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Ferrante ND, Kallan MJ, Sukkestad S, Kodani M, Kitahata MM, Cachay ER, Bhattacharya D, Heath S, Napravnik S, Moore RD, Yendewa G, Mayer KH, Reddy KR, Hayden T, Kamili S, Martin JN, Kim HN, Lo Re V. Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B-coinfected adults in care in the United States. J Viral Hepat 2023; 30:879-888. [PMID: 37488783 PMCID: PMC10592429 DOI: 10.1111/jvh.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross-sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log-binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody-positivity associated with determinants of interest (age, injection drug use [IDU], high-risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%-5.6%) were HDV IgG antibody-positive, and 10/596 (1.7%; 95% CI, 0.6%-2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09-5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody-positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.
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Affiliation(s)
- Nicole D. Ferrante
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Michael J. Kallan
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sophia Sukkestad
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Maja Kodani
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mari M. Kitahata
- Division of Allergy and Infectious Disease, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Edward R. Cachay
- Department of Medicine, Division of Infectious Diseases and Global Public Health University of California, San Diego, CA
| | - Debika Bhattacharya
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sonya Heath
- Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, AL
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - Richard D. Moore
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - George Yendewa
- Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - K. Rajender Reddy
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tonya Hayden
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Saleem Kamili
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - H. Nina Kim
- Division of Allergy and Infectious Disease, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Tsegay B, Gebrecherkos T, Kahsay AG, Abdulkader M. Seroprevalence and Associated Factors of Hepatitis B and Hepatitis C Viral Infections Among Prisoners in Tigrai, Northern Ethiopia. Infect Drug Resist 2023; 16:3743-3750. [PMID: 37333685 PMCID: PMC10276587 DOI: 10.2147/idr.s410017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/07/2023] [Indexed: 06/20/2023] Open
Abstract
Background Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigrai, Ethiopia. Methods A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20 and p<0.05 was considered statistically significant. Results The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15-13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17-7.74, p=0.022) were significantly associated with HBV infections. Conclusion The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.
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Affiliation(s)
- Belaynesh Tsegay
- Ayder Comprehensive Specialized Hospital Laboratory Department, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Teklay Gebrecherkos
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Atsebaha Gebrekidan Kahsay
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Mahmud Abdulkader
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
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Tesfu MA, Belay NB, Habtemariam TT. Co-infection of HIV or HCV among HBsAg positive delivering mothers and its associated factors in governmental hospitals in Addis Ababa, Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0273300. [PMID: 36026484 PMCID: PMC9417033 DOI: 10.1371/journal.pone.0273300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Blood borne viral infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency virus (HIV) cause substantial mortality and morbidity worldwide. Viral hepatitis during pregnancy is closely related to high risks of maternal and neonatal complications. In Ethiopia, only a little information is available on co-infection of HCV or HIV among Hepatitis B surface Antigen (HBsAg) positive pregnant mothers. Thus, the study aimed to determine HIV or HCV co-infection and associated risk factors among HBsAg positive delivering mothers. METHOD A health facility-based cross-sectional study was conducted in five governmental hospitals in Addis Ababa among 265 HBsAg positive delivering mothers in the year 2019 and 2020. A purposive sampling technique was used to select the study participants. Structured questionnaires and laboratory test results were used to collect the data. SPSS version 20 software was used to enter and analyze the data. Multivariable logistic regression was used to identify independent predictors of HIV or HCV co-infections. RESULTS Of the HBsAg positive delivering mothers, 9 (3.4%) and 3 (1.1%) were co-infected with HIV and HCV, respectively. None of them were with triplex infection. All of the socio-demographic characteristics were not significantly associated with both HIV and HCV co-infections. Mothers who had a history of sexually transmitted diseases (STDs) were 9.3 times more likely to have HBV-HIV co-infection (AOR = 9.3; 95% CI: 1.84-47.1). Mothers who had multiple sexual partners were 5.96 times more likely to have HIV co-infection (AOR = 5.96; 95% CI: 1.074-33.104). The odds of having HBV-HIV co-infection were 5.5 times higher among mothers who had a history of sharing shavers, razors, and earrings (AOR = 5.5;95% CI: 1.014-29.69). HCV co-infection was not significantly associated with any of the potential risk factors. CONCLUSION This dual infection rate of HBsAg positive delivering mother with HIV or HCV indicates that a substantial number of infants born in Ethiopia are at high risk of mother-to-child transmission (MTCT) of HBV, HIV, and HCV. Thus, all pregnant mothers need to be screened for HBV, HCV, and HIV during antenatal care, and also need implementation of prevention mechanisms of MTCT of these viral infections.
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Affiliation(s)
| | - Nega Berhe Belay
- Aklilu Lemma Institute of Pathobiology, Addis Ababa Universty, Addis Ababa, Ethiopia
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Ceesay A, Lemoine M, Cohen D, Chemin I, Ndow G. Clinical utility of the 'Determine HBsAg' Point-of-Care Test for Diagnosis of Hepatitis B Surface Antigen in Africa. Expert Rev Mol Diagn 2022; 22:497-505. [PMID: 35574686 DOI: 10.1080/14737159.2022.2076595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Chronic infection with hepatitis B virus (HBV) is a leading cause of morbidity and death, especially in sub-Saharan Africa (sSSA), where approximately 60 million adults are infected. More than 90% of these patients are unaware of their HBV status. AREAS COVERED Scaling-up of HBV screening programs in SSA are essential to increase diagnosis, linkage to care and access to treatment, and will ultimately reduce HBV disease burden to achieve WHO hepatitis elimination targets. Such scale up will rely on inexpensive rapid point-of-care (POC) tests, especially in remote areas where gold standard serological assays are not routinely available. This review discusses the diagnostic performance and clinical utility of the Determine™ (Abbott, USA) hepatitis B surface Antigen (HBsAg) POC test for improving HBV screening in SSA, in light with others available HBsAg rapid tests. EXPERT OPINION The Determine™ HBsAg POC test has demonstrated relatively good diagnostic accuracy at the low cost, in the African field and laboratory and should be used for large scale mass screening of HBV infection in Africa.
