HIV-HBV Coinfection Research Articles

Possible viral immunochemical status of children with elevated blood fibrinogen in some herbal homes and hospitals in Nigeria

Study Background: Viral infection in children can elicit acute-phase response which can cause significant alterations in the level of acute-phase proteins such as fibrinogen.Aim and Objective: This work was designed to determine the possible viral immunochemical status of children aged 3–7 years with elevated blood fibrinogen of >6.0 g/L who received treatments as patients in herbal homes and hospitals in Nigeria.Materials and Methods: Children with elevated blood fibrinogen >6.0 g/L were recruited from 10 herbal homes (n = 27; 3–7 years) and three hospitals (n = 27; 3–7 years) and children with normal blood fibrinogen (3.1 ± 1.0 g/L; n = 30; 3–7 years) were also studied. Anti-hepatitis C virus (HCV), hepatitis B surface antigen, and human immunodeficiency virus type 1 (HIV1) p24 antigen were determined in each of the children immunochemically by ELISA, while blood fibrinogen was assayed using the Clauss method. Acid-fast bacilli were determined in the sputum by the Ziehl–Neelsen stain, and Plasmodium spp. identification was carried out using Giemsa staining -thick blood film technique.Results: The viral immunochemical status obtained in children with elevated blood fibrinogen who received treatments in herbal homes showed 3.7% (1) HIV mono-infection; 7.4% (2) HCV mono-infection; 18.5% (5) hepatitis B virus (HBV) mono-infection; 3.7% (1) HIV-HBV coinfection; and 7.4% (2) HCV-HBV coinfection with no coinfection of HIV-HCV and HIV-HCV-HBV, while those who received treatments in the hospitals showed only 11.1% (3) HBV mono-infection. The viral immunochemical status obtained in children with normal blood fibrinogen showed 3.3% (1) HBV mono-infection and 3.3% (1) HCV mono-infection with no HIV mono-infection and HIV-HBV, HIV-HCV, HCV-HBV, and HIV-HCV-HBV coinfections.Conclusion: Viral seromarkers of HCV, HBV, HIV, HIV-HBV, and HCV-HBV were more in children with elevated blood fibrinogen who received treatments in herbal homes than those who received treatments in the hospital and those with normal blood fibrinogen, which suggests blood fibrinogen as a possible diagnostic indicator in viral infection in herbal homes.

Hepatocellular carcinoma: Clinical-pathological features and HIV infection in Mozambican patients,

Background and aims: Mozambique had been ranked among the countries with the highest global incidence of HCC with chronic hepatitis B infection and high exposure to aflatoxin-B1 (AFB1) being major risk factors. Indeed, HCC remains one of the most frequent cancer in Maputo. On the other hand, Mozambique has a high prevalence of infection with Human Immunodeficiency virus (HIV). Our study aims to describe the epidemiology, clinicopathological and serological features of patients with HCC in Maputo Central Hospital and its relationship with HIV. Methods: A series of 206 patients, diagnosed with HCC via fine needle aspiration, were consecutively included in the study. Patient data was collected using a questionnaire and all patients were tested for HBV, HCV, HIV. Results: Median age was 49 years old and the M: F sex ratio was 2.4. A total of 114 (56.2%) of the patients were HBsAg positive. Hepatitis C antibodies were present in 8.9% of cases, and co-infection with HBV and HCV (HBsAg/anti-HCV) was observed in 4 (2.0%) cases. The remainder, 36.3%, were neither hepatitis B- nor C-related. HIV was detected in 34 cases (18.0%) cases. HIV-HBV or HIV-HCV co-infections were observed in 22 (68.8%) and 2 (6.2%) cases. Overall, positivity for HIV was associated with younger age, and especially in patients with HBsAg+/anti-HCV+. Conclusions: Our data emphasize the need for a reinforcement of secondary prevention measures in Mozambique. Serological screening for HBV in people born before universal anti-hepatitis B immunization (2001), effective screening, and specific management in HIV(+) patients are urgently needed.

