Abstract
CONTEXT: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) infections are major global public health problems because of their frequency, complications and probable socio-demographic consequences.Viral hepatitis B is identified as more frequent cause of morbidity and mortality in people living with HIV.The objective of this study was to describe the epidemiological and evolutionary profile of HIV-HBV co-infected patients, treated at CTA/CHNU Fann, in Dakar, Senegal.METHODOLOGY: This is a retrospective, descriptive and analytical study of patients aged at least 18 years, co-infected with HIV-HBV and followed-up at CTA under ART for at least one year from January 2010 to December 2014.RESULTS: The study included 457 patients. 58 of these patients were diagnosed positive, (12.7%) of HIV-HBV prevalence. The average age of patients was 39.62 ± 10.12 years with extremes ranging from 21 to 61 years. The sex ratio was 1.23. (96%) of patients were infected with HIV-1 and those at WHO stages III and IV were (67%). The average CD4 count at baseline was 235 cells/mm3 [3-936]. Plasma HIV viral load average at baseline was 4.1 log copies/ml [3.89-5.12] copies/ml. The average body mass index (BMI) was 21.42 ± 3.82 Kg/m². Fever and degraded general status were respectively (65%) and (60%) followed by hepatomegaly and jaundice. The lethality was 3.45%. Of the 58 patients co-infected with HIV-HBV, 51/58 (87.93%) were under a therapeutic regimen containing Tenofovir/lamivudine or Tenofovir/Emtricitabine and 7 patients under a regimen containing lamivudine. At 48 weeks of treatment a good evolution of the biological parameters was noted: (90%) had a controlled viral load, (91%) a normal transaminase, (79%) a normal serum creatinine. Only 29% had a CD4 cell count <350 cells/mm3.CONCLUSION: The Seroprevalence of viral hepatitis B remains relatively high (12.70%) among PLHIV in Dakar. While active search for hepatitis B has been effective in all PLHIV since 2010, overall management remains a challenge as hepatitis B markers and viral DNA assay are not at the reach of patients.
Highlights
Human immunodeficiency virus and hepatitis B virus (HIV/HBV) co-infection is common due to similar methods of transmission.HBV infection in people living with human immunodeficiency virus (PLHIV) in sub-Saharan Africa is characterized by high prevalence, vertical and horizontal transmission, late diagnosis, and severe prognosis due to late diagnosis (Attia et al, 2012)
The sex ratio was 1.23. (96%) of patients were infected with HIV-1 and those at WHO stages III and IV were (67%)
While active search for hepatitis B has been effective in all PLHIV since 2010, overall management remains a challenge as hepatitis B markers and viral DNA assay are not at the reach of patients
Summary
Human immunodeficiency virus and hepatitis B virus (HIV/HBV) co-infection is common due to similar methods of transmission. HBV infection in people living with human immunodeficiency virus (PLHIV) in sub-Saharan Africa is characterized by high prevalence, vertical and horizontal transmission, late diagnosis, and severe prognosis due to late diagnosis (Attia et al, 2012). The prevalence of co-infection with hepatitis B virus (HBV) is high in the population of PLVIH. This is observed in 5 to 15% of patients infected with the human immunodeficiency virus (HIV) in the world (OMS, 2013). Few epidemiological data are available on this co-infection (Thio et al, 2013). In Africa, the prevalence of co-infection ranges from 20 to 30% (Attia, 2007). Vertical and perinatal transmissions are the most frequent routes, including sexual and blood transmissions
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