Abstract
BackgroundTanzania is currently scaling-up access to anti-retro viral therapy (ART) to reach as many eligible persons as possible. Hepatitis viral co-infections are known to influence progression, management as well as outcome of HIV infection. However, information is scarce regarding the prevalence and predictors of viral hepatitis co-infection among HIV-infected individuals presenting at the HIV care and treatment clinics in the country.MethodsA cross-sectional study conducted between April and September 2006 enrolled 260 HIV-1 infected, HAART naïve patients aged ≥18 years presenting at the HIV care and treatment clinic (CTC) of the Muhimbili National Hospital (MNH). The evaluation included clinical assessment and determination of CD4+ T-lymphocyte count, serum transaminases and serology for Hepatitis A, B and C markers by ELISA.ResultsThe prevalence of anti HAV IgM, HBsAg, anti-HBc IgM and anti-HCV IgG antibodies were 3.1%, 17.3%, 2.3% and 18.1%, respectively. Dual co-infection with HBV and HCV occurred in 10 individuals (3.9%), while that of HAV and HBV was detected in two subjects (0.8%). None of the patients had all the three hepatitis viruses. Most patients (81.1%) with hepatitis co-infection neither had specific clinical features nor raised serum transaminases. History of blood transfusion and jaundice were independent predictors for HBsAg and anti-HBc IgM positivity, respectively.ConclusionThere is high prevalence of markers for hepatitis B and C infections among HIV infected patients seeking care and treatment at MNH. Clinical features and a raise in serum alanine aminotransferase were of limited predictive values for the viral co-infections. Efforts to scale up HAART should also address co-infections with Hepatitis B and C viruses.
Highlights
Tanzania is currently scaling-up access to anti-retro viral therapy (ART) to reach as many eligible persons as possible
Study design and setting This was a hospital based descriptive cross-sectional study conducted at the Muhimbili National Hospital's (MNH) human immunodeficiency virus (HIV) care and treatment centre (CTC) between April 2006 and September 2006
This study reveals a high burden of hepatitis viral co-infection among HIV infected, ART naïve patients who sought care at a tertiary public health facility in Tanzania, with more than a third of the study participants being coinfected
Summary
Tanzania is currently scaling-up access to anti-retro viral therapy (ART) to reach as many eligible persons as possible. Information is scarce regarding the prevalence and predictors of viral hepatitis co-infection among HIV-infected individuals presenting at the HIV care and treatment clinics in the country. 440,000 AIDS patients by the end of 2008; and to track the disease progression in some 1.2 million HIV-infected persons who were not clinically eligible for ART. By December 2007, the numbers of health facilities providing HIV care and treatment was 210. These provided non-ART care to estimated 118,286 clients and ART to 69,250 eligible patients [2]. Despite these achievements, relatively little is known regarding hepatitis viral co-infections among HIV infected patients enrolling at the CTC's. Findings obtained will provide valuable information for stakeholders within and outside Tanzania involved in scaling up care and treatment services
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