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Affiliation(s)
- Amie Ceesay
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, P.O. Box 273, Banjul, The Gambia.,Cancer Research Center, INSERM U1052, Lyon, France
| | - Maud Lemoine
- Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Imperial College London. St. Mary's Hospital campus, London, UK
| | - Damien Cohen
- Cancer Research Center, INSERM U1052, Lyon, France
| | | | - Gibril Ndow
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, P.O. Box 273, Banjul, The Gambia.,Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Imperial College London. St. Mary's Hospital campus, London, UK
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Shahriar S, Araf Y, Ahmad R, Kattel P, Sah GS, Rahaman TI, Sadiea RZ, Sultana S, Islam MS, Zheng C, Hossain MG. Insights Into the Coinfections of Human Immunodeficiency Virus-Hepatitis B Virus, Human Immunodeficiency Virus-Hepatitis C Virus, and Hepatitis B Virus-Hepatitis C Virus: Prevalence, Risk Factors, Pathogenesis, Diagnosis, and Treatment. Front Microbiol 2022; 12:780887. [PMID: 35222296 PMCID: PMC8865087 DOI: 10.3389/fmicb.2021.780887] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Human immunodeficiency virus, hepatitis B virus, and hepatitis C virus are three blood-borne viruses that can cause major global health issues by increasing severe morbidity. There is a high risk of coinfection with these viruses in individuals because of their same transmission routes through blood using shared needles, syringes, other injection equipment, sexual transmission, or even vertical transmission. Coinfection can cause various liver-related illnesses, non-hepatic organ dysfunction, followed by death compared to any of these single infections. The treatment of coinfected patients is complicated due to the side effects of antiviral medication, resulting in drug resistance, hepatotoxicity, and a lack of required responses. On the other hand, coinfected individuals must be treated with multiple drugs simultaneously, such as for HIV either along with HBV or HCV and HBV and HCV. Therefore, diagnosing, treating, and controlling dual infections with HIV, HBV, or HCV is complicated and needs further investigation. This review focuses on the current prevalence, risk factors, and pathogenesis of dual infections with HIV, HBV, and HCV. We also briefly overviewed the diagnosis and treatment of coinfections of these three blood-borne viruses.
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Affiliation(s)
- Sagarika Shahriar
- Biotechnology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Yusha Araf
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Rasel Ahmad
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Pravakar Kattel
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Ganga Sagar Sah
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Tanjim Ishraq Rahaman
- Department of Biotechnology and Genetic Engineering, Faculty of Life Sciences, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Rahila Zannat Sadiea
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Shahnaj Sultana
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md. Sayeedul Islam
- Department of Biological Sciences, Graduate School of Science, Osaka University, Osaka, Japan
| | - Chunfu Zheng
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
| | - Md. Golzar Hossain
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Ferrante ND, Lo Re V. Epidemiology, Natural History, and Treatment of Hepatitis Delta Virus Infection in HIV/Hepatitis B Virus Coinfection. Curr HIV/AIDS Rep 2020; 17:405-414. [PMID: 32607773 DOI: 10.1007/s11904-020-00508-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Limited data exist on the prevalence, determinants, and outcomes of hepatitis delta virus (HDV) infection among HIV/hepatitis B virus (HBV)-coinfected persons. This review provides current evidence on the epidemiology, natural history, and treatment of HDV infection in patients with HIV/HBV coinfection and highlights future research needs. RECENT FINDINGS Cross-sectional studies in Europe, Africa, South America, and Asia show that the prevalence of HDV among HIV/HBV-coinfected patients ranges from 1.2 to 25%. No studies have evaluated the prevalence of HDV infection among HIV/HBV-coinfected patients in the USA. HDV infection increases the risk of hepatic decompensation and hepatocellular carcinoma among HIV/HBV-coinfected patients. HDV treatment remains limited to pegylated interferon-alpha, which results in sustained virologic response in fewer than 25%. Data on the epidemiology, natural history, and treatment of HDV among HIV/HBV-coinfected persons remain limited. More research is needed to address these knowledge gaps in order to better manage HDV coinfection in HIV/HBV-coinfected patients.
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Affiliation(s)
- Nicole D Ferrante
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA.
- Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Xiao Y, Thompson AJ, Howell J. Point-of-Care Tests for Hepatitis B: An Overview. Cells 2020; 9:cells9102233. [PMID: 33023265 PMCID: PMC7650625 DOI: 10.3390/cells9102233] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the heavy disease burden posed by hepatitis B, around 90% of people living with hepatitis B are not diagnosed globally. Many of the affected populations still have limited or no access to essential blood tests for hepatitis B. Compared to conventional blood tests which heavily rely on centralised laboratory facilities, point-of-care testing for hepatitis B has the potential to broaden testing access in low-resource settings and to engage hard-to-reach populations. Few hepatitis B point-of-care tests have been ratified for clinical use by international and regional regulatory bodies, and countries have been slow to adopt point-of-care testing into hepatitis B programs. This review presents currently available point-of-care tests for hepatitis B and their roles in the care cascade, reviewing evidence for testing performance, utility, acceptability, costs and cost-effectiveness when integrated into hepatitis B diagnosis and monitoring programs. We further discuss challenges and future directions in aspects of technology, implementation, and regulation when adopting point-of-care testing in hepatitis B programs.
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Affiliation(s)
- Yinzong Xiao
- Burnet Institute, 3004 Melbourne, VIC, Australia;
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
| | - Alexander J. Thompson
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
| | - Jessica Howell
- Burnet Institute, 3004 Melbourne, VIC, Australia;
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, 3004 Melbourne, VIC, Australia
- Correspondence:
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Sullivan RP, Davies J, Binks P, Dhurrkay RG, Gurruwiwi GG, Bukulatjpi SM, McKinnon M, Hosking K, Littlejohn M, Jackson K, Locarnini S, Davis JS, Tong SYC. Point of care and oral fluid hepatitis B testing in remote Indigenous communities of northern Australia. J Viral Hepat 2020; 27:407-414. [PMID: 31785060 DOI: 10.1111/jvh.13243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 01/17/2023]
Abstract
Many Indigenous Australians in northern Australia living with chronic hepatitis B are unaware of their diagnosis due to low screening rates. A venous blood point of care test (POCT) or oral fluid laboratory test could improve testing uptake in this region. The purpose of this study was to assess the field performance of venous blood POCT and laboratory performance of an oral fluid hepatitis B surface antigen (HBsAg) test in Indigenous individuals living in remote northern Australian communities. The study was conducted with four very remote communities in the tropical north of Australia's Northern Territory. Community research workers collected venous blood and oral fluid samples. We performed the venous blood POCT for HBsAg in the field. We assessed the venous blood and oral fluid specimens for the presence of HBsAg using standard laboratory assays. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the POCT and oral fluid test, using serum laboratory detection of HBsAg as the gold standard. From 215 enrolled participants, 155 POCT and 197 oral fluid tests had corresponding serum HBsAg results. The POCT had a sensitivity of 91.7% and specificity of 100%. Based on a population prevalence of 6%, the PPV was 100% and NPV was 99.5%. The oral fluid test had a sensitivity of 56.8%, specificity of 98.1%, PPV of 97.3% and NPV of 65.9%. The venous blood POCT has excellent test characteristics and could be used to identify individuals with chronic HBV infection in high prevalence communities with limited access to health care. Oral fluid performance was suboptimal.