English

Hepatitis B infection (HBV) infection is a serious public health problem worldwide and its co-infection with human immune deficiency virus (HIV) is common due to shared routes of transmission. An increased mortality due to accelerated hepatic disease progression and the frequent hepatotoxicity caused by antiretroviral therapy are the challenges in the clinical management of HIV. Epidemiological studies on HBV and HBV/HIV co infection are scarce in Ethiopia, particularly at the study area. The aim of this study was to determine the magnitude of HBV, its risk factors and co-infection with HIV among clients of a voluntary counseling and testing (VCT) center in Southern Ethiopia. A facility based cross-sectional study was conducted from 1st February 2016 to 15th March among clients of Nigist Eleni Memorial Hospital VCT Center. Data were collected by face-to-face interview and specific formula sheet as well recorded results of laboratory diagnosis of blood sample from each participant. Both descriptive and inferential statistics were used for data analysis. Multivariable logistic regression modeling was done to identify predictors of HBV. Overall, 331 participants were included in the study. The prevalence of HBV was 8.8%, HBV/HIV co-infection was found in 3.6%. Individuals with a history of multiple sexual partner [AOR = 10.3; 95% CI, 3.71 - 28.83], previous history of invasive procedure [adjusted odds ratio (AOR) = 10.88; 95% CI, 3.84 - 30.86] and history of surgical procedure [AOR = 9.2; 95% CI, 3.1 - 27.88] were identified as in dependent predictors of HBV infection. High HBV infection and HBV/HIV co-infection was found in the study. Previous history of surgical procedure, invasive procedure and multiple sexual partners were identified as independent predictor of HBV infection. Key words: Hepatitis B virus (HBV), human immune deficiency virus, HBV-HIV co-infection, risk factors, Hosanna.

Impact of HBV and HCV coinfection on CD4 cells among HIV-infected patients: a longitudinal retrospective study

The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. We aimed to examine the impact of HBV and HCV coinfection on CD4 cell count and CD4/CD8 ratio in adults with HIV. We conducted a longitudinal retrospective study in Brazil between January 1, 2002, and June 30, 2016, including 205 patients with HIV monoinfection, 37 with HIV-HBV coinfection, 35 with HIV-HCV coinfection, and 62 with HIV-HCV (48 HCV genotype 1 and 14 HCV genotype 3). Median duration of follow-up was 2,327 (interquartile range: 1,159-3,319) days. An increased CD4 cell count and CD4/CD8 ratio over time was observed in all groups receiving combined antiretroviral therapy (cART). Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was also no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during follow-up on cART. However, CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. HIV patients with HCV genotype 3 coinfection showed significantly lower CD4/CD8 ratio during follow-up on cART than those coinfected with HCV genotype 1 coinfection. No statistically significant effect of coinfection was observed on the efficacy of cART. HIV-infected patients are more likely to show better immunological responses to cART when they are not coinfected with HCV.

High frequency of drug resistance mutations in the HBV genome in ART-experienced HIV-coinfected patients in southwestern Nigeria.

HBV and HIV infections are highly endemic in sub-Saharan Africa and Nigeria while HBV-HIV coinfection is not uncommon. Antiretroviral (ART)-treatment for HIV can affect HBV whereby antiviral resistance mutations in the HBV genome can be selected. Here, we determined the prevalence of resistance mutations among ART-experienced and ART-naive HIV-HBV-coinfected patients in southwestern Nigeria. A total of 81 serum samples from HBV-HIV-coinfected patients who were either ART-naive or received lamivudine (3TC)-containing ART-therapy and HBV-monoinfected patients were analysed. Hepatitis B surface antigen (HBsAg) was detected using ELISA. HBV-positive samples were confirmed by PCR amplification of the surface and polymerase regions. Mutations conferring drug resistance to HBV were analysed by direct sequencing. Phylogenetic analysis was performed to identify the HBV genotype. Of the 81 HBsAg-positive samples, 27 had detectable HBV DNA by real-time PCR with mean viral loads of 6.77 log IU/ml. Phylogenetic analyses showed a predominance of HBV genotype E. A high prevalence (22.2%; 6/27) of HBV resistance mutations among ART-experienced HBV-HIV-coinfected patients was detected. However, a relatively high selection rate of resistance mutations in drug-naive HIV-HBV-coinfected (3.7%; 1/27) and in HBV-monoinfected patients, potential drug resistance mutations (7.4%; 2/27) were also observed. HBV polymerase amino acid substitutions found included rtV173L, rtL180M, rtM204V, rtK212R, rtS213T, rtV214A, rtL229V and rtP237A/S. Drug resistant mutations were detected frequently in ART-experienced HIV-HBV patients. Well-coordinated antiviral therapy for HIV patients coinfected with HBV should include proper HBV diagnosis and resistance testing to minimize the emergence and spread of antiviral drug resistance.

Seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected patients in an HBV endemic area in Brazil.

BackgroundHepatitis B virus (HBV) and hepatitis C virus (HCV) are a common cause of complications in liver disease and immunological impairment among human immunodeficiency virus (HIV)-infected patients. The aim of this study was to assess the seroprevalence of HBV and HCV and their correlation with CD4+ T-cells among HIV-infected patients in an HBV endemic area.MethodsA cross-sectional observational and retrospective study was carried out in a reference center in Southern Brazil between January 2005 and December 2016. Socio-demographic data were collected by using a structured questionnaire. Serological tests and analysis of CD4+ T-cell count levels were performed using standard procedures.ResultsThe seroprevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.10%, 3.10%, and 0.16%, respectively. At baseline, anti-hepatitis B surface and anti-hepatitis B core antigens were detected in 46.27% and 16.74% of HIV-monoinfected patients and in 31.25% and 21.86% of the HIV-HCV coinfected patients, respectively. The median CD4+ T-cell count at baseline in the HIV-monoinfected group was higher than that in the HIV-coinfected groups, but without statistical significance. The median CD4+ T-cell count and the CD4/CD8 ratio were significantly higher in HIV-HBV and HIV-HCV groups after 24 months of combination antiretroviral therapy (cART) compared to the pre-cART values. When comparing patients with HIV-HBV and HIV-HCV on cART, CD4+ T-cell recovery was more rapid for HIV-HBV patients.ConclusionAlthough the analyzed region was endemic for HBV, the prevalence of HIV-HBV and HIV-HCV coinfection was lower than the rate found in the general population of Brazil. HBV and HCV had no significant impact on CD4+ T-cell counts among HIV-infected patients at baseline.

Prevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus among blood donors of Mekelle blood bank, Northern Ethiopia: A three-year retrospective study.

Blood transfusion services are a vital and integral part of modern healthcare services. However, the risk of transfusion transmittable infections (TTI) has been a major handicap. Therefore, this study was aimed at determining the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors. A retrospective study was conducted to collect data about the blood donors who consecutively donated blood from October 2011 to 2014. A three-year retrospective study was conducted in Mekelle Blood Bank. A data abstraction format was used to collect the sociodemographic and clinical data, and the prevalence of HBV, HCV, and HIV was determined. Data were analyzed using STATA version 10 analytical software. P value less than 0.05 was considered significant in all the analyses. A total of 10 728 blood donors, median (interquartile range) of age 30 (23-45) years and 3750 (34.9%) males were enrolled in this study. Of the participants 407(3.79%), 143(1.33%), and 111(1.03%) blood donors were positive for HBV, HCV, and HIV, respectively. HBV-HIV coinfections were found 10 (1.93%) blood donors, followed by HBV-HCV and HIV-HCV. A significant association between sex and marital status with HBV and HIV infection was found. However, significant association of HCV was observed among sex ( X 2 = 33.18, P < 0.001) and occupational ( X 2 = 84.33, P < 0.001). A significant percentage of HBV, HCV, and HIV among blood donors was observed. To select a donor and collect safe blood risk factors exposing blood donor should be studied, and community-based prevalence studies onTTI are also required.

Hepatitis B virus and HIV coinfection among adults residing in Cameroon: A systematic review and meta-analysis of prevalence studies.

