Viral Hepatitis Coinfection Research Articles

Impact of antiviral therapy for disease progression and non-invasive liver fibrosis index in patients with chronic hepatitis C: Markov chain model analysis.

Antiviral therapy advancements resulted in an era in which eradication of hepatitis C has become a goal, however, there are few reports on the long-term course of liver disease progression with antiviral therapy. The aim of this study was to use the Markov model to analyze disease progression and non-invasive liver fibrosis index in hepatitis C Patients. Patients with chronic hepatitis C (n=1432) were diagnosed between January 2012 and May 2021 in the Musashino Red Cross Hospital. Patients with other hepatitis virus co-infection, chronic liver disease, and hepatocellular carcinoma (HCC) at the beginning of the study were excluded. A total of 618 patients with a 1-year or longer observation period were studied. The liver disease state was defined as chronic hepatitis (CH), compensated liver cirrhosis (CLC), decompensated liver cirrhosis (DLC), and HCC. Cirrhosis and high FIB-4 index (≥3.61) were 42 cases (6.8%) and 208 cases (33.6%), respectively at the start of the study. The 40years estimated transition analysis of 40-year-old CH low FIB-4 level (<3.61) revealed that the proportion of CH low/high, CLC low/high, DLC low/high, and HCC were 10.83%/10.86%, 0.35%/2.64%, 0%/3.21% 72.11% in untreated unit and 47.83%/9.21%, 6.69%/1.32%, 0.70%/0.99%, 33.27% in treated unit, respectively. Antiviral therapy suppressed liver fibrosis, disease progression, and HCC development significantly. Markov model analysis of hepatitis C virus patients showed the impact of antiviral therapy on the suppression of disease progression in the order of CH, CLC, and DLC.

Hepatitis E in a Portuguese cohort of human immunodeficiency virus positive patients: High seroprevalence but no chronic infections.

IntroductionHepatitis E virus (HEV) infection causes zoonotic hepatitis in Europe, with a higher risk of complications in immunocompromised hosts. HEV natural history in human immunodeficiency virus (HIV) positive patients is not fully understood, and its prevalence is unknown.ObjectivesTo study the seroprevalence of HEV and prevalence of chronic HEV in HIV‐positive patients from Porto, Portugal.MethodsWe randomly selected patients from the cohort of HIV‐positive patients followed in our hospital. We performed an enzyme‐linked immunosorbent assay to search for immunoglobulin G for HEV. When the absorbance/cut‐off was inferior to 3.5, the test was repeated, and a confirmatory test executed in that sample. For reactive tests and for immunosuppressed patients (CD4 count < 200/mm3) with nonreactive test, a polymerase chain reaction (PCR) test was also performed.ResultsWe included 299 patients. The mean age was 48 and 75.3% were men. Regarding HIV infection, the median follow‐up time was 10 years, the acquisition was mainly heterosexual contact, and 94% were on antiretroviral therapy. Seventy‐six patients (25.4%) had reactive immunoglobulin G (IgG) hepatitis E serology. Patients with a reactive test were older (statistically significant difference). Otherwise, there was no difference between groups concerning birthplace, rural residence, chronic viral hepatitis coinfection, or cirrhosis. Nadir and actual TCD4+ lymphocyte counts did not differ significantly from patients with HEV reactive and nonreactive serology. Gamma‐glutamyl‐transferase (GGT) was higher in patients with reactive IgG HEV. All serum HEV PCR tests were negative.ConclusionsSeroprevalence of HEV was 25.4% in HIV‐positive patients. Older age and higher GGT correlated to HEV reactive IgG test. No cases of current hepatitis E were found.

