Abstract
BackgroundThe prevalence of hepatitis B virus (HBV) amongst South African infants and children has been reported in the pre-HIV era. Despite the reported high prevalence of HIV in the general population of South Africa, the rate of HIV/HBV co-infection amongst infants and children remains poorly reported.ObjectivesWe describe the prevalence of HBV infection amongst HIV-positive and HIV-negative infants by molecular methods of diagnosis using dried blood spot samples.MethodsThis retrospective cross-sectional study was conducted between July 2011 and December 2011 in an academic referral laboratory offering viral diagnostic services to the entire KwaZulu-Natal province of South Africa. A total of 322 study samples were collected from discarded residual dried blood spot samples following routine infant diagnosis of HIV. Equal proportions of HIV-positive and HIV-negative infant specimens were studied. Statistical differences in the prevalence of HBV between the HIV-positive and HIV-negative samples were calculated using the Pearson chi-square test, and a p-value < 0.05 was considered statistically significant. Further testing for HBV DNA using a nested polymerase chain reaction method was performed.ResultsThe overall prevalence of HBV was 10%. In the HIV-positive group, 21 of 161 infants tested positive for HBV compared with 12 of 161 HIV-negative infants who tested positive for HBV. The proportion of infants infected with HBV was marginally higher amongst HIV-positive infants (13.0%; 95% CI 6.8–19.9) compared with HIV-negative infants (7.5%; 95% CI 2.5–13.7; P = 0.098), though not statistically significant.ConclusionThe finding of a 10% HBV prevalence in this infant cohort is clinically significant. The non-statistically significant difference in HBV prevalence between the HIV-positive and HIV-negative infants suggests that high prevalence of HBV infection in children may be a problem independent of HIV.
Highlights
Hepatitis B virus (HBV) infection remains a major health care problem throughout the world
Amongst the HIV-positive infants, 21 tested positive for HBV compared with 12 HIV-negative infants who tested positive for HBV
The proportion of HBV infection amongst HIV-positive infants was found to be marginally higher than amongst HIV-negative infants
Summary
Hepatitis B virus (HBV) infection remains a major health care problem throughout the world. There is a growing body of evidence showing that the prevalence of HBV is significantly higher amongst HIV-positive individuals, mainly because of shared risk factors.[7,8,9,10] Despite the generally reported high prevalence of HIV and HBV, there is still no clear government policy in South Africa http://www.ajlmonline.org. The prevalence of hepatitis B virus (HBV) amongst South African infants and children has been reported in the pre-HIV era. Despite the reported high prevalence of HIV in the general population of South Africa, the rate of HIV/HBV co-infection amongst infants and children remains poorly reported
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