This systematic review and meta-analysis was conducted to determine the prevalence of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection among adults in Cameroon. We searched PubMed, EMBASE, Web of Science, Global Index Medicus, and Africa Journal Online with no language restriction to identify articles published from Jan 1996 until Dec 2017. We considered observational studies conducted in apparently healthy populations (pregnant women, blood donors, and general population). We used a random-effects model to pool data. We included 24 studies (23,295 participants) from seven of the ten regions in Cameroon. Four, 20, and no studies had low, moderate, and high risk of bias respectively. The overall HBV-HIV coinfection prevalence was 0.8% (95%CI 0.5-1.0; 11 studies). The overall HBV prevalence in people with HIV was 12.9% (95%CI 9.7-16.5; 20 studies). The HBV prevalence in people with HIV was significantly higher in rural compared to urban. No study reported the prevalence of HIV infection in people with HBV. Although we found a low prevalence of HIV-HBV coinfection in Cameroon, this study presented a high HBV prevalence in people with HIV. Effective strategies to interrupt the transmission of HBV are required, especially among people with HIV infection in rural areas.

HIV-hepatitis B virus coinfection: epidemiology, pathogenesis, and treatment.

: HIV infection has a significant impact on the natural history of chronic hepatitis B virus (HBV) infection, with increased levels of HBV DNA, accelerated progression of liver disease and increased liver-associated mortality compared with HBV monoinfection. Widespread uptake and early initiation of HBV-active antiretroviral therapy has substantially improved the natural history of HIV-HBV coinfection but the prevalence of liver disease remains elevated in this population. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease and seroconversion in HIV-HBV coinfection in the era of HBV-active antiretroviral therapy and the effects of HIV directly on liver disease. We also review novel therapeutics for the management of HBV with a particular emphasis on clinical strategies being developed for an HBV cure and an HIV cure and their impact on HIV-HBV coinfected individuals.

Hepatitis B virus and HIV co-infection among pregnant women in Rwanda

BackgroundHepatitis B virus (HBV) affects people worldwide but the local burden especially in pregnant women and their new born babies is unknown. In Rwanda HIV-infected individuals who are also infected with HBV are supposed to be initiated on ART immediately. HBV is easily transmitted from mother to child during delivery. We sought to estimate the prevalence of chronic HBV infection among pregnant women attending ante-natal clinic (ANC) in Rwanda and to determine factors associated with HBV and HIV co-infection.MethodsThis study used a cross-sectional survey, targeting pregnant women in sentinel sites. Pregnant women were tested for hepatitis B surface antigen (HBsAg) and HIV infection. A series of tests were done to ensure high sensitivity. Multivariable logistic regression was used to identify independent predictors of HBV-HIV co-infection among those collected during ANC sentinel surveillance, these included: age, marital status, education level, occupation, residence, pregnancy and syphilis infection.ResultsThe prevalence of HBsAg among 13,121 pregnant women was 3.7% (95% CI: 3.4–4.0%) and was similar among different socio-demographic characteristics that were assessed. The proportion of HIV-infection among HBsAg-positive pregnant women was 4.1% [95% CI: 2.5–6.3%]. The prevalence of HBV-HIV co-infection was higher among women aged 15-24 years compared to those women aged 25–49 years [aOR = 6.9 (95% CI: 1.8–27.0)]. Women residing in urban areas seemed having HBV-HIV co-infection compared with women residing in rural areas [aOR = 4.3 (95% CI: 1.2–16.4)]. Women with more than two pregnancies were potentially having the co-infection compared to those with two or less (aOR = 6.9 (95% CI: 1.7–27.8). Women with RPR-positive test were seemed associated with HBV-HIV co-infection (aOR = 24.9 (95% CI: 5.0–122.9).ConclusionChronic HBV infection is a public health problem among pregnant women in Rwanda. Understanding that HBV-HIV co-infection may be more prominent in younger women from urban residences will help inform and strengthen HBV prevention and treatment programmes among HIV-infected pregnant women, which is crucial to this population.

