Prevalence of Hepatitis C Virus and Hepatitis B Virus Infections in Patients Infected with HIV Through Blood Donation or Transfusion in China

Editor: It is well known that HIV (human immunodeficiency virus), HBV (hepatitis B virus), and HCV (hepatitis C virus) infections share analogous transmission routes and therefore coinfection is frequent. We investigated all living 1,016 HIV-infected patients who were infected by blood donation or transfusion in the early to middle 1990s from Queshan county of Henan province, which was a typical region for HIV infection by these routes in China. We found that the HCV infection rate was 91.5% (930/1,016), and 762 (75%) patients had detectable HCV RNA before treatment, and the HBV infection rate was 3.1% (31/1,016), and 7 (22.6%) patients had detectable HBV DNA before treatment.

However, our result is clearly different from the recent data presented by Fujie Zhang and colleagues, ¹ who reported that 418 of 33,861 patients comprising a large cohort were infected as a result of blood donation or transfusion, and only 40.2% (168/418) were infected with HCV.

Actually, HIV coinfection with HCV is most common in China; this is because the largest known HIV population was infected through blood donation or transfusion in the early to middle 1990s in Henan province, ² and the related blood donation screening process for HCV was absent before 1993. ³ However, the most common form of transmission for HBV was vertical or during early childhood in China. ¹ Therefore, in the clinic, HIV and HCV are almost always accompanied by each other in middle-aged or relatively older coinfected patients who mode of contraction was via blood donation or transfusion.

Additionally, several studies have previously described the coinfection rate of the hepatitis viruses and HIV, ^4,5 which seems very simple; however, in our opinion, it can become more sophisticated when different combinations of transmission routes and viruses are encountered. Unfortunately, no detailed data are available for a full-scale coinfection profile in all of these interesting combinations.