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Affiliation(s)
- Richard P Sullivan
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Casuarina, NT, Australia.,Department of Infectious Diseases, Immunology and Sexual Health, St George & Sutherland Clinical School, UNSW, Kogarah, NSW, Australia
| | - Jane Davies
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Casuarina, NT, Australia
| | - Paula Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | | | | | | | - Melita McKinnon
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Kelly Hosking
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Top End Health Service, Primary Health Care Branch, Northern Territory Government, Darwin, NT, Australia
| | - Margaret Littlejohn
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Kathy Jackson
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Stephen Locarnini
- Victorian Infectious Diseases Research Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
| | - Joshua S Davis
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Steven Y C Tong
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Victorian Infectious Disease Service, The Royal Melbourne Hospital, Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia
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Frempong MT, Ntiamoah P, Annani-Akollor ME, Owiredu WKBA, Addai-Mensah O, Owiredu EW, Adu-Gyasi D, Agyapong EO, Sallah L. Hepatitis B and C infections in HIV-1 and non-HIV infected pregnant women in the Brong-Ahafo Region, Ghana. PLoS One 2019; 14:e0219922. [PMID: 31323077 PMCID: PMC6641208 DOI: 10.1371/journal.pone.0219922] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B (HBV) or hepatitis C (HCV) virus co-infections in HIV are alarming during pregnancy due to the risk of vertical transmission and the eventual adverse effects on neonates. This study was conducted to ascertain the sero-prevalence of HIV/HBV and HIV/HCV co-infections, evaluate the effect of the co-infections on the immunological and virological characteristics and assess the association between some demographic and lifestyle characteristics and risk of HBV, HCV, HIV/HBV and HIV/HCV co-infections among pregnant women living in the Brong-Ahafo Region of Ghana. METHODS This comparative cross-sectional study was conducted at the anti-retroviral therapy (ART) clinics of the St. Elizabeth Hospital and the Holy Family Hospital, Brong-Ahafo Region, Ghana. A total of 248 consecutive consenting pregnant Ghanaian women, 148 diagnosed with HIV [HIV (+)] and 100 who were HIV negative [HIV (-)], were recruited. Validated questionnaire was used to obtain demographic and lifestyle data. Venous blood samples were obtained and HCV status, HBV profile, CD4+ T cell count, and HIV-1 RNA load were determined. RESULTS The sero-prevalence of HIV (+) /HBV, HIV (+) /HCV, HIV (-)/HBV, and HIV (-)/HCV infections were 22 (14.9%), 6 (4.1%), 10 (10.0%), and 12 (12.0%) respectively. HIV-1 viral load was not significantly different between HIV/HBV, HIV/HCV co-infection and HIV mono-infection. However, CD4+ T lymphocyte count (364 vs 512 vs 514 cells/μl; p = 0.0009) was significantly lower in HIV/HBV co-infection compared to HIV/HCV and HIV mono-infection respectively. There was no significant association between demographic and lifestyle characteristics and risk of HBV and HCV infections in HIV positive and negative subjects except for late diagnosis of HIV and history of sharing razors blades and pins, where increased odds of HIV (+) /HBV and HIV (-)/HBV infection were observed. CONCLUSIONS The prevalence of HIV (+)/HBV (14.9%), HIV (+)/HCV (4.1%), HIV (-)/HBV (10.0%), and HIV (-)/HCV (12.0%) are high among pregnant women in the Brong Ahafo Region of Ghana. HIV/HBV is associated with reduced CD4+ T lymphocyte count but not HIV-1 viral load. Early diagnosis of HIV and intensification of routine antenatal HBV and HCV are essential to abate the risk of maternal to child transmission.
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Affiliation(s)
- Margaret T. Frempong
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paul Ntiamoah
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William K. B. A. Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Lorraine Sallah
- Department of Physiology, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Ranin J, Salemovic D, Brmbolic B, Marinkovic J, Boricic I, Pesic PI, Zerjav S, Stanojevic M, Jevtovic D. Comparison of Demographic, Epidemiological, Immunological, and Clinical Characteristics of Patients with HIV Mono-infection Versus Patients Co-infected with HCV or/and HBV: A Serbian Cohort Study. Curr HIV Res 2019; 16:222-230. [PMID: 30014804 DOI: 10.2174/1570162x16666180717115614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The study aimed to correlate the status of hepatitis C (HCV) and hepatitis B virus (HBV) co-infection in patients with human immunodeficiency virus (HIV) infection with clinical and demographic data prior to starting highly active antiretroviral therapy (HAART) and assess the impact of HCV and HBV co-infection on the natural history of HIV infection. PATIENTS AND METHODS The study involved a total of 836 treatment-naive patients with available serological status for HBV and HCV at the point of therapy initiation. Patients were stratified into four groups: HIV mono-infection, HIV/HCV, HIV/HBV, and HIV/HCV/HBV co-infection. Demographic, epidemiological, immunological and clinical characteristics were analyzed in order to assess the possible impact of HCV and HBV co-infection on HIV - related immunodeficiency and progression to AIDS. RESULTS The prevalence of HCV and HBV co-infection in our cohort was 25.7% and 6.3%, respectively. Triple HIV/HCV/HBV infection was recorded in 1.7% of the patients. In comparison with those co-infected with HCV, patients with HIV mono-infection had lower levels of serum liver enzymes activity and higher CD4 cell counts, and were less likely to have CD4 cell counts below100 cells/µL and clinical AIDS, with OR 0.556 and 0.561, respectively. No difference in the development of advanced immunodeficiency and/or AIDS was recorded between patients with HIV monoinfection and those co-infected with HBV, or both HCV/HBV. CONCLUSION HIV/HCV co-infection was found to be more prevalent than HIV/HBV co-infection in a Serbian cohort. Co-infection with HCV was related to more profound immunodeficiency prior to therapy initiation, reflecting a possible unfavorable impact of HCV on the natural history of HIV infection.
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Affiliation(s)
- J Ranin
- University of Belgrade Faculty of Medicine, University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - D Salemovic
- University of Belgrade Faculty of Medicine, University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - B Brmbolic
- University of Belgrade Faculty of Medicine, University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - J Marinkovic
- University of Belgrade Faculty of Medicine, Institute for Medical Statistics, Belgrade, Serbia
| | - I Boricic
- University of Belgrade Faculty of Medicine, Institute for Pathohystology, Belgrade, Serbia
| | - Pavlovic I Pesic
- Virology Laboratory, Microbiology Department, Clinical Center Serbia, Belgrade, Serbia
| | - S Zerjav
- Virology Laboratory, Microbiology Department, Clinical Center Serbia, Belgrade, Serbia
| | - M Stanojevic
- University of Belgrade Faculty of Medicine, Institute of Microbiology and Immunology, Belgrade, Serbia
| | - D Jevtovic
- University of Belgrade Faculty of Medicine, University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
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Extremely low hepatitis C prevalence among HIV co-infected individuals in four countries in sub-Saharan Africa. AIDS 2019; 33:353-355. [PMID: 30475267 PMCID: PMC6319567 DOI: 10.1097/qad.0000000000002070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A multicentric, retrospective case-series analysis (facility-based) in five sites across Kenya, Malawi, Mozambique, and Uganda screened HIV-positive adults for hepatitis C virus (HCV) antibodies using Oraquick rapid testing and viral confirmation (in three sites). The results reveal a substantially lower prevalence than previously reported for these countries, suggesting that targeted integration of HCV screening in African HIV programs may be more impactful than routine screening.