Abstract 17 Improving Counseling and Interventions to Reduce HCV Transmission and Liver Disease Progression in Patients With Non-cirrhotic Chronic HCV Infection

Current AASLD guidelines recommend measures directed at reducing HCV transmission and liver disease progression in patients with active HCV infection. These measures are routinely addressed in patients with cirrhosis; however, they can be overlooked in patients with non-cirrhotic chronic HCV infection. Our aim was to design an intervention to improve counseling and interventions in patients with non-cirrhotic chronic HCV infection. An electronic medical record (EMR) template was designed to be used with all encounters for chronic HCV infection in a fellow’s continuity clinic during the second year of fellowship. Patients with cirrhosis were excluded from the analysis. The template included a progress note with reminders to assess HAV and HBV immunity, HIV and HBV coinfection, liver fibrosis, and alcohol use at each visit. The template also included patient instructions addressing resources for alcohol cessation counseling, when applicable, and education on HCV transmission prevention. The frequencies at which these measures were assessed in year 2 were compared with year 1 when the template was not used. Statistical significance was assessed using a two-tailed Fisher’s exact test. There were a total of 45 patient encounters for non-cirrhotic chronic HCV during the study period, 25 during year 1 and 20 during year 2. The assessment of HAV and HBV immunity (44% vs 90%, P = .0017), HIV coinfection (28% vs 95%, P = .0001), and HCV transmission prevention (8% vs 95%, P = .0001) each improved significantly between year 1 and year 2. The assessment of HBV coinfection (72% vs 95%, P = .0592), liver fibrosis (80% vs 100%, P = .0562), and alcohol use (72% vs 95%, P = .0592) each showed a trend toward improvement, but were not statistically significant between year 1 and year 2. Counseling and interventions to reduce HCV transmission and liver disease progression are an important aspect of the care of patients with non-cirrhotic chronic HCV infection. A simple EMR template can improve patient care and adherence to current guidelines.

Hepatitis B testing and treatment in HIV patients in The Gambia-Compliance with international guidelines and clinical outcomes.

BackgroundCompliance with WHO guidelines on HBV screening and treatment in HIV-coinfected patients is often challenging in resource limited countries and has been poorly assessed in sub-Saharan Africa.MethodsBetween 2015 and 2016, we assessed physician’s compliance with WHO guidelines on HIV-HBV coinfection in the largest HIV clinic in The Gambia, and the hepatic outcomes in HIV-HBV coinfected patients as compared to randomly selected HIV-monoinfected controls.Results870 HIV-infected patients regularly seen in this clinic agreed to participate in our study. Only 187 (21.5%, 95% CI 18.8–24.3) had previously been screened for HBsAg, 23 (12.3%, 95% CI 8.0–17.9) were positive of whom none had liver assessment and only 6 (26.1%) had received Tenofovir. Our HBV testing intervention was accepted by all participants and found 94/870 (10.8%, 95% CI 8.8–13.1) positive, 78 of whom underwent full liver assessment along with 40 HBsAg-negative controls. At the time of liver assessment, 61/78 (78.2%) HIV-HBV coinfected patients received ART with 7 (11.5%) on Tenofovir and 54 (88.5%) on Lamivudine alone. HIV-HBV coinfected patients had higher APRI score compared to controls (0.58 vs 0.42, p = 0.002). HBV DNA was detectable in 52/53 (98.1%) coinfected patients with 14/53 (26.4%) having HBV DNA >20,000 IU/L. 10/12 (83.3%) had at least one detectable 3TC-associated HBV resistance, which tended to be associated with increase in liver fibrosis after adjusting for age and sex (p = 0.05).ConclusionsCompliance with HBV testing and treatment guidelines is poor in this Gambian HIV programme putting coinfected patients at risk of liver complications. However, the excellent uptake of HBV screening and linkage to care in our study suggests feasible improvements.

Impact of HIV/HBV infection and HIV/HBV co-infection on outcomes of pregnancy

Both HIV and HBV infection have become major health problems, of global concern, due to the high prevalence in the past few decades. Data from cumulated epidemiological surveys have shown the links between maternal HIV or HBV infection and adverse outcomes on pregnancy. Maternal HIV or HBV infection may also increase the mother-to-child (MTCT) transmission of the two diseases. However, association between HIV-HBV co-infection and adverse pregnancy is still inconclusive. Does maternal HIV-HBV co-infection have an impact on mother-to-child transmission on either HIV or HBV? Study on effective precautionary measures to promote both maternal and child's health is deemed necessary.

