|Title:||Seroprevalence of Viral Hepatitis and Infectious Complications among Human Immunodeficiency Virus-Infected Injection Drug Users at a Referral Hospital||Authors:||LIANG, SHIOU-HAUR
LIN, HSI- HSUN
|Keywords:||Endocarditis;Hepatitis;viral;human;HIV infection;Substance abuse;intravenous;Tuberculosis||Issue Date:||2008||Journal Volume:||v.41||Journal Issue:||n.3||Start page/Pages:||200-208||Source:||JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION||Abstract:||
Background and Purpose: The seroprevalence of viral hepatitis and spectrum of infectious complications among human immunodeficiency virus ( HIV-infected injection drug users (IDUs) remains unclear in Taiwan, although there has been a significant increase in the prevalence of HIV infection among IDUs in the last 2 to 3 years. Methods: The medical records of HIV-infected IDUs who sought medical care at a referral hospital for HIV care from June 1994 to December 2006 were retrospectively reviewed. A standardized case record form was used to collect demographic , clinical, laboratory and microbiologic data. Results: During the 12- year study period, a total of 102 HIV-infected IDUs with a median age of 39.5 years (range, 19 to 73 years) sought HIV care at the referral hospital. The male-to-female case ratio was 6 and males were significantly older than females (39.5 vs 28 years, p<0.001). The overall median CD4+ cell count and plasma HIV RNA load by reverse transcriptase-polymerase chain reaction at enrollment were 374 cells/mu L and 4.45 log(10) copies/ mL, respectively. The CD4+ cell count of HIV- infected IDUs enrolled after year 2003 was significantly higher than those enrolled before 2003 (438 vs 23 cells/mu L , p<0.001). The seroprevalence of hepatitis C virus (86.6 % overall) increased over time, while that of hepatitis B virus decreased in the patients born after 1984, when nationwide hepatitis B vaccination was started in Taiwan. Gram-positive bacteria were causative for 69.7% of the 33 bacteremic episodes, and Staphylococcus aureus was the leading pathogen (16 episodes), with methicillin-sensitive S . aureus accounting for 11 bacteremic episodes (33.3%). The most common bacterial infection was infective endocarditis. Tuberculosis occurred more frequently in men, and extrapulmonary tuberculosis was more common than pulmonary tuberculosis and was associated with a lower CD4+ count. Conclusions: Bacteremia, infective endocarditis and tuberculosis were the three most common patterns of infection among HIV-infected IDUs who sought medical care at a referral hospital; and methicillin-sensitive S. aureus was the most common etiology of bacteremia. The high seroprevalence of hepatitis B and C and subsequent hepatic complications may present a future challenge to the health care system.
|Appears in Collections:||醫學檢驗暨生物技術學系|
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