Retention on antiretroviral therapy in person with HIV and viral hepatitis coinfection in Ethiopia: a retrospective cohort study

BackgroundHIV coinfection with viral hepatitis B (HBV) or viral hepatitis C (HCV) is not uncommon in Ethiopia. Although the coinfections are presumed to interfere with antiretroviral treatment (ART), this is not widely studied in Sub-Saharan African settings. This study was conducted to determine ART retention in persons coinfected with HIV + HBV or HIV + HCV.MethodsWe reviewed the medical records of HIV-positive adults who initiated ART between 2011 to 2018 in four high-burden hospitals of Addis Ababa. Retention in care was the primary outcome of the study, which was compared between HIV and either HBV or HCV coinfected persons, and HIV-monoinfected persons. A parametric Gompertz regression model was used to compare retention between the coinfected and monoinfected groups.ResultsA total of 132 coinfected persons and 514 HIV-monoinfected individuals who initiated ART in 2011–2018 were compared. At 12-months of follow-up, 81.06% [95% CI: 73.3–86.9%] of the coinfected and 86.96% [95% CI: 83.7–89.6%] of the monoinfected were still on ART care. Cumulative retention in the coinfected group was 68.93% [60.4–76.3%] versus 80.35% [76.6–83.5%, p = 0.0048] in the monoinfected group. The cumulative retention was lower (61.25, 95% CI: 49.9–71.4%) in male coinfected patients than male monoinfected patients (77.77, 95% CI: 71.8–82.7%, p = 0.0041). In contrast, cumulative retention was similar in females in the coinfected group (80.76, 95% CI:67.3–89.5%) versus the monoinfected group (82.29, 95% CI:77.4–86.3%, p = 0.792). Overall, HIV-positive with viral hepatitis coinfection were 24 and 31% less likely to still be on ART care than the monoinfected group at 12 months and overall, with sub-distribution adjusted hazard ratio (AHR) of 0.76(95% CI:0.61–0.96, p = 0.021) and 0.69(95% CI:0.54–0.87, p = 0.002) respectively.ConclusionsWe observed that coinfected individuals are less likely to stay on ART than HIV monoinfected individuals. The low retention in the coinfected group from this study may affect the success of survival gained in people living with HIV (PLHIV) in the long term. More concerted efforts need to be made to retain coinfected individuals at least at the level of monoinfected persons on long-term ART care. Future studies are needed to better understand the difference in retention, preferable in a prospective manner.

Special Considerations in the Management of HIV and Viral Hepatitis Coinfections in Liver Transplantation

Modern therapies for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus have become so effective that patients treated for these conditions can have normal life-expectancies. Suitable livers for transplantation remain a scarce and valuable resource. As such, significant efforts have been made to expand donation criteria at many centers. This constant pressure, coupled with the increasing effectiveness of antiviral therapies, has meant that more and more patients infected with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) may be considered appropriate donors in the right circumstances. Patients with these infections are also more likely to be considered appropriate transplantation recipients than in the past. The treatment of HBV, HCV, and HIV after liver transplantation (LT) can be challenging and complicated by viral coinfections. The various pharmaceutical agents used to treat these infections, as well as the immunosuppressants used post-LT must be carefully balanced for maximum efficacy, and to avoid resistance and drug–drug interactions.

The Correlated Risk Factors for Severe Liver Damage Among HIV-Positive Inpatients With Abnormal Liver Tests.

Background:This study investigated the factors correlated with severe liver damage among HIV-infected inpatients.Methods:We retrospectively collected the first hospitalized HIV-infected patients in the Department of Infectious Disease of the First Affiliated Hospital of China Medical University from January 1, 2010, to December 31, 2019. We used multivariate logistic regression to identify the factors associated with severe liver damage.Results:A total of 493 patients with abnormal liver tests were recruited. Among 63 cases (12.8%) with severe liver injury, drug-induced liver injury (DILI) identified by the updated Roussel Uclaf Causality Assessment Method (RUCAM) score as the direct cause was found in 43 cases. Anti-tuberculosis drug (ATD) exposure [adjusted odds ratio (aOR) = 1.835, 95% confidence interval (CI): 1.031–3.268], cotrimoxazole exposure (aOR = 2.775, 95% CI: 1.511–5.096), comorbidity of viral hepatitis (aOR = 2.340, 95% CI: 1.161–4.716), alcohol consumption history (aOR = 2.392, 95% CI: 1.199–4.769), and thrombocytopenia (aOR = 2.583, 95% CI:1.127–5.917) were associated with severe liver injury (all P < 0.05).Conclusions:DILI was the predominant cause of severe liver damage, followed by hepatitis virus co-infection. For patients with alcohol consumption and thrombocytopenia, frequent monitoring of liver function tests should be considered.

