-prevalence area of China.…”