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Sarkar J, Saha D, Bandyopadhyay B, Saha B, Chakravarty R, Guha SK. Lamivudine plus tenofovir versus lamivudine plus adefovir for the treatment of hepatitis B virus in HIV-coinfected patients, starting antiretroviral therapy. Indian J Med Microbiol 2018; 36:217-223. [PMID: 30084414 DOI: 10.4103/ijmm.ijmm_17_37] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Combination of tenofovir disoproxil fumarate (TDF), lamivudine (3TC) and efavirenz (EFV) is preferred in the treatment of HIV/hepatitis B virus (HBV) coinfection. We postulated that a HBV active nucleoside reverse transcriptase (RT) inhibitor/nucleotide RT inhibitor backbone of adefovir dipivoxil (ADV) +3TC would be as effective as TDF +3TC for the Indian population. Objective ADV + 3TC could be an alternative option for these HIV/HBV coinfected individuals, preserving the dually active TDF + 3TC as second-line nucleoside backbone following failure of the first-line ART. Materials and Methods This randomised control trial (CTRI/2012/03/002471) was carried out at the ART Centre of Calcutta School of Tropical Medicine, India. Seventy-eight (39 on each arm) treatment-naïve HIV/HBV coinfected patients were randomised to receive either the combination of lamivudine + tenofovir + EFV or lamivudine + adefovir + zidovudine + EFV and followed up for 120 weeks. Results Median age of the study participants was 36 years (21-62), majority were male (61/78; 78.2%) and heterosexually (39/78; 50%) infected. Baseline characteristics were identical in both arms. There was no statistically significant difference in median aspartate aminotransferase (37 vs. 29.5 U/L), alanine aminotransferase (ALT) (36 vs. 34.5 U/L), ALT normalisation rate (80 vs. 70%), AST to platelet ratio index (0.45 vs. 0.33), CD4 count (508 vs. 427 cells/mm3), HBV DNA suppression (81.8 vs. 70%), hepatitis B e antigen loss (9 vs. 5%), hepatitis B surface antigen seroclearance rate (6.06 vs. 18.75%) and death (3 vs. 3) at 120 weeks between TDF (n = 33) and ADV (n = 32), respectively. Conclusions Adefovir plus lamivudine is an effective alternative of tenofovir plus lamivudine in long-term HBV treatment outcome in HIV/HBV coinfected patients.
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Affiliation(s)
- Jayeeta Sarkar
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Debraj Saha
- Department of Virology ICMR Virus Unit, ID and BG Hospital Campus, Kolkata, West Bengal, India
| | - Bhaswati Bandyopadhyay
- Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Bibhuti Saha
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Runu Chakravarty
- Department of Virology ICMR Virus Unit, ID and BG Hospital Campus, Kolkata, West Bengal, India
| | - Subhasish Kamal Guha
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
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Epidemiology of hepatitis B, C and D in Malawi: systematic review. BMC Infect Dis 2018; 18:516. [PMID: 30314448 PMCID: PMC6186098 DOI: 10.1186/s12879-018-3428-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022] Open
Abstract
Background Viral hepatitis is an important public health issue in sub-Saharan Africa. Due to rising mortality from cirrhosis and hepatocellular carcinoma and limited implementation of screening and treatment programmes, it has been characterised as a neglected tropical disease. Synthesis of the existing evidence on the epidemiology of viral hepatitis B, C and D in Malawi is required to inform policy and identify research gaps. Methods We searched Pubmed, EMBASE and Scopus for studies reporting the epidemiology of viral hepatitis B, C and D in Malawi from 1990 to 2018. Articles reporting prevalence estimates were included provided they described details of participant selection, inclusion criteria and laboratory methods (detection of HBsAg, anti-HCV or anti-HDV antibody, HCV antigen or HCV RNA or HDV RNA). We assessed study quality using a prevalence assessment tool. Where appropriate, a pooled prevalence was calculated using a DerSimonian Laird random effects model. Results Searches identified 199 studies, 95 full text articles were reviewed and 19 articles were included. Hepatitis B surface antigen (HBsAg) seroprevalence was assessed in 14 general population cohorts. The pooled prevalence among adults was 8.1% (95% CI 6.1, 10.3). In 3 studies where HBsAg was stratified by HIV status, no effect of HIV on HBsAg prevalence was observed (OR 1.2 (95% CI: 0.8, 1.6, p = 0.80)). In a single study of HIV/HBV infected individuals, anti-hepatitis D antibody (anti-HDV) prevalence was low (1.5%). HCV antibody prevalence (anti-HCV) ranged from 0.7 to 18.0% among 12 cohorts in general populations. Among three studies which used PCR to confirm current infection, the pooled rate of HCV RNA confirmation among anti-HCV positive individuals was only 7.3% (95% CI: 0.0, 24.3). Conclusions Hepatitis B is highly prevalent in Malawi. There is a paucity of epidemiological data from rural areas where 85% of the population reside, and the Northern region. Priority research needs include large-scale representative community studies of HBV, HDV and HCV seroprevalence, assessment of children following introduction of the HBV vaccine in 2002, prevalence estimates of viral hepatitis among individuals with cirrhosis and HCC and data on HCV prevalence using PCR confirmation, to support a viral hepatitis strategy for Malawi. Electronic supplementary material The online version of this article (10.1186/s12879-018-3428-7) contains supplementary material, which is available to authorized users.
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Amidou SA, Dovonou CA, Houehanou C, Kpangon AA, Ahanhanzo-Glele R, Kpangon JH, Alassan KS, Angelo AC, Tchaou B, Salifou K, Adoukonou T, Zannou DM, Houinato DS. [Impact of HIV status on the overall prevalence of chronic hepatitis B infection in Parakou, Benin]. Pan Afr Med J 2018; 30:180. [PMID: 30455809 PMCID: PMC6235507 DOI: 10.11604/pamj.2018.30.180.16117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/05/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The prevalence of hepatitis B is very variable across geographic areas and seems to be influenced by HIV infection. This study aims to evaluate the impact of serologic HIV status on the overall prevalence of hepatitis B in a Hospital in Parakou, Benin. METHODS We conducted a cross-sectional study of adults aged 18 years old and over hospitalized in the Departmental University Hospital Center in Parakou between May 2011 and June 2012. The diagnosis of hepatitis B was made on the basis of rapid HBsAg tests while the diagnosis of HIV was made on the basis of rapid HIV tests using venous blood samples. Data were analyzed using EpiInfo software. Multivariate logistic regression model was implemented to investigate factors associated with hepatitis B. RESULTS Out of 1516 subjects included, 744 were HIV seropositive. The average age was 31.3 + 11.1 years and 65.1% were women. The prevalence rate of hepatitis B in the whole sample was 13.9% [CI95:12.2%-15.7%]. This prevalence was higher in HIV seropositive subjects (16.9% vs 10.9%; p < 0.0006), however there was not a more significant difference in multivariate analysis, except for the group of subjects from Borgou/Alibori (p < 0.02). A consistent association was observed between age group 24-44 years (p < 0.03), male sex (p < 0.01), primary school education (p < 0.02) and a high prevalence of hepatitis B. CONCLUSION The prevalence of hepatitis B was higher in HIV seropositive subjects. This was influenced by age, sex, education level and geographical origin.