Prevalence and Risk Factors of HBV and HCV Co-Infection Among People Living with HIV in an Egyptian Setting.

Human Immune Deficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections constitute a global health concern. They share common modes of transmission, increasing the likelihood of co-infection. Co-infection accelerates viral replication, promotes the progression of chronic liver diseases and challenges antiviral therapy. There are no available data addressing the magnitude of chronic viral hepatitis co-infection in people living with HIV in Egypt. Nor is there a mandate for HCV/HBV screening. This cross-sectional study provides needed data on HBV and/or HCV co-infection in Egyptian people living with HIV. The study was conducted at the HIV clinic in Alexandria Fever Hospital. The investigation included 168 confirmed HIV cases. All cases were interviewed and tested for HCV-Ab and HBsAg by ELISA. There were 52 (31%) persons who were anti-HCV positive. 40 of them had detectable HCV RNA (76.9%). HIV/HCV co-infection was significantly higher among males (40.7%) compared to only (10.9%) among females (OR = 3). History of imprisonment (OR = 4.84, CI: 1.33-17.62), accidental puncture with protruding needle contaminated with blood (OR = 3.35, CI: 0.99-11.72), alcohol use (OR = 3.03, CI: 1.13-8.09) and male gender (OR = 2.96, CI: 0.99-8.88) were all significant predictors for HIV/HCV co-infection. On the other hand, HIV/HCV co-infection was inversely associated with high education level (OR = 0.28, CI: 0.10-0.76). HBsAg was detected in 4 (2.4%), and anti-HBc in 49 (29.2%) of HIV patients. Previous HBV infection (positive anti-HBc/negative anti-HBs) was significantly associated with a history of female genital mutilation circumcision, injection drug use, invasive procedures, non-specific fatigue and HCV-Ab seropositivity. Egyptian people living with HIV have an increased frequency of HCV antibody and HCV infection compared to the general population indicating a higher risk of infection and suggest a higher risk of HCV exposure. Past or present HBV co-infections are also elevated. Routine screening of these viruses in the management protocol of people living with HIV in Egypt is recommended.

Specific features of pregnancy and delivery in HIV-infected women

HIV-infected women have a higher risk of complications during pregnancy and delivery (chronic placental insufficiency, anemia, placental abruption, preterm birth) compared with HIV-negative women, especially in case of opportunistic infections, immunodeficiency and a high viral load in the blood. The obstetrical pathologies are hard to study in these women because the above conditions are associated with a range of confounding factors that are not directly related to HIV infection but are often present, such as drug addiction, weight deficit, and chronic viral hepatitis coinfection. The literature review provides data from domestic and international studies on the correlation between HIV infection and the frequency of complications during pregnancy, delivery and the postpartum period, as well as the effect of the infection on the condition of newborns. The article cites current recommendations on the choice of delivery types for HIV-infected women.

Diagnostic value of serological biomarkers for detection of non-alcoholic fatty liver disease (NAFLD) and/or advanced liver fibrosis in people living with HIV.

