Abstract
Sub-Saharan Africa remains the region most affected with HIV. The wide use of highly active anti-retroviral therapy has led to improvement in life expectancy among HIV infected individuals. However, hepatitis B virus related complications like liver cirrhosis and liver failure are now becoming common causes of morbidity and mortality in this group. The aim of this study was to determine the seroprevalence and risk factors of HBV/HIV co-infection among HIV infected children enrolled into care at Kilimanjaro Christian Medical Centre (KCMC). This cross sectional analytical study was conducted among 323 HIV infected children at KCMC between February 2013 and May 2013. Investigations included interviews, physical examination and HBsAg analysis. HIV serostatus and CD4 counts/percentages were obtained from patients records. In addition, information on hepatitis vaccine status was recorded. Among 323 HIV-infected children enrolled, 177 (54.8%) were males. The prevalence of hepatitis B virus and HIV co-infection was found to be 1.2% (n=4). Hepatitis B virus co-infection was not significantly associated with any of the sociodemographic or behaviour risk factors which were assessed. CD4 counts were significantly associated with hepatitis B virus status whereby children with CD4 counts less than 350 cells/mm3 were 14 times more likely to have hepatitis B virus co- infection as compared to those who had CD4 counts greater than 350 cells/mm3. All of the hepatitis B virus co-infected children had no records of hepatitis B virus immunization, though one was born during the period of universal infant’s hepatitis B vaccination (<4 years old). The frequency of hepatitis B virus co-infection with HIV infection was low among HIV infected children in our set up. It is important to strengthen the implementation of the universal infant’s hepatitis B virus vaccination. The screening of HIV infected children for hepatitis B virus co-infection is still important whenever possible with immunization of all HIV infected children and adolescents with negative HBsAg.
Highlights
Both hepatitis B virus (HBV) and HIV are known to be major global public health problems
Children Enrolled into Care at Kilimanjaro Christian Medical Centre, Tanzania
The prevalence of HBV infection in the studied group of HIV infected children was low (1.2%). This was in accordance with the prevalence of 1.2% which was reported by Telatela et al in 2007 in Tanzania and a prevalence of 2.0% reported by Abera et al in 2014 in Ethiopia [5, 8]
Summary
Both hepatitis B virus (HBV) and HIV are known to be major global public health problems. Worldwide more than 400 million people are estimated to have chronic HBV infection and about 34 million people have HIV infection [1, 2]. Sub-Saharan Africa constitutes about 69% of HIV infected individuals [2]. Individuals with HBV and HIV co-infection have an increased risk of developing complications such as lamivudine resistance, liver cirrhosis, hepatocellular carcinoma and death [4]. Only two studies were published documenting the seroprevalence of HBV co-infection among HIV infected children in Tanzania [5, 6], and more over there are no existing guidelines on the management of these children. This study was conducted to determine the seroprevalence and risk factors of HBV/HIV co-infection among HIV infected children enrolled into care at Kilimanjaro Christian Medical Centre (KCMC)
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