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Affiliation(s)
- Salimanou Ariyoh Amidou
- Centre d'Information de Prospectives et de Conseils sur les IST/VIH/Sida, Parakou, Bénin
- Service de Médecine Interne, Centre Hospitalier Universitaire de Parakou, Bénin
- Laboratoire d'Epidémiologie des Maladies Chroniques et Neurologiques (LEMACEN), Faculté des Sciences de la Santé de Cotonou, Bénin
| | | | - Corine Houehanou
- Laboratoire d'Epidémiologie des Maladies Chroniques et Neurologiques (LEMACEN), Faculté des Sciences de la Santé de Cotonou, Bénin
| | | | - Rhonel Ahanhanzo-Glele
- Centre d'Information de Prospectives et de Conseils sur les IST/VIH/Sida, Parakou, Bénin
- Service de Médecine Interne, Centre Hospitalier Universitaire de Parakou, Bénin
| | | | | | | | - Blaise Tchaou
- Service des Urgences, Centre Hospitalier Universitaire de Parakou, Bénin
| | - Kabibou Salifou
- Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Parakou, Bénin
| | - Thierry Adoukonou
- Service de Médecine Interne, Centre Hospitalier Universitaire de Parakou, Bénin
- Laboratoire d'Epidémiologie des Maladies Chroniques et Neurologiques (LEMACEN), Faculté des Sciences de la Santé de Cotonou, Bénin
| | | | - Dismand Stephan Houinato
- Laboratoire d'Epidémiologie des Maladies Chroniques et Neurologiques (LEMACEN), Faculté des Sciences de la Santé de Cotonou, Bénin
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Deressa T, Damtie D, Fonseca K, Gao S, Abate E, Alemu S, Aleka Y, Swain MG, van Marle G, Coffin CS. The burden of hepatitis B virus (HBV) infection, genotypes and drug resistance mutations in human immunodeficiency virus-positive patients in Northwest Ethiopia. PLoS One 2017; 12:e0190149. [PMID: 29281718 PMCID: PMC5744989 DOI: 10.1371/journal.pone.0190149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/09/2017] [Indexed: 12/24/2022] Open
Abstract
Background In sub-Saharan Africa, the hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are endemic. Although there has been great progress in HIV care, universal HBV vaccination and care is lacking. In this study, we aimed to determine the prevalence of HBV, HBV genotypes, and drug resistance mutations in dual infected cases in a cohort of HIV patients in Northwest Ethiopia. Methods A total of 308 HIV-1 positive patients were enrolled into the study and tested for HBsAg in plasma. In HBsAg positive samples, HBV DNA was analyzed for HBV genotype using in-house nested PCR with HBV-specific pre-core / core or surface primers, and for HBV drug resistance mutations (DRMs) in polymerase region. Odds ratio at 95% confidence interval was calculated. Results Of the 308 HIV-positive subjects, 62.7% were female, median age 38 years (range 18–68, IQR: 27–49), and the median CD4 count 405 cells/μl (IQR: 75–734). Overall, 94.2% were on antiretroviral therapy (ART) frequently with combinations of Zidovudine (AZT)- Lamivudine (3TC)—Nevirapine (NVP). HBsAg was detected in 5.5% (95%CI 2.95–8.08%) of the study participants, of which the majority were infected with HBV genotype A (7A, 2E, 2D, 1C, 1 G). All HIV/HBV positive cases were on ART with anti-HBV activity (i.e., 3TC) and 3TC associated HBV DRMs (i.e., rtV173L, rtL180M, and rtM204V) were detected in 7/13 (53.8%) subjects. Conclusion In this cross-sectional study of HIV-infected individuals, we found 5.5% HBV/HIV co-infected cases. Most were receiving the first generation anti-HBV therapy with a low genetic barrier to resistance, and several carried mutations associated with anti-HBV (3TC) drug resistance. These data underscore the importance of integrating HBV screening to the HIV treatment guidelines for better management and prevention of HBV-related liver disease.
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Affiliation(s)
- Tekalign Deressa
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Debasu Damtie
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kevin Fonseca
- Provincial Laboratory for Public Health, Calgary, Alberta, Canada
| | - Shan Gao
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ebba Abate
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Ethiopian Public health institute, Addis Ababa, Ethiopia
| | - Shitaye Alemu
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yetemwork Aleka
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mark G. Swain
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Guido van Marle
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carla S. Coffin
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Abstract
Viral suppression of human immunodeficiency virus (HIV) with combination antiviral therapy (cART) has led to increasing longevity but has not enabled a complete return to health among aging HIV-infected individuals (HIV+). Viral coinfections are prevalent in the HIV+ host and are implicated in cancer, liver disease, and accelerated aging. We must move beyond a simplistic notion of HIV becoming a "chronic controllable illness" and develop an understanding of how viral suppression alters the natural history of HIV infection, especially at the intersection of HIV with other common viral coinfections in the context of an altered, aging immune system.
