Article

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.

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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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