Epidemiological Profile and Risk Factors for Acquiring HBV and/or HCV in HIV-Infected Population Groups in Nepal.

Manjula Bhattarai,Jagat Bahadur Baniya,David A Stein,Pardip Kumar Oli,Nirmal Aryal,Birendra Prasad Gupta,Ram Deo Pandit,Pratik Koirala,Ramanuj Rauniyar,Anurag Adhikari,Bimal Shrestha

doi:10.1155/2018/9241679

Abstract

HBV and HCV infections are widespread among the HIV-infected individuals in Nepal. The goals of this study were to investigate the epidemiological profile and risk factors for acquiring HBV and/or HCV coinfection in disadvantaged HIV-positive population groups in Nepal. We conducted a retrospective study on blood samples from HIV-positive patients from the National Public Health Laboratory at Kathmandu to assay for HBsAg, HBeAg, and anti-HCV antibodies, HIV viral load, and CD4+ T cell count. Among 579 subjects, the prevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.62%, 2.93%, and 0.34%, respectively. Multivariate regression analysis indicated that spouses of HIV-positive migrant labourers were at significant risk for coinfection with HBV infection, and an age of >40 years in HIV-infected individuals was identified as a significant risk factor for HCV coinfection. Overall our study indicates that disadvantaged population groups such as intravenous drug users, migrant workers and their spouses, female sex workers, and men who have sex with HIV-infected men are at a high and persistent risk of acquiring viral hepatitis. We conclude that Nepalese HIV patients should receive HBV and HCV diagnostic screening on a regular basis.

Highlights

As of 2015, 240 million people are living with chronic Hepatitis B virus HCV (HBV) infection [1], 184 million people have chronic HCV infection, and an estimated 36.9 million people are infected with HIV [1,2,3]
Marital status of the individual had a positive correlation with HCV coinfection (P < 0.05); the same did not hold for HBV coinfection
In North India, HBV seropositive cases are reported as high as 6.2% and HCV seropositive cases as low as 1.56% among HIV-infected individuals [16]

Summary

Introduction

As of 2015, 240 million people are living with chronic HBV infection [1], 184 million people have chronic HCV infection, and an estimated 36.9 million people are infected with HIV [1,2,3]. Data on the infectious burden and clinical severity of HCV and/or HBV coinfection among these key populations of HIV-infected individuals is scant and of uneven quality. The dominant transmission mode for HBV, HCV, and HIV infection is different for each virus [5], key population groups such as migrant labourers, female sex workers, and intravenous drug users (IDUs) are common victims of all three viruses [6]. IDUs in Nepal have a high-likelihood of being infected with HCV (41.9%), HBV (3.5%), or HIV (13.8%) [10]. Sex workers are at high risk for HCV, HBV, and/or HIV infection and, according to data from 2003, the number of Nepalese girls

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