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Diagnostic accuracy of tests to detect hepatitis B surface antigen: a systematic review of the literature and meta-analysis. BMC Infect Dis 2017; 17:698. [PMID: 29143619 PMCID: PMC5688498 DOI: 10.1186/s12879-017-2772-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic Hepatitis B Virus (HBV) infection is characterised by the persistence of hepatitis B surface antigen (HBsAg). Expanding HBV diagnosis and treatment programmes into low resource settings will require high quality but inexpensive rapid diagnostic tests (RDTs) in addition to laboratory-based enzyme immunoassays (EIAs) to detect HBsAg. The purpose of this review is to assess the clinical accuracy of available diagnostic tests to detect HBsAg to inform recommendations on testing strategies in 2017 WHO hepatitis testing guidelines. METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using 9 databases. Two reviewers independently extracted data according to a pre-specified plan and evaluated study quality. Meta-analysis was performed. HBsAg diagnostic accuracy of rapid diagnostic tests (RDTs) was compared to enzyme immunoassay (EIA) and nucleic-acid test (NAT) reference standards. Subanalyses were performed to determine accuracy among brands, HIV-status and specimen type. RESULTS Of the 40 studies that met the inclusion criteria, 33 compared RDTs and/or EIAs against EIAs and 7 against NATs as reference standards. Thirty studies assessed diagnostic accuracy of 33 brands of RDTs in 23,716 individuals from 23 countries using EIA as the reference standard. The pooled sensitivity and specificity were 90.0% (95% CI: 89.1, 90.8) and 99.5% (95% CI: 99.4, 99.5) respectively, but accuracy varied widely among brands. Accuracy did not differ significantly whether serum, plasma, venous or capillary whole blood was used. Pooled sensitivity of RDTs in 5 studies of HIV-positive persons was lower at 72.3% (95% CI: 67.9, 76.4) compared to that in HIV-negative persons, but specificity remained high. Five studies evaluated 8 EIAs against a chemiluminescence immunoassay reference standard with a pooled sensitivity and specificity of 88.9% (95% CI: 87.0, 90.6) and 98.4% (95% CI: 97.8, 98.8), respectively. Accuracy of both RDTs and EIAs using a NAT reference were generally lower, especially amongst HIV-positive cohorts. CONCLUSIONS HBsAg RDTs have good sensitivity and excellent specificity compared to laboratory immunoassays as a reference standard. Sensitivity of HBsAg RDTs may be lower in HIV infected individuals.
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Tang W, Chen W, Amini A, Boeras D, Falconer J, Kelly H, Peeling R, Varsaneux O, Tucker JD, Easterbrook P. Diagnostic accuracy of tests to detect Hepatitis C antibody: a meta-analysis and review of the literature. BMC Infect Dis 2017; 17:695. [PMID: 29143615 PMCID: PMC5688422 DOI: 10.1186/s12879-017-2773-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although direct-acting antivirals can achieve sustained virological response rates greater than 90% in Hepatitis C Virus (HCV) infected persons, at present the majority of HCV-infected individuals remain undiagnosed and therefore untreated. While there are a wide range of HCV serological tests available, there is a lack of formal assessment of their diagnostic performance. We undertook a systematic review and meta-analysis to evaluate he diagnostic accuracy of available rapid diagnostic tests (RDT) and laboratory based EIA assays in detecting antibodies to HCV. METHODS We used the PRISMA checklist and Cochrane guidance to develop our search protocol. The search strategy was registered in PROSPERO (CRD42015023567). The search focused on hepatitis C, diagnostic tests, and diagnostic accuracy within eight databases (MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, SCOPUS, Literatura Latino-Americana e do Caribe em Ciências da Saúde and WHO Global Index Medicus. Studies were included if they evaluated an assay to determine the sensitivity and specificity of HCV antibody (HCV Ab) in humans. Two reviewers independently extracted data and performed a quality assessment of the studies using the QUADAS tool. We pooled test estimates using the DerSimonian-Laird method, by using the software R and RevMan. 5.3. RESULTS A total of 52 studies were identified that included 52,673 unique test measurements. Based on five studies, the pooled sensitivity and specificity of HCV Ab rapid diagnostic tests (RDTs) were 98% (95% CI 98-100%) and 100% (95% CI 100-100%) compared to an enzyme immunoassay (EIA) reference standard. High HCV Ab RDTs sensitivity and specificity were observed across screening populations (general population, high risk populations, and hospital patients) using different reference standards (EIA, nucleic acid testing, immunoblot). There were insufficient studies to undertake subanalyses based on HIV co-infection. Oral HCV Ab RDTs also had excellent sensitivity and specificity compared to blood reference tests, respectively at 94% (95% CI 93-96%) and 100% (95% CI 100-100%). Among studies that assessed individual oral RDTs, the eight studies revealed that OraQuick ADVANCE® had a slightly higher sensitivity (98%, 95% CI 97-98%) compared to the other oral brands (pooled sensitivity: 88%, 95% CI 84-92%). CONCLUSIONS RDTs, including oral tests, have excellent sensitivity and specificity compared to laboratory-based methods for HCV antibody detection across a wide range of settings. Oral HCV Ab RDTs had good sensitivity and specificity compared to blood reference standards.
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Affiliation(s)
- Weiming Tang
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, 510095 China
- Guangdong Provincial Dermatology Hospital (Dermatology Hospital, Southern Medical University), Guangzhou, China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Wen Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Ali Amini
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Debi Boeras
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Jane Falconer
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Helen Kelly
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Rosanna Peeling
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Olivia Varsaneux
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Joseph D. Tucker
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, 510095 China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Philippa Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
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Chipetah F, Chirambo A, Billiat E, Shawa IT. Hepatitis B virus seroprevalence among Malawian medical students: A cross-sectional study. Malawi Med J 2017; 29:29-31. [PMID: 28567193 DOI: 10.4314/mmj.v29i1.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) predominantly spreads through contact with infected blood or other body fluids and causes liver disease. HBV vaccination for students at the College of Medicine, University of Malawi, is done without screening for the virus. It is important to assess the prevalence of HBV antigens among foundation-year students in order to consolidate evidence in support of HBV screening before vaccination. The aim of this study was to determine the seroprevalence of HBV antigens among 2013-2014 foundation-year students at the University of Malawi College of Medicine. METHODS A prospective cross-sectional descriptive study was conducted among 2013-2014 foundation year students at the Malawi College of Medicine. Out of the 234 foundation-year students, written consent was obtained from 89 students. Venous blood samples were collected and tested for HBV surface antigen using SD Bioline immunochromatographic rapid assays. RESULTS Out of the 62 (69.7%) male students, none tested HBV-positive, and out of 27 (30.3%) female students, none were seropositive. This suggested the absence of HBsAg among students or presence of HBsAg levels below detectable limits. CONCLUSIONS This study showed levels of HBsAg below detectable limits among healthy young adults in Malawi. HBV screening for medical students should further be assessed to ensure adequate protection before they are assigned clinical duties. These findings provide enough grounds to agitate for further surveys to support the establishment of a universal HBV immunisation programme in Malawi.
