title: Co-infections of tuberculosis, hepatitis B or C viruses in a cohort of people living with HIV/AIDS in China: predictors and sequelae.
abstract: The co-infection of viral hepatitis and tuberculosis (TB) among people living with HIV/AIDS (PLWHA) makes the syndemic of HIV even worse as there is higher mortality and morbidity among PLWHA with co-infections compared to people with HIV mono-infection. In the current study, we explored predictors and sequelae among a group of Chinese PLWHA to guide future program strategies and enhance the repertoire of action for both preventative and clinical purposes. Between October 2012 and August 2013, we conducted a cross-sectional study in Guangxi Autonomous Region (Guangxi) of China. With an overall participation rate of 90%, we finally recruited 3002 patients with 2987 (99.5%) completed the survey and were included in the data analysis. We employed both predictive and explanatory modeling strategies to explore predictors and sequelae of co-infections among PLWHA. The overall prevalence of co-infection was 15.6% with 4.4% of HBV, 5.4% of HCV and 4.8% of TB, respectively. Predictors of co-infections included history of injecting drugs or drinking alcohol, sharing needles, having sex with sex workers or casual partners, higher viral loads and lower CD4 counts. Meanwhile, co-infections were associated with various physical and psychological problems among PLWHA. As an entangled phenomenon, co-infections among PLWHA produce continuous and shifting scenarios, which add complexity to clinic, epidemiological and political ways of dealing with health risks among PLWHA in China. Exploring predictors and sequelae can help to prevent and manage co-infection comorbidities among PLWHA.
authors.affiliation: a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Chen
authors.identifier: 0000-0002-8771-561X
authors.initials: C
authors.lastname: Zhang
authors.affiliation: b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.affiliation: c Division of HIV/STD Prevention, Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: c Division of HIV/STD Prevention, Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: c Division of HIV/STD Prevention, Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012747:Sexual Partners; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult
keywords: China; HBV; HCV; People living with HIV/AIDS; TB; co-infections