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HIV/Hepatitis C Virus Co-infection among Adults Beginning Antiretroviral Therapy, Malawi

机译:在马拉维开始抗逆转录病毒疗法治疗的成人中,HIV /丙型肝炎病毒共感染

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To the Editor: Throughout the world, ≈115 million persons have hepatitis C virus (HCV) antibodies, ≈37 million are infected with HIV type 1, and an estimated 2.3 million persons are infected with both viruses (1). The estimated prevalence of HIV infection among adults in Malawi is 9.1% (2). Data concerning HCV seroprevalence in Malawi are conflicting and range from 0.0% to 18.0%, depending on the studied population and the chosen methods for HCV infection diagnosis (3–6). In a recent study, researchers used stored blood samples (without HCV confirmatory assays) from studies in rural and urban Malawian populations (1989–2008); an HCV seroprevalence of 6.8% was found in HIV-positive patients (7). In contrast, in a cohort of HIV-negative mothers (2006–2010), only 0.5% were found to be HCV positive with confirmatory HCV testing by immunoblot (8). These studies were not included in a 2015 metaanalysis that estimated the seroprevalence of HCV infection and HIV/HCV co-infection in Malawi to be 7.7% and 2.0%, respectively (9). Liver disease progresses more rapidly in HIV/HCV co-infected patients than in HCV monoinfected patients (10), and the highly effective second-generation direct-acting antiviral therapies are less toxic than interferon-based treatment regimens. It is crucial to gather accurate epidemiologic information on the burden of HIV/HCV co-infection to support the design and implementation of HCV treatment initiatives in resource-limited settings such as sub-Saharan Africa.
机译:致编辑:全世界约有1.15亿人患有丙型肝炎病毒(HCV)抗体,约有3,700万人感染了1型艾滋病毒,估计有230万人感染了这两种病毒(1)。在马拉维,成年人中HIV感染的估计患病率为9.1%(2)。马拉维的HCV血清阳性率数据相互矛盾,范围从0.0%到18.0%,具体取决于所研究的人群和所选择的HCV感染诊断方法(3–6)。在最近的一项研究中,研究人员使用了在马拉维农村和城市地区(1989-2008年)进行的研究中存储的血液样本(无HCV确证试验)。 HIV阳性患者的HCV血清阳性率为6.8%(7)。相比之下,在一组HIV阴性母亲(2006-2010年)中,通过免疫印迹进行的确诊HCV检测仅发现0.5%的HCV阳性(8)。这些研究未包括在2015年的荟萃分析中,该荟萃分析估计马拉维的HCV感染和HIV / HCV合并感染的血清阳性率分别为7.7%和2.0%(9)。在HIV / HCV合并感染的患者中,肝脏疾病的进展比在HCV单一感染的患者中更快(10),并且高效的第二代直接作用抗病毒疗法的毒性比基于干扰素的治疗方案低。至关重要的是,要收集有关HIV / HCV合并感染负担的准确流行病学信息,以支持在资源有限的地区(如撒哈拉以南非洲)设计和实施HCV治疗计划。

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