We aimed to evaluate the accuracy of serological biomarkers for non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis (METAVIR-F3F4) in HIV mono-infected individuals. In all, 674 participants from the PROSPEC-HIV study (NCT02542020), who had blood sample tests and transient elastography (TE) performed on the same day, were eligible. Exclusion criteria were viral hepatitis co-infection (n=90), abusive alcohol intake (n=61), missing data (n=47) or unreliable TE (n=39). NAFLD was defined by controlled attenuation parameter≥248dB/m and advanced fibrosis by liver stiffness measurement≥8.7kPa with M probe or ≥7.2kPa with XL probe. Biomarkers for NAFLD [Steato-ELSA, Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), NAFLD-Liver Fat Score (NAFLD-LFS)] and fibrosis [Fibrosis-4 score (FIB-4), Aspartate-to-Platelet Ratio Index (APRI) and NAFLD Fibrosis Score (NFS)] were calculated. A total of 437 patients [57% female, age=44 (interquartile range: 35-52)years, body mass index (BMI)=26.1 (23.4-29.3)kg/m2 , CD4=660 (427-901)cells/μL] were included. The prevalence [95% confidence interval (CI)] of NAFLD and advanced fibrosis were 38.2% (33.8-42.9) and 10.5% (8.0-13.8), respectively. The areas (95% CI) under the receiver operator curve (AUROCs) for diagnosis of NAFLD were 0.854 (0.818-0.889), 0.840 (0.804-0.877), 0.805 (0.762-0.847) and 0.793 (0.750-0.836) for Steato-ELSA, FLI, HSI and NAFLD-LFS (P<0.001), respectively. All tests yielded satisfactory sensitivities, specificities and negative predictive values (NPVs). The AUROCs (95% CI) for diagnosis of advanced fibrosis were 0.736 (0.659-0.814), 0.700 (0.614-0.7851) and 0.795 (0.726-0.864) for FIB-4, APRI and NFS (P=0.077), respectively. These tests yielded high specificities and negative predictive values (NPVs)>90%. Biomarkers for NAFLD had a good accuracy and those for fibrosis had high specificities and NPVs. These tests should be integrated to HIV care to detect NAFLD and to exclude advanced liver fibrosis.

Prevalence and Associated Factors of Hepatitis B Surface Antigen (HBsAg) among People Living with HIV (PLWHIV) Attending at CTC Mawenzi Regional Hospital Kilimanjaro, Northern Tanzania

Background: Human immunodeficiency virus (HIV) and hepatitis virus (HBV) coinfection are common due to shared modes of transmission between these viruses. Also studies have shown that HIV appears to be a risk factor for reactivation of hepatitis B in patients who have developed hepatitis B surface antibodies HBsAg which is considered as a marker of chronic HBV infection. The magnitude of HIV/HBV coinfection among people living with HIV in Tanzania is not well known. Objective: The aim of this study was to determine the prevalence and associated factors of HBsAg among HIV Positive Clients at CTC at Mawenzi Regional Hospital. Methods: It was a cross sectional study that included 100 HIV Positive CTC clients at Mawenzi Regional Hospital. Ethical clearance was obtained at KCMUCo ethical committee, structured questionnaires with closed-ended question were used to collect the information needed done by interviewing the person, blood sample was collected from median cubital vein and HBsAg Rapid Test Strips were used. Data processing and analysis were done using SPSS version 20. Results: Of 100 HIV patients, only 8 (8%) tested positively for HBsAg. There was a significant association between residence and HBV infection. People from rural areas had high prevalence compared to urban areas (OR 8.71, 95% CI: 1.029 - 73.66). Other social demographic and clinical characteristics in this study had no significant association with HBsAg positivity. Conclusion: Significant numbers of 8% HIV patients are HBsAg positive. HIV patients from rural residency are more likely to acquire HBV than Urban residents that showed significant association.

Viral Hepatitis Co-infection Impact on Response to Antiretroviral Therapy and HIV Disease Progression: Virologic and Immunological Indices Outlook

