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: 1.14). 06/2009; 3(5):369-75. DOI: 10.3855/jidc.245
Source: PubMed


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.

Download full-text


Available from: Olufemi O Adewole, Aug 05, 2014
77 Reads
  • Source
    • "These subjects represent a classical low risk group and this could account for the very low prevalence observed when compared to our study despite the urban environment of Jos, Nigeria. In a cohort of 260 HIV positive individuals in Abuja, Central Nigeria 11.5% were co-infected with HBV, 2.3% were co-infected with HCV while 1.5% had triple infection [23]. The cosmopolitan nature of Abuja as well as cultural differences as it concerns marriages may account for this. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Highly active antiretroviral therapy (HAART) has improved survival of human immunodeficiency virus (HIV) patients. Concurrent morbidities from liver diseases among these patients have also been observed due to co-infection with hepatitis B and C viruses (HBV and HCV). HAART reduces liver-associated morbidities and mortalities in such patients. Unfortunately free testing of HBV and HCV are not provided alongside free HIV testing and treatment in Nigeria. We assessed the seroprevalence of HBV and HCV among HIV patients presenting for treatment in our center. This prospective study of adult patients with HIV/AIDS assessed the seroprevalence of HBV and HCV co-infection using a 19-item questionnaire and collection of 2ml venous blood for hepatitis B surface antigens (HBsAg) and anti-HCV antibodies. All previously diagnosed HIV patients of the unit were excluded from the study. Of the 404 patients, 69.2% were females while 30.8% were males. Married participants were 59.6%, 25.3% were single and 15% were previously married. A large proportion (69%) of patients were farmers, artisans and traders. Most had some formal education; secondary (55.3%), primary 27.3%, tertiary 13.8%. HBsAg positive participants were 9 (2.2%) while 3 (0.7%) were positive for HCV. No participant had triple infection of HIV/HBV/HCV. Seroprevalence of HBV and HCV is low among HIV patients in Orlu. However there is a need for HBV and HCV testing of all HIV positive patients to reduce morbidities and mortalities from liver diseases.
    Pan African Medical Journal 09/2013; 16:7. DOI:10.11604/pamj.2013.16.7.3077
  • Source
    • "In the present study, there is no statistically significant CD4 count mean difference between HIV mono-infected, HIV-HBV and HIV- HCV co-infected study participants. However, study participants who had HIV-HBV co-infection in this study have the mean CD4 count (250 cells/mm3) which was incomparable with mean CD4 count of 141.6 cells/mm3 and 121 cells/mm3 in the studies which were conducted in South Africa and Nigeria respectively [35,46]. These controversial results may be due to the differences in the immune status of the individual who have been participated in the study or it may be due to the viral hepatitis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The co-existence of viral hepatitis caused by HBV and HCV become common causes of severe liver complication and immunological impairment among HIV infected individuals. The aim of this study was to assess the seroprevalence of HBV and HCV and their correlation with CD4 and liver enzyme levels among HAART naïve HIV positive individuals. Method A Cross-sectional study was conducted from March-May, 2011 at University of Gondar Teaching Hospital, Northwest Ethiopia. HBV and HCV serological tests and liver enzymes as well as CD4 T cell level determination were assessed following the standard procedures. Socio-demographic data was collected by using structured questionnaire. The data was entered and analyzed by using SPSS version 20.0 statistical software and p < 0.05 was considered as statistically significant. Result Among 400 study participants, the overall prevalence of HIV-viral hepatitis co-infection was 42(11.7%). The prevalence of HIV-HBV, HIV-HCV and HIV-HBV-HCV co-infections were 20(5.6%), 18(5.0%) and 4(1.1%) respectively. Study participants who had HIV-HBV, HIV-HCV and HIV-HBV-HCV co-infection have relatively raised mean liver enzyme levels (ALT, AST and ALP) than HIV mono-infected once. Individuals with HIV-HBV, HIV-HCV and HIV-HBV-HCV co-infection also had a lower mean CD4 levels than HIV mono-infected study participants. The mean CD4 value in males was lower than females. Conclusion The prevalence of HBV and HCV was higher than reports from general population of the country. Raised levels of liver enzymes and lowered mean CD4 counts were seen in HIV-HBV, HIV-HCV and HIV-HBV-HCV co-infections. These findings underscore the importance of screening all HIV positive individuals before initiating antiretroviral treatment.
    Virology Journal 05/2013; 10(1):171. DOI:10.1186/1743-422X-10-171 · 2.18 Impact Factor
  • Source
    • "Based on current estimates in Iran, the range of HBV/ HIV co-infection varies from 9 to 44% (Badie et al., 2010; Sumathi et al., 2010; Adewole et al., 2009; Saravanan et al., 2007; Alter, 2006); however, HBV/HCV/HIV coinfection is estimated to be from 1 to 20% (Badie et al., 2010; Sumathi et al., 2010; Adewole et al., 2009; Alter, 2006). In a survey carried out in Ahvaz, a city south of Iran, the co-infection rates of HBV, HCV, and HBV/HCV in HIV patients was respectively 44%, 74% and 20% (Alavi and Etemadi, 2007). "
Show more