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Affiliation(s)
- Froid Chipetah
- Department of Pathology and Medical Laboratory Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Aaron Chirambo
- Department of Pathology and Medical Laboratory Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Ednas Billiat
- Department of Pathology and Medical Laboratory Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Isaac Thom Shawa
- Department of Pathology and Medical Laboratory Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
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Garve R, Garve M, Türp JC, Fobil JN, Meyer CG. Scarification in sub-Saharan Africa: social skin, remedy and medical import. Trop Med Int Health 2017; 22:708-715. [DOI: 10.1111/tmi.12878] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Roland Garve
- Center for Natural and Cultural History of Man; Danube Private University; Krems Austria
| | - Miriam Garve
- Department of Quality Management and Accreditation; Leuphana University; Lüneburg Germany
| | - Jens C. Türp
- Center for Natural and Cultural History of Man; Danube Private University; Krems Austria
- University Center for Dental Medicine Basel; University of Basel; Basel Switzerland
| | - Julius N. Fobil
- Department of Biological, Environmental and Occupational Health Sciences; University of Ghana; Accra Ghana
| | - Christian G. Meyer
- Duy Tan University; Da Nang Vietnam
- Institute for Tropical Medicine; Eberhard Karls University; Tübingen Germany
- Health Focus GmbH; Potsdam Germany
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Mandiwana A, Tshitenge S. Prevalence of human immunodeficiency virus — hepatitis B virus co-infection amongst adult patients in Mahalapye, Ngami, Serowe, Botswana: a descriptive cross-sectional study. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2016.1272230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Stephane Tshitenge
- Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
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Schnelltest-Diagnostik sexuell übertragbarer Infektionen in niedrigschwelligen Einrichtungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 60:245-254. [DOI: 10.1007/s00103-016-2496-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Luma HN, Eloumou SAFB, Ekaney DSM, Lekpa FK, Donfack-Sontsa O, Ngahane BHM, Mapoure YN. Sero-prevalence and Correlates of Hepatitis B and C Co-infection Among HIV-infected Individuals in Two Regional Hospitals in Cameroon. Open AIDS J 2016; 10:199-208. [PMID: 27867437 PMCID: PMC5095895 DOI: 10.2174/1874613601610010199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Liver disease related to Hepatitis B (HBV) and C (HCV) infection has become a major cause of morbidity and mortality in HIV/AIDS patients. Data on the prevalence of HBV and HCV in Cameroon remains inconclusive. OBJECTIVE We aimed to determine the sero-prevalence and correlates of Hepatitis markers in HIV/AIDS patients in two Regional Hospitals. METHODS A cross-sectional study carried out from December 2014 to March 2015. HIV/AIDS patients aged 21 were included and above, receiving care at HIV treatment centres. Data was collected using a structured questionnaire. Blood samples were collected to screen for Hepatitis with HBsAg and anti HCV antibody rapid immunochromatographic test kits. Correlates of hepatitis were investigated by logistic regression. STATA was used for data analysis. RESULTS We included 833 HIV/AIDS patients,78.8% (657) were female. Mean age was 44(SD 11) years. Prevalence of Hepatitis in general (total of two viral markers tested) was 8.9% (74/833), with 6.1% for HBsAg and 2.8% for Anti-HCV antibodies. From multivariate analysis, the likelihood of having hepatitis was independently increased by a history of surgical interventions [OR: 1.82(1.06-3.14)], and of sexually transmitted infections [OR: 2.20(1.04-4.67)]. CONCLUSION Almost one in ten participants with HIV/AIDS attending the BRH and LRH tested positive for either HBsAg or anti HCV antibodies. Screening for HBV and HCV should therefore be integrated to the existing guidelines in Cameroon as it can influence management. More studies are needed to evaluate the extent of liver disease and magnitude of HIV suppression in hepatitis and HIV coinfection in this setting.
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Affiliation(s)
- Henry Namme Luma
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Servais Albert Fiacre Bagnaka Eloumou
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | | | - Bertrand Hugo Mbatchou Ngahane
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Yacouba Njankouo Mapoure
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Kye-Duodu G, Nortey P, Malm K, Nyarko KM, Sackey SO, Ofori S, Afari EA. Prevalence of hepatitis B virus co-infection among HIV-seropositive persons attending antiretroviral clinics in the Eastern Region of Ghana. Pan Afr Med J 2016; 25:7. [PMID: 28210375 PMCID: PMC5292113 DOI: 10.11604/pamj.supp.2016.25.1.6172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/06/2016] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Hepatitis B and HIV infections are endemic in sub-Saharan Africa including Ghana. Understanding the extent of the co-infection is critical to the optimal care of persons living with HIV and AIDS (PLHIV). We determined the prevalence and risk factors of HBV co-infection in PLHIV and assessed the knowledge of health care workers (HCW) in Antiretroviral Therapy (ART) clinics regarding the co-infection. METHODS A cross sectional study was conducted in five ART clinics to obtain data from a systematic random sample of PLHIV in the Eastern region of Ghana from March to June 2012. We used self-administered questionnaires to assess knowledge of HCW on knowledge and management of the co-infection. Descriptive statistics and logistic regression models were used for analysis at 5% significance level. RESULTS Of 320 PLHIV recruited into study, with median age of 40 years (IQR: 33-50 years), 28 tested positive for HBsAg giving an overall prevalence of 8.8%. There were significant associations between HBV infection and being an adult (p=0.004), increasing serum ALT levels (p=0.002) and partner with history of HBV infection (p=0.010). HCW obtained 84.2% (SD± 20.53; 95% CI: 89-98.1) and 53.1% (SD± 35.06; 95% CI: 13.0-88.9) in the "general knowledge" and "management practice" indexes respectively. CONCLUSION Prevalence of HBV-HIV co-infection was relatively high among PLHIV in Eastern region. Knowledge of HCW on management practices of HBV-HIV co-infection and HBV vaccination coverage among PLHIV were found to be relatively low. Regular trainings of HCW and a HBV vaccination programme targeted at PLHIV should be considered.
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Affiliation(s)
- Gideon Kye-Duodu
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
| | - Priscillia Nortey
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
| | - Keziah Malm
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
| | - Kofi Mensah Nyarko
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
| | - Sampson Ofori
- Ghana Health Service, Regional Hospital, Koforidua, Eastern Region, Ghana
| | - Edwin Andrews Afari
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, P.O. Box LG 13, Accra, Ghana
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Basnayake SK, Easterbrook PJ. Wide variation in estimates of global prevalence and burden of chronic hepatitis B and C infection cited in published literature. J Viral Hepat 2016; 23:545-59. [PMID: 27028545 DOI: 10.1111/jvh.12519] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/14/2016] [Indexed: 12/15/2022]
Abstract
To evaluate the extent of heterogeneity in global estimates of chronic hepatitis B (HBV) and C (HCV) cited in the published literature, we undertook a systematic review of the published literature. We identified articles from 2010 to 2014 that had cited global estimates for at least one of ten indicators [prevalence and numbers infected with HBV, HCV, HIV-HBV or HIV-HCV co-infection, and mortality (number of deaths annually) for HBV and HCV]. Overall, 488 articles were retrieved: 239 articles cited a HBV-related global estimate [prevalence (n = 12), number infected (n = 193) and number of annual deaths (n = 82)]; 280 articles had HCV-related global estimates [prevalence (n = 86), number infected (n = 203) and number of annual deaths (n = 31)]; 31 had estimates on both HBV and HCV; 54 had HIV-HBV co-infection estimates [prevalence (n = 42) and number co-infected (n = 12)]; and 68 had estimates for HIV-HCV co-infection [prevalence (n = 40) and number co-infected (n = 28)]. There was considerable heterogeneity in the estimates cited and also a lack of consistency in the terminology used. Although 40% of 488 articles cited WHO as the source of the estimate, many of these were from outdated or secondary sources. Our findings highlight the importance of clear and consistent communication from WHO and other global health agencies on current consensus estimates of hepatitis B and C burden and prevalence, the need for standardisation in their citation, and for regular updates.