High Rate of Hepatitis B Virus Surface Antigenemia Among People Living with HIV/AIDS in Kakuri, Kaduna State, North West Nigeria.

Globally, increased incidence of liver disease caused by hepatitis B virus (HBV) is responsible for high morbidity and mortality among human immunodeficiency virus (HIV)-infected individuals. This is because both viruses share common routes of transmission. We determined prevalence of HBV-HIV coinfection and the influence of some risk factors on concomitant infection among people living with HIV in a treatment center in Kakuri, Kaduna State. Two hundred consenting individuals with HIV infection participated in the study. Fifty-seven males and 143 females were screened using commercial hepatitis B virus surface antigen (HBsAg) rapid membrane-based immunoassay kit (Fastep™ HBV). Seventeen patients tested positive to HBsAg (8.5%). There were more males (14.0%) than females (6.3%). Patients within 40-49 years of age had more coinfection (20.6%) compared to those older than 50 years who had the least prevalence (2.7%). Age of HBV/HIV coinfection was statistically significant (p = 0.02). Risk factors include no knowledge of HBV infection, sharing sharp objects, history of sexually transmitted diseases, history of surgeries, and no HBV immunization. High infection rate observed in this study underscores the need for public awareness, to educate people on modes of transmission. Routine screening is advocated for early HBV identification, as this will facilitate reduction of comorbidity and mortality resulting from opportunistic infection. Findings from this study support introduction of HBV vaccination as part of the Expanded Programme on Immunization in Nigeria.

High sero-prevalence of hepatitis B virus and human immunodeficiency virus infections among pregnant women attending antenatal clinic at Temeke municipal health facilities, Dar es Salaam, Tanzania: a cross sectional study

BackgroundHepatitis B virus (HBV) and Human immunodeficiency virus (HIV) infection in pregnancy is associated with direct effect of pregnancy and potential viral transmission from mother to newborn. In Tanzania very little in known on prevalence of HBV infection and their associated factors among pregnant women in lower health facilities. The main objective of the study was to determine the prevalence of HBsAg, HIV and HBV-HIV co-infection among pregnant women attending antenatal clinics in Dar es Salaam.MethodsThis cross sectional study was conducted in three Temeke municipal health-care facilities between May 2014 and June 2014. A total of 249 pregnant women attending antenatal clinic (ANC) were consecutively enrolled in the study. A data collection tool was used to extract socio-demographic characteristics from ANC card. Commercial ARCHITECT® ci4100™ was used to assess HBsAg status and liver function (Alanine amino-transferase (ALAT). HIV status was determined by anti-HIV antibody test.ResultsOf 249 pregnant women enrolled the median age was 25 years (IQR 22–30) and most of them were married (72.4%). The overall prevalence of HBsAg and HIV were 8.03% (95% CI: 5.0–12.1%) and 17.2% (95% CI: 12.8–22.5%), respectively. HBV/HIV co-infection rate was 2.8% (95% CI; 1.3–5.4%). HBsAg positive rate was significantly high in women who were HIV positive (p < 0.05). Being employed /student were less associated with HBV infection (aOR 0.35, 95% CI 0.13–0.95). Only 3 (15%) of pregnant women with HBsAg positive had abnormal ALAT.ConclusionsHigh prevalence of HBV and HIV infections among pregnant women were reported in this setting thus calls for the national expansion of the integration of prevention of mother-to-child transmission (PMTCT) services for HBV infection.

PREVALENCE OF HBV, HIV, AND HIV-HBV CO-INFECTIONS AMONG HEALTHCARE WORKERS IN IBADAN, NIGERIA

BackgroundHIV and HBV are endemic in Nigeria. HBV is globally the leading cause of death due to liver disease amongst HIV-infected persons. The study was done to ascertain the prevalence...

RELATIONSHIP OF HIV-HBV CO-INFECTION WITH CD4 CELL COUNT AND ALANINE TRANSAMINASE LEVELS IN ANTI-RETROVIRAL THERAPY-NAïVE PATIENTS

BackgroundIn sub-Saharan Africa, the prevalence of hepatitis B virus (HBV) is between 6–20%. In Zambia, prevalence of HIV and HBV co-infection has been reported to be between 7.1% and 31.1%....