<i>Introduction</i>: Due to the availability of anti-retroviral treatment (ART), infected individuals with HIV in Sub-Sahara Africa live longer with reduced mortality and morbidity. But there’s rising cases of co-infection with viral hepatitis, reliable data on Hepatitis V virus (HBV) or Hepatitis C (HCV) co-infection prevalence among HIV infected adults in North Central Nigeria. <i>Methods</i>: A descriptive cross sectional study was carried out among 289 seropositive drug experienced HIV patients attending Federal Medical centre Keffi in Nasarawa State from December 2019 to march, 2020. The enrolled participants  18 years were tested for anti-HCV and HBsAg. Serological markers profile for Hepatitis B virus was performed on HBV positive samples. HBV DNA viral load and CD4+ T cells cunt were determined using BD faces analyser and CORBAS Tag-MAN Ampli-prep analyser (USA) respectively. <i>Results</i>: The HBV/HCV coinfection prevalence among sero-positive HIV drug experience patient was 5.1%. the prevalence of HBV-HIV and HCV- HIV coinfection were 9.5 and 9.3% respectively. Active viral carriers of HBeAg) were associated with HBV-HIV co-infected individuals was 8.6% and the HBeAg is associated with sever immune-suppression and decrease in CD4+ T cells and increase in viral load. Dependent risk factors for HCV-HBV-HIV infection are: CD4+ T cells OR; 0.4 (0.1-1.5), age 18-30years 2.1 (1.6-2.1), multiple sex partners 0.7 (0.1-2.3). Participants aged 18–30 years [OR=2.1 (1.6–2.1); p=0.046], male gender [OR=0.9 (0.3–1.4); p=0.034], CD4+ T cell count [OR=0.4 (0.1–1.5); p=0.045], History of Blood transfusion [OR=0.8 (0.2–4.0); p=0.012] and being married [OR=0.6 (0.2–4.3); p=0.039] were independent risk factors of HIV-HBV-HCV co-infections. <i>Conclusion</i>: Increase in viral load, severe immune suppression and decrease in CD4+ T Cells was predominant highlights in HBV, HCV coinfection amount HIV patients, increase HBV, HCV screening should be encouraged among seropositive HIV infected individuals.

HIV Pozitif Olgularda Viral Hepatit ve Sifiliz Koinfeksiyonu Seroprevalansının İrdelenmesi

HIV Pozitif Olgularda Viral Hepatit ve Sifiliz Koinfeksiyonu Seroprevalansının İrdelenmesi

Liver steatosis and nonalcoholic fatty liver disease with fibrosis are predictors of frailty in people living with HIV.

The aim was to investigate the contribution of liver steatosis and significant fibrosis alone and in association [nonalcoholic fatty liver disease (NAFLD) with fibrosis] to frailty as a measure of biological age in people living with HIV (PLWH). This was a cross-sectional study of consecutive patients attending Modena HIV Metabolic Clinic in 2018-2019. Patients with hazardous alcohol intake and viral hepatitis coinfection were excluded. Liver steatosis was diagnosed by controlled attenuation parameter (CAP), while liver fibrosis was diagnosed by liver stiffness measurement (LSM). NAFLD was defined as presence of liver steatosis (CAP ≥248 dB/m), while significant liver fibrosis or cirrhosis (stage ≥F2) as LSM at least 7.1 kPa. Frailty was assessed using a 36-Item frailty index. Logistic regression was used to explore predictors of frailty using steatosis and fibrosis as covariates. We analysed 707 PLWH (mean age 53.5 years, 76.2% men, median CD4 cell count 700 cells/μl, 98.7% with undetectable HIV RNA). NAFLD with fibrosis was present in 10.2%; 18.9 and 3.9% of patients were classified as frail and most-frail, respectively. Univariate analysis demonstrated that neurocognitive impairment [odds ratio (OR) = 5.1, 1.6-15], vitamin D insufficiency (OR = 1.94, 1.2-3.2), obesity (OR = 8.1, 4.4-14.6), diabetes (OR = 3.2, 1.9-5.6), metabolic syndrome (OR = 2.41, 1.47-3.95) and osteoporosis (OR = 0.37, 0.16-0.76) were significantly associated with NAFLD with fibrosis. Predictors of frailty index included steatosis (OR = 2.1, 1.3-3.5), fibrosis (OR = 2, 1-3.7), NAFLD with fibrosis (OR = 9.2, 5.2-16.8), diabetes (OR = 1.7, 1-2.7) and multimorbidity (OR = 2.5, 1.5-4). Liver steatosis and NAFLD with fibrosis were associated with frailty. NAFLD with fibrosis exceeded multimorbidity in the prediction of frailty, suggesting the former as an indicator of metabolic age in PLWH.