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Affiliation(s)
| | - P J Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
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Olawumi HO, Olanrewaju DO, Shittu AO, Durotoye IA, Akande AA, Nyamngee A. Effect of Hepatitis B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients. Ghana Med J 2016; 49:2-6. [PMID: 26339077 DOI: 10.4314/gmj.v49i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co- infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and co-infected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co-infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.
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Affiliation(s)
- H O Olawumi
- Department of Haematology and Blood Transfusion, University of Ilorin, Ilorin, Nigeria
| | - D O Olanrewaju
- Department of Haematology and Blood Transfusion, Ambrose Alli University, Ekpoma, Nigeria
| | - A O Shittu
- Department of Haematology and Blood Transfusion, University of Ilorin, Ilorin, Nigeria
| | - I A Durotoye
- Department of Haematology and Blood Transfusion, University of Ilorin, Ilorin, Nigeria
| | - A A Akande
- Department of Chemical Pathology and Immunology, University of Ilorin, Ilorin, Nigeria
| | - A Nyamngee
- Department of Microbiology and Parasitology, University of Ilorin, Ilorin, Nigeria
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Varo R, Chris Buck W, Kazembe PN, Phiri S, Andrianarimanana D, Weigel R. Seroprevalence of CMV, HSV-2 and HBV among HIV-Infected Malawian Children: A Cross-sectional Survey. J Trop Pediatr 2016; 62:220-6. [PMID: 26884443 PMCID: PMC4912665 DOI: 10.1093/tropej/fmv105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Little is known about viral co-infections in African human immunodeficiency virus (HIV)-infected children. We examined the prevalence of seromarkers for cytomegalovirus (CMV), herpes simplex virus type 2 (HSV-2) and hepatitis B virus (HBV) infections among HIV-infected, antiretroviral treatment (ART)-naïve children in Lilongwe, Malawi. METHODS Ninety-one serum samples were tested for IgG and IgM antibodies to CMV, and IgG antibodies to HSV-2 and hepatitis B surface antigen (HBsAg). Baseline demographic, clinical and laboratory data were abstracted from electronic records. RESULTS CMV IgG was the most common positive result in all age groups (in 73% of children <1 year, and 100% in all other groups). Three patients were CMV IgM positive (3.3%), suggesting acute infection. HSV-2 IgG was positive in four patients (4.4%), and HBsAg in two (2.2%). CONCLUSIONS CMV infection occurred early in life, and few children had specific signs of CMV infection at the time of ART initiation. Unrecognized HBV infection represents opportunities for testing and treatment of HIV/HBV co-infected children.
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Affiliation(s)
- Rosauro Varo
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique Barcelona Institute for Global Health (IS Global), Barcelona, Spain
| | - W. Chris Buck
- University of California Los Angeles, David Geffen School of Medicine, Maputo, Mozambique,Baylor College of Medicine Abbott Fund Children’s Clinical Centre of Excellence, Lilongwe, Malawi
| | - Peter N. Kazembe
- Baylor College of Medicine Abbott Fund Children’s Clinical Centre of Excellence, Lilongwe, Malawi
| | | | | | - Ralf Weigel
- Liverpool School of Tropical Medicine, Liverpool, UK
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28
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Taha TE, Rusie LK, Labrique A, Nyirenda M, Soko D, Kamanga M, Kumwenda J, Farazadegan H, Nelson K, Kumwenda N. Seroprevalence for Hepatitis E and Other Viral Hepatitides among Diverse Populations, Malawi. Emerg Infect Dis 2016; 21:1174-82. [PMID: 26079666 PMCID: PMC4480384 DOI: 10.3201/eid2107.141748] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Analysis of blood samples collected over 20 years suggests substantial underestimation of this virus in this country. Data on prevalence of hepatitis E virus (HEV) in Malawi is limited. We tested blood samples from HIV-uninfected and -infected populations of women and men enrolled in research studies in Malawi during 1989–2008 to determine the seroprevalence of HEV, hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Samples were tested for IgG against HEV, total antibodies against HAV and HCV, and presence of HBV surface antigens. Of 800 samples tested, 16.5% were positive for HEV IgG, 99.6% were positive for HAV antibodies, 7.5% were positive for HBV surface antigen, and 7.1% were positive for HCV antibodies. No clear trends over time were observed in the seroprevalence of HEV, and HIV status was not associated with hepatitis seroprevalence. These preliminary data suggest that the seroprevalence of HEV is high in Malawi; the clinical effects may be unrecognized or routinely misclassified.
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Atsbaha AH, Asmelash Dejen T, Belodu R, Getachew K, Saravanan M, Wasihun AG. Sero-prevalence and associated risk factors for hepatitis C virus infection among voluntary counseling testing and anti retroviral treatment clinic attendants in Adwa hospital, northern Ethiopia. BMC Res Notes 2016; 9:121. [PMID: 26905429 PMCID: PMC4765222 DOI: 10.1186/s13104-016-1936-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 02/12/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major health concern where about 3% of the world's population is infected globally. In Ethiopia the prevalence ranges from 0.9 to 1.3% in the general populations. Human immune deficiency virus (HIV) patients due to their weak immune response are heavily affected by the virus. There is no data on magnitude and associated risk factors for HCV infection among voluntary counseling, testing center and anti retroviral treatment clinic Attendants in the study area. Therefore, the aim of this study was to determine the sero-prevalence and associated risk factors for HCV infection among voluntary counseling testing and anti retroviral treatment clinic attendants Adwa general hospital. METHODS Cross sectional study was carried out among 302 participants (151 HIV-negative from VCT and 151 HIV-positive from ART follow up) clinics of Adwa hospital from September to December, 2014. About 5 ml of venous blood samples were collected from study participants for anti HCV antibody tests. Univariate analyses were used to identify associated variables with anti HCV positivity. Variables having p < 0.05 were considered as statistically significant association. RESULTS Out of the total 302 participants, 52.6% of them were females and 47.4% males. The mean age of the participants was 34.1 year (SD ± 10.5). The overall sero-prevalence of HCV in this study was 4.3%. The prevalence HCV (6.6%) was higher among the ART clinic attendants than the VCT (2%) clinic attendants. History of hospitalization (p = 0.001), tooth extraction (p = 0.018) and blood transfusion (p = 0.041) showed statistically significant association with anti-HCV antibody. CONCLUSION HCV sero-prevalence in this study was high. The prevalence was three fold higher among HIV positive patients than their counter parts. Thus, screening of HCV should be done among HIV patients for close monitoring and better management in HIV patients.
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Affiliation(s