Abstract
BackgroundGabon is an endemic area for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and the risk of co-infection is high.MethodBetween November 2015 and April 2016, we conducted retrospective study on HCV infection among people living with HIV/AIDS (PLHA). A total of 491 PLHA were included in this study and tested for the presence of HCV infection. HIV viral loads were obtained using the Generic HIV viral Load® assay and the CD4+ T cells count was performed using BD FACSCount™ CD4 reagents. HCV screening was performed using the MP Diagnostics HCV ELISA 4.0 kit. HCV genotypes were determined by sequence analysis of NS5B and Core regions. The Mann-Whitney test was used to compare the groups. Chi-2 test and Fisher's Exact Test were used to compare prevalence.ResultsHCV seroprevalence was 2.9% (14/491), (95% confidence interval (CI):1.4–4.3%). The percentage of HCV viremic patients, defined by the detection of HCV RNA in plasma, was 57% (8/14), representing 1.6% of the total population. HCV seroprevalence and replicative infection were not statistically differ with gender. The percentage of co-infection increased with age. No correlation with CD4+ T cells count and HIV viral load level was registered in this study. Identified HCV strains were predominantly of genotype 4 (87.5%) including 4k, 4e, 4g, 4p, 4f and 4c subtypes. Only one strain belonged to genotype 2 (subtype 2q). Analysis of the NS5B region did not reveal the presence of resistance-associated substitutions for sofosbuvir.ConclusionA systematic screening of hepatitis C is therefore strongly recommended as well as genotyping of HCV strains in order to adapt treatments for the specific case of people living with HIV/AIDS in Central Africa.
Highlights
People living with human immunodeficiency virus (HIV) often become infected by hepatitis viruses, whether hepatitis C (HCV), and/or hepatitis B (HBV), occasionally associated with hepatitis Delta (HDV)
A systematic screening of hepatitis C is strongly recommended as well as genotyping of hepatitis C virus (HCV) strains in order to adapt treatments for the specific case of people living with HIV/AIDS in Central Africa
HCV antibody detection was performed on 500 blood samples taken from people living with HIV/AIDS (PLHA) who came to the laboratory as part of their virological and immunological follow-up (HIV viral load and CD4+ T cells count)
Summary
People living with human immunodeficiency virus (HIV) often become infected by hepatitis viruses, whether hepatitis C (HCV), and/or hepatitis B (HBV), occasionally associated with hepatitis Delta (HDV). Reactivation of hepatitis virus in patients infected with HIV is considered significant [1,2] These co-infected people are at increased risk for serious, life-threatening complications [3]. The HIV/HCV co-infection is associated with an elevated level of HCV viral load and complications in treatment efficacy involved in the fight against HCV [6] This affects the rate of transmission of HCV, a factor further aggravating the epidemiological situation in this region of the world. These co-infected people usually present severe liver fibrosis, with a risk 2 to 5 times higher of developing faster cirrhosis than mono-infected patients [7]. Gabon is an endemic area for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and the risk of co-infection is high
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