Coronavirus disease 2019 and viral hepatitis coinfection: Provide guidelines for integrated screening and treatment.

The rapid spread of severe acute respiratory syndrome coronavirus 2, the virus, that causes Coronavirus disease 2019 (COVID-19) threatens global health. Emerging evidence and past experience from other coronaviruses suggests that people with underlying liver disease including viral hepatitis could be at risk of disease severity and mortality. However, with the present relatively low screening rates for the most prevalent viral hepatitis - Hepatitis B and C, many COVID-19 cases especially in low middle income countries are unlikely to be screened for viral hepatitis coinfection. Without active screening, little will be known about the clinical and epidemiological manifestations which could negatively impact public health efforts. In this commentary, we call for systematic and integrated screening of Hepatitis B and C for COVID-19 confirmed patients. We also call for guidelines for management and treatment as well as research to understand the epidemiology of coinfection This article is protected by copyright. All rights reserved.

SEN virus genotype H distribution in β-thalassemic patients and in healthy donors in Iraq: Molecular and physiological study.

The SEN virus (SENV) has been linked to transfusion-associated non-A-E hepatitis; however, information regarding SENV infections in patients with thalassemia, particularly in those with hepatitis virus co-infections, remains limited. This study investigated the frequency of SENV (genotypes D and H) infections in Iraqi patients with thalassemic patients infected and not infected with hepatitis C virus. The study involved 150 β-thalassemia patients (75 with HCV infections and 75 without) and 75 healthy blood donors. Patient levels of vitamins C and E, liver function markers, and glutathione peroxidase (GPX) were determined. Recovered viral nucleic acids were amplified using the conventional polymerase chain reaction (SENV DNA) or the real-time polymerase chain reaction (HCV RNA) techniques. Only 10% of healthy donors had evidence of SENV infection. Among patients with thalassemia, 80% and 77% of patients with and without concurrent HCV infections, respectively, had SENV infections. DNA sequencing analyses were performed on blood samples obtained from 29 patients. Patients with thalassemia, particularly those with SENV infections, had higher levels of several enzymatic liver function markers and total serum bilirubin (P < 0.05) than did healthy blood donors. Among the examined liver function markers, only gamma-glutamyl transferase demonstrated significantly higher levels in HCV-negative patients infected with SENV-H than in those infected with SENV-D (P = 0.01). There were significantly lower vitamin C, vitamin E, and glutathione peroxidase levels in patients than in healthy donors (P < 0.05), but only glutathione peroxidase levels were significantly lower in HCV-negative thalassemia patients infected with SENV than in those without SENV infections (P = 0.04). The SENV-H genotype sequences were similar to the global standard genes in GenBank. These results broaden our understanding the nature of the SENV-H genotype and the differential role of SENV-H infections, compared to SENV-D infections, in patients with thalassemia, in Iraq.

Proportion and Characterization of Co-infections of HIV and Hepatitis C or Hepatitis B among People with HIV in Alabama, 2007-2016.

People living with human immunodeficiency virus (HIV) have an increased risk of other infections, including viral hepatitis, which can complicate the treatment and progression of the disease. We sought to characterize Alabama cases of HIV co-infected with hepatitis C virus or hepatitis B virus. Using surveillance data, we defined co-infection as a person identified as having hepatitis C or hepatitis B and HIV during 2007-2016. We compared demographics, outcomes, and risk factors for co-infected versus monoinfected individuals with HIV. We mapped co-infected individuals' distribution. Of 5824 people with HIV, 259 (4.4%) were co-infected with hepatitis C (antibody or RNA positive) and 145 (2.5%) with hepatitis B (surface antigen, e antigen, or DNA positive) during 2007-2016. Individuals with HIV and hepatitis C had a greater odds of injection drug use (adjusted odds ratio 9.7; 95% confidence interval 6.0-15.5). Individuals with HIV and hepatitis B had a greater odds of male-to-male sexual contact (adjusted odds ratio 1.7; 95% confidence interval 1.1-2.6). Co-infection was greater in urban public health districts. We identified risk behaviors among Alabama populations associated with increased odds for HIV and viral hepatitis co-infection. Outreach, prevention, testing, and treatment resources can be targeted to these populations.

