Hepatitis B and C virus co-infection in Nigerian patients with HIV infection.

Medicine Department, NHA, Abuja, Nigeria.
The Journal of Infection in Developing Countries (Impact Factor: 1.27). 06/2009; 3(5):369-75. DOI: 10.3855/jidc.245
Source: PubMed

ABSTRACT We set out to determine the seroprevalence of hepatitis B and hepatitis C viruses among human immunodeficiency virus infected individuals and its impact on pattern of presentation.
A serological study for hepatitis B and hepatitis C viruses was performed on 260 HIV-positive individuals. These patients were tested for the presence of hepatitis B surface antigen and anti-hepatitis C virus (HCV) antibody.
Thirty (11.5%) patients tested positive for hepatitis B surface antigen, six (2.3%) tested positive for anti-hepatitis C virus antibody, four (1.5%) were positive for both hepatitis B surface antigen and anti-hepatitis C virus and the overall prevalence was 15.4% . Individuals younger than 40 years of age were more affected, and the odds ratio of a female being co-infected was 1.2, 25% versus 75% p value = 0.03. The prevalence of HIV and hepatitis co-infection rises with age except for hepatitis C. There was no significant difference in the mean levels of liver enzymes (AST, ALT) among the various groups. The groups differ significantly in their mean CD4 count: it was lowest for those co-infected with hepatitis B and hepatitis C; 106 cells/mm(3), 171 cells/mm(3) for those with HIV alone; and the highest value of 260 cells/mm(3) was obtained in those who tested positive for anti-HCV. Scarification marks and multiple blood transfusions were more common among those infected. There was no case of intravenous drug abuse identified.
This low frequency of HIV/HCV co-infection is probably due to the uncommon intravenous drug abuse in this population. Co-infection with hepatitis B virus is common among our HIV-infected patients and should be a major consideration in the initiation and choice of therapy.


Available from: Olufemi O Adewole, Aug 05, 2014
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    ABSTRACT: Human immunodeficiency virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the three most common chronic viral infections all over the world. Co-infections of HIV-HBV and/or HIV-HCV are common and becoming a large public health problem in the globe. The impact of viral interaction on the natural history and treatment has become increasingly important in the clinical management of HBV-HIV and HCV-HIV co-infected individuals especially in regions where these diseases are endemic. Though HAART improves the lives of many HIV positive individuals, liver diseases become a major cause of morbidity and mortality in HIV-viral hepatitis co-infected individuals. The clinicians need accurate information regarding the risk of hepatotoxicity, anaemia and psychiatric problems associated with antiretroviral drugs especially when there is viral hepatitis co-infection. There should be also guidelines that support health care providers how to manage HIV-HBV and HIV-HCV co-infected individuals. It is also important to give special attention for drug induced hepatotoxicity in HIV-HBV/HCV co-infected individuals before initiation of antiviral treatment. In addition, prevention strategies like screening of all HIV-positive patients for HBV and HCV before initiation of ART, vaccination against HBV, safe sexual practice and harm-reduction for intravenous drug users, safe blood and blood products are important for HIV positive patients to be beneficial from HAART programs. Regular monitoring of HIV patients who have chronic HBV and HCV is also mandatory in order to avoid complications of liver diseases. Farther more, creating awareness in the community is also important to solve the problem.
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    ABSTRACT: Background: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are global health concerns. Due to shared routes of transmission, co‑infection is common. Their co‑existence can cause severe liver complications and immunological impairment in infected individuals. Aim: To find the prevalence of HBV co‑infection in HIV patients and to assess the pattern of liver enzymes and CD4 T‑cell counts in HIV monoinfected and HIV/HBV co‑infected patients. Materials and Methods: A total of 342 consecutive confirmed HIV positive treatment naïve patients were tested for hepatitis B surface antigen (HBsAg). Clinical staging was done according to Centers for Disease Control and Prevention classification guidelines. Liver function tests were performed by an autoanalyser. CD4 T‑cells were estimated by FACS Calibur. Results: Hepatitis B virus co‑infection was detected in 8.7% of HIV positive patients as compared to 1.42% in the HIV negative control group (P < 0.05). Majority of the HIV monoinfected and co‑infected patients were below 38 years. HBsAg positivity was higher in males (9.4%) and the route of transmission was heterosexual. Categorical data revealed significantly higher proportion of alanine aminotransferase and aspartate aminotransferase (AST) in the co‑infected patients compared to the monoinfected patients (P < 0.05). The HIV/HBV co‑infected patients had significantly lower CD4 T‑cell counts (P = 0.03) and significantly higher AST, alkaline phosphatase and serum bilirubin values (P = 0.023, P = 0.029, P = 0.009 respectively) than the monoinfected group. Males had 1.33 times higher risk than females for co‑infection (odds ratio = 1.33; 95% confidence interval 0.57–3.10). Conclusion: The prevalence of co‑infection was high. Raised levels of liver enzymes and lowered CD4 counts were seen in co‑infected patients. These findings underscore the importance of HBV screening of all HIV positive individuals before initiating antiretroviral treatment.
    01/2015; 5(1):36-40. DOI:10.4103/2229-516X.149235
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    ABSTRACT: Abstract Infections from HIV, Hepatitis B and Hepatitis C viruses constitute a major public health challenge in sub- Saharan Africa, and concurrent morbidities from liver diseases among HIV patients have also been observed due to co-infection with hepatitis B (HBV) and C (HCV) viruses. Free testing of HBV and HCV are not provided alongside free HIV treatment in Nigeria. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected individuals, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Ikole Ekiti, Nigeria. This was a cross- sectional study among HIV individuals attending Specialist Hospital, Ikole Ekiti, Nigeria. One hundred and fifty eight (158) HIV infected individuals were first screened and later tested for marker of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) and their demography information were collected. Data were analysed using packages within SPSS software and a p <0.05 was regarded as significant. Prevalence rates of Hepatitis B and C virus infections obtained were 5.7% and 1.9%, respectively. Two (1.3%) had triple infection of HIV/HBV/HCV. The CD4 count of the sample tested ranged from 2 to 2140cell/mm3 with a mean value of 210cell/mm3 . About 62.5% of them had CD4 T cell count less than 200 cells/mm3. The mean ALT and AST are 23.8 IU/L and 25.9 IU/L respectively. In conclusion, Co-infection with hepatitis B and C virus is common among HIV-infected individuals and this confirm the necessity for routine screening for this markers before initiation of highly active antiretroviral therapy. Also, HBV negative individuals should be immunized with HBV vaccine to improve the prognosis of their HIV status. Keywords: Coinfection, Hepatitis B, Hepatitis C , HIV, ELISA