Changing Epidemiology of HBV and HCV Co-Infection in HIV-Positive Population in China: Results from the Third and Fourth Nationwide Molecular Epidemiologic Surveys.

Background The transmission of HIV and HBV/HCV is similar in modes/routes and related risk factors. Understanding the long-term changing epidemiology of HIV, HBV, and HCV co-infection is important for evaluation of existing disease control policy and healthcare planning. Accordingly, we described the HBV and HCV co-infection based on the latest two nationwide molecular epidemiologic surveys of HIV infection in mainland China in 2007 and 2015. Methods The seroprevalence of HBV and HCV infections were determined in antiretroviral treatment (ART)-naive HIV-1-positive individuals from two nationwide surveys conducted in 2007 and 2015 from 31 provinces, municipalities and autonomous regions in mainland China. Demographic characteristics, route of HIV transmission and CD4 + cells count, were captured in the national database. Logistic regression was used to study the association between co-infections statuses and possible relevant risk factors. Results 6,611 (n=1571, 2007; n=5040, 2015) HIV-1-positive but ART-naive individuals met the eligibility criteria. The prevalence of HBV and HCV co-infection in HIV-infected populations decreased from 61.1% in 2007 to 18.0% in 2015. Significant co-infection proportion reduction was found for HCV (from 53.7% to 4.9%), and a moderate decrease for HBV (17.8% to 13.9%). There is an increase of HBV/HIV co-infections among 12 provinces, municipalities and autonomous regions, with an association to domestic migrations (AOR: 6.34, 95% CI: 1.82, 22.09). Conclusion Significant decrease of HBV and HCV co-infection in HIV-positive populations was observed. Due to the limited health resources and high transmission efficiency, concerted efforts should be made to further control the viral hepatitis epidemics in HIV-infected populations.