ปัจจัยที่มีความสัมพันธุ์ต่อการติดเชื้อร่วมของไวรัสตับอักเสบบี และหรือ ไวรัสตับอักเสบซี ในผู้ป่วยกลุ่มชนชาติพันธุ์ที่ติดเชื้อเอชไอวี พื้นที่ภาคเหนือตอนบน พ.ศ. 2557

Abstract

ABSTRACT

BACKGROUND: HIV infection and AIDS are the major public health problems in the world. In 2015, World Health Organization estimates that 36.7 million people are infected with HIV, and around 2.1 million people are the new cases. Moreover the trend of co-infection among HIV/AIDS and Hepatitis B virus and Hepatitis C virus were rapidly increasing especially in the Hill tribe in the northern region of Thailand. The co-infection was accelerated disease progression reciprocally.

OBJECTIVES: This study was investigated the prevalence and the associated factors with HBV and/or HCV co-infection with HIV in hill tribe in northern region, Thailand, 2015.

METHODS: A case-control study research design was conducted through hospital-based at antiretroviral clinic. Thirty one of fifty one hospitals in the Phayao, Chiang Mai and Chiang Rai province were recruited in this study. The collection data period was provided since February 2015 to October 2016. The validity and reliability questionnaires and 5 cc. blood were collected in all participants. Cases were the HIV infection of hill tribe patients who HBV and/or HCV co-infection with. HBV and HCV infection were confirmed by having one or more positive tests for HBV and HCV serology. Controls were those with all negative tests for HBV and HCV.  The descriptive statistics (frequency, percentage, mean) and non-parametric statistics (chi-square) and parametric (simple and multiple logistic Regression) statistic were used to analyze for answering the research question and the objectives of this study.

RESULT: Three hundred and fifty-three participants were age 47.1% of 30-43 years old, 74.1% of females, 37.8% of Lahu and 26.5% of Karen. The prevalence rate of HBV and HIV co-infection was 17.28% and of HCV and HIV co-infection were 9.92, while the prevalence rate of HBV and/or HCV co-infection with HIV was 26.35%. Moreover, the multiple logistic regression was found gender, addictive substance, CD4 level and period of HIV infection significantly of co-infection (p<0.05). 

DISSCUSIONS AND CONCLUSIONS:

According to the associated factors of co-infection, the recommendation should provide the prevention and control approach which 1) to provide the health education program into the hill tribe patients for stopping the addictive substance use especially injection drug users (IDUs), 2) to add new finding of the associated factors of co-infection in the health education program and should provide into the participants in all ARV clinic and 3) all cases newly diagnosed with HIV should be screened for all hepatitis co-infection. Additionally, a general promotion and awareness campaign for viral hepatitis testing is necessary.