Seroprevalence of hepatitis B virus/hepatitis C virus among human immunodeficiency virus-infected patients at a tertiary care teaching hospital in Mangalore, South India

Background: The human immunodeficiency virus (HIV) pandemic has continued to be a major public health problem even after more than three and a half decade of existence. According to the World Health Organization estimates, 36.7 million people were living with HIV by 2015 end while chronic infection of hepatitis B virus (HBV) and hepatitis C virus (HCV) occurs in 240 and 130–150 million people worldwide, respectively. Since the general modes of transmission are similar to HIV, coinfection of HIV with HBV/HCV is commonly found, being variable worldwide. Aims and Objectives: The aims and objectives of this study were (1) To investigate the seroprevalence of HBV/HCV in HIV-positive patients and (2) To analyze the demographic pattern and laboratory parameters. Settings and Design: This was a descriptive cross-sectional study. Materials and Methods: The serum samples from confirmed HIV-positive patients were screened and confirmed for HBV and HCV following standard operative procedures. The demographic pattern and laboratory parameters were also obtained. Statistical Analysis Used: SPSS software version 23.0 was used for statistical analysis. Results: The seroprevalence of HBV and HCV in HIV-positive patients was found to be 6.6% and 0.7%, respectively. Males (n = 7) were more commonly infected than females (n = 3) with the age group of 31–40 years being the most common and majority were married (n = 9). In HBV-HIV coinfection, the mean values of serum globulin, serum total bilirubin, conjugated bilirubin, aspartate amino-transferase, alanine aminotransferase (ALT), and alkaline phosphatase were increased, but in the only case of HCV-HIV coinfection, only hemoglobin and platelet count were decreased. A majority (n = 8) improved on discharge. Conclusions: The seroprevalence of HBV/HCV was high with laboratory test showing a significant correlation between HBV-HIV coinfection and serum globulin and ALT. Hence, creating awareness, understanding these diseases, and providing screening test in suspected individuals is the need of the hour which will improve the mortality rates related to them.

Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study

BackgroundDespite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea.Materials and MethodsA cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013.ResultsAmong the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13).ConclusionsHBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.

Renal outcomes after up to 8 years of tenofovir exposure in HIV-HBV-coinfected patients.

Renal toxicity is a common side effect during tenofovir (TDF)-use in HIV-infected, but not necessarily HBV-infected, patients. Nevertheless, little is known regarding TDF-use on renal impairment during HIV-HBV coinfection. We aimed to evaluate the progression and determinants of renal impairment in coinfected patients undergoing TDF. A total of 175 coinfected patients initiating TDF-containing antiretroviral therapy were prospectively followed. Estimated glomerular filtration rates (eGFR) were calculated at baseline and every 6-12 months. Determinants of eGRF change from baseline (ΔeGFR) were evaluated using mixed-effect linear regression and progression towards renal impairment using proportional-hazards regression. At baseline, average eGFR was 96.7 ml/min per 1.73m2 (95% CI 93.8, 99.6). During a median 58.3 months (IQR 33.7-92.1) of treatment, eGFR decreased a monthly average of -0.14 ml/min per 1.73m2 (95% CI -0.16, -0.12). Significantly faster ΔeGFR was associated with baseline eGFR>90 (P=0.002), male gender (P=0.04), previous AIDS-defining illness at baseline (P=0.03), baseline liver cirrhosis (P=0.03) and concomitant protease inhibitor use (P=0.005). Between respective baseline and end of follow-up visits, the proportion of patients with renal impairment increased: normal function, 65.7% to 53.1%; mild impairment, 32.6% to 40.0%; moderate impairment, 1.7% to 6.9%. Higher age (P=0.01) and previous AIDS-defining illness (P=0.02) at baseline were independent risk-factors for developing impairment, while undetectable HBV DNA on-treatment was protective (P=0.006). Five (2.9%) patients permanently discontinued TDF after a renal event. Severe HIV-related and HBV-related morbidity negatively affects renal function in coinfected patients undergoing long-term TDF. Although most patients only developed mild/moderate impairment, close renal monitoring is warranted for this particular population.