Molecular Identification of HIV-1 in the Presence of Hepatitis B Virus and Hepatitis C Virus Co-infections

Background:Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health.Aims:To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey.Study Design:Retrospective cross-sectional study.Methods:The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency virus were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Anti-human immunodeficiency virus positive patients with HBsAg and/or anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene.Results:We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-1 infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study.Conclusion:Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative.

Serological screening of HIV and viral hepatitis revealed low prevalence among visceral leishmaniosis patients in Sudan.

There is an increasing concern about the co-infection of visceral leishmaniosis (VL) with human immunodeficiency virus (HIV) and/or viral hepatitis B/C. The aim of this study was to determine the prevalence of HIV and viral hepatitis co-infections among VL patients in a hyperendemic area in Eastern Sudan and to assess antibody levels in co-infected patients. This is a retrospective study where the sera of confirmed VL cases and non-VL individuals were analysed. The sera were screened for co-infections using immunochromatographic tests and ELISA for anti-HIV 1+2 antibodies, hepatitis B surface antigen (HBsAg), and anti-hepatitis C virus (HCV). Anti-Leishmania donovani antibodies in the sera of VL alone were assessed and compared to the sera of co-infected patients. Of the 100 screened VL sera, 6 (6%), 0 (0%), and 1 (1%) were positive for HBsAg, anti-HCV, and anti-HIV, respectively. These values were 5 (5%), 0 (0%), and 1 (1%) in the control group. Of note, the HCV screening test (Biorex, UK) showed positive reactivity in 32 (32%) and 17 (17%) sera of VL and control groups, respectively. All reactive sera tested negative in HCV ELISA. Of the 93 VL sera, 75 (80.6%) had strong DAT titers (1:˃102400), 2 (2.1%) demonstrated the lowest DAT titers (1:≤800), and 5 (5.4%) had marginal DAT titers (1:1600). Interestingly, the VL/HIV co-infected serum had a negative antibody titer (1:1600). Of the 6 VL/HBV co-infected sera, 1 (16.7%) and 5 (83.3%) demonstrated moderate (1:12800–1:51600) and strong (1:≥102400) DAT titers, respectively. The strong DAT titers observed in the VL/HBV co-infected sera were comparable to the DAT titers of the VL sera. The VL co-infection with HIV and hepatitis B/C is low in endemic areas in Eastern Sudan but may create a diagnostic difficulty. VL/HIV co-infected patients can have low Leishmania antibodies, thus alternative methodologies (e.g., antigen tests) may help the diagnosis.

Viral hepatitis B and C co-infection with Human Immunodeficiency Virus among adult patients attending selected highly active anti-retroviral therapy clinics in Nigeria’s capital

ABSTRACTHepatitis B and C are liver diseases caused by hepatitis B and C viruses, and co-infection in HIV-positive individuals is common, with increased mortality and morbidity. This study determined the seroprevalence of HIV co-infection with the two viruses among patients attending three major hospitals in the Federal Capital Territory, Nigeria. From February to July 2019, 311 sera samples were collected from HIV positive patients and screened for Hepatitis B and C infection. Immunochromatographic and ELISA techniques for HBsAg and HCV were used. Socio-demographic features and responses to risk factors were obtained using questionnaires. Patients’ data and results obtained were analyzed with SPSS version 25. The prevalence of HIV/HBV/HCV, HIV/HBV, and HIV/HCV co-infection were 0.64%, 6.43%, and 3.86%, respectively. The triple infection and both co-infections were preponderant among females than males, with a prevalence rate of 0.64%, 3.85%, 2.57%, and 0%, 2.57%, 1.29%, respectively. People aged 31–40 years had the highest triple infection (0.64%) and HIV/HCV infection rate (2.57%), while patients aged 21–30 years had the highest HBV co-infection (3.22%) rates. Widowed patients had the most co-infection rate in all cases. High-risk behavior indicated that there was a significant association between blood donation/reception and engagement in unprotected sex and HIV/HBV/HCV co-infection. The other risk factors revealed no significant effect (p > .05). There was generally a low rate of exposure to associated risk factors. This study highlighted the endemicity of hepatitis virus co-infection in Abuja and the existence of few reports of HIV co-infection with HBV and HCV compared to the nation’s population.

