title: Genotypic distribution and hepatic fibrosis among HIV/HCV co-infected individuals in Southern China: a retrospective cross-sectional study.
abstract: BACKGROUND
  End-stage liver disease and hepatocellular carcinoma due to hepatitis C virus (HCV) co-infection are increasingly common causes of death among HIV-infected individuals. However, there are few clinical investigations of HIV/HCV co-infected individuals from low and middle-income nations. Here, we compare the epidemiology of HCV-infected and HIV/HCV co-infected individuals in Southern China and examine hepatic fibrosis scores in co-infected individuals.
  
  
  METHODS
  We conducted a retrospective cross-sectional study of treatment-naïve HIV/HCV co-infected and HCV mono-infected subjects. Bivariate and multivariate models were used to examine the association between demographics and HCV genotype. Among co-infected individuals, we also studied the relationship between fibrosis scores derived from non-invasive studies and HCV genotype.
  
  
  RESULTS
  Data were collected from 175 HCV-infected individuals, including 89 (51 %) HIV/HCV co-infected individuals. HIV/HCV co-infection was correlated with intravenous drug use (AOR 46.25, p < 0.001) and not completing high school (AOR 17.39, p < 0.001) in a multivariate model. HIV/HCV co-infected individuals were more likely to be infected with HCV genotype 6a (p < 0.0001) or 3a (p < 0.023), whereas increased fibrosis (FIB-4 score) was associated with HCV genotype 3a infection (β 2.18, p < 0.001).
  
  
  CONCLUSIONS
  Our results suggest that intravenous drug use is driving HIV/HCV co-infection in Southern China. While additional studies are needed, HCV genotype 6a is more common and genotype 3a appears to be associated with more severe hepatic fibrosis in co-infected individuals.
  
  
  CONCLUSIONS
  Future HIV/HCV co-infection research in China should focus on at risk populations, HCV testing uptake, and genotype-specific treatment.
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. kalizhou26@gmail.com.
authors.forename: Kali
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. gz8hhfy@126.com.
authors.forename: Fengyu
authors.initials: F
authors.lastname: Hu
authors.affiliation: UNC-Project - China, Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA. charles_wang@brown.edu.|Department of Medicine, Division of Gastroenterology Providence, Brown University School of Medicine, Rhode Island, USA. charles_wang@brown.edu.
authors.forename: Charles
authors.initials: C
authors.lastname: Wang
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. gz8hxm@126.com.
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. lanyun.vip@126.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lan
authors.affiliation: University of South Florida, Morsani College of Medicine, USF International, Tampa, FL, USA. jmorano@health.usf.edu.
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Morano
authors.affiliation: UNC-Project - China, Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA. smlemon@med.unc.edu.|Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA. smlemon@med.unc.edu.
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Lemon
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. jdtucker@med.unc.edu.|UNC-Project - China, Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA. jdtucker@med.unc.edu.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou, China. gz8hcwp@126.com.
authors.forename: Weiping
authors.initials: W
authors.lastname: Cai
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D014758:Viral Core Proteins / Q000737:chemistry / Q000145:classification / Q000235:genetics
chemical_list: D012367:RNA, Viral; D014758:Viral Core Proteins