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.

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Available from: Olufemi O Adewole, Aug 05, 2014
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    • "HIV co-infection results lower ALT levels in HBV infected individuals with positive HBeAg than in HIV-negative similar patients [20] . In addition, different studies also reported that serum ALT has limited predictive value to identify viral coinfection [21] [22] [23] [24] . "
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    ABSTRACT: Objective To assess hepatitis B and hepatitis C virus infections and associated risk factors among HIV infected patients at Debretabor hospital. Methods A cross-sectional study was conducted among HIV/AIDS patients attending Debretabor hospital from February to April, 2012. Venous blood samples were collected from study participants for HBsAg and anti HCV antibody tests. Bivariate and multivariate analyses were used to identify associated variables with HBsAg and anti HCV positivity. Variables having P<0.05 was taken as statistically significant association. Results From a total of 395 HIV infected patients included in this study, 234 (59.2%) were females and 161 (40.8%) males with mean (±SD) age of 36.31 (±9.91) years. The prevalence of HBsAg and anti HCV antibody was 6.1% and 1.3%, respectively. In multivariate analysis, multiple sexual partner (AOR=8.1, 95% CI=1.8–33.97) and history of opportunistic infections (AOR=3.17, 95% CI=1.3–7.7) were statistically associated with HBsAg positivity. History of blood transfusion (AOR=5.61, 95% CI= 1.03-36.59) was associated with presence of anti–HCV antibody. Conclusions The prevalence of HBsAg and anti HCV antibodies in HIV coinfected patients was intermediate. However, it is relevant for HIV infected patients since viral hepatitis co-infections in HIV patients can cause multiple complications. Therefore, routine HBV and HCV screening with reliable diagnostic markers need to be carried out for close monitoring and better management in HIV patients.
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    • "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. "
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    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.
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    • "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. "
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