The Variation of the Infection with Hepatitis B, C and E Viruses in HIV-1 Positive Patients in China

Background: HIV-1 and viral hepatitis have similar transmission moods and social factors related to their infections. This research aims to study the prevalence of co-infection of HIV-1 and hepatitis B virus (HBV) /hepatitis C virus (HCV)/hepatitis E virus (HEV). Methods: The prevalence of HBV, HCV and HEV infections were measured in two Chinese national HIV-1 molecular surveys at 2007 and 2015. The individuals were recruited from 31 cities and provinces. Demographic characteristics, route of HIV transmission and CD4 cells count, were captured in the national HIV epidemiology database. The infection of HIV, HBV, HCV and HEV was detected using plasma specimens. Logistic regression was used to study the association between co-infections status and possibly relevant factors. Finding: The viral hepatitis co-infections in HIV-1 infected populations were decreased from 75.6% in 2007 to 44.1% in 2015. Significant co-infection reductions were found for HCV (from 51.1% to 4.9%) and HBV (17.8% to 13.9%) and HEV co-infections (41.7% to 32.8%). There is an increase of 4.4% HBV co-infections among MSM between the two surveys. And the increase might be associated with migrations from high to low HBV epidemic regions [AOR=6.34, 95% CI: (1.82, 22.1)). Interpretation: This study showed that there were significant decreases in the co-infections of HBV, HCV and HEV in HIV infected populations. Due to the limited health resources and higher transmission efficiency of the viral hepatitis than HIV-1, concerted efforts should be made to further control the viral hepatitis epidemics in HIV affected populations. Funding Statement: This study was supported by National Natural Science Foundation of China (Grants 31600734). Declaration of Interests: All the authors declare that they have no conflict of interest. Ethics Approval Statement: This study was approved by the institutional review board at the National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention. In the sample collection, all participants provided informed written consent.

The EuroSIDA study: 25 years of scientific achievements.

The EuroSIDA study was initiated in 1994 and follows adult people living with HIV (PLHIV) in 100 collaborating clinics across 35 countries covering all European regions, Israel and Argentina. The study aims to study the long-term virological, immunological and clinical outcomes of PLHIV and to monitor temporal changes and regional differences in outcomes across Europe. Annually collected data include basic demographic characteristics, information on AIDS- and non-AIDS-related clinical events, and details about antiretroviral therapy (ART), hepatitis C treatment and other medications, in addition to a range of laboratory values. The summer 2016 data set held data from a total of 23071 individuals contributing 174481 person-years of follow-up, while EuroSIDA's unique plasma repository held over 160000 samples. Over the past 25years, close to 300 articles have been published in peer-reviewed journals (h-index 52), covering a range of scientific focus areas, including monitoring of clinical and virological outcomes, ART uptake, efficacy and adverse events, the influence of hepatitis virus coinfection, variation in the quality of HIV care and management across settings and regions, and biomarker research. Recognizing that there remain unresolved issues in the clinical care and management of PLHIV in Europe, EuroSIDA was one of the cohorts to found The International Cohort Consortium of Infectious Disease (RESPOND) cohort consortium on infectious diseases in 2017. In celebration of the EuroSIDA study's 25th anniversary, this article aims to summarize key scientific findings and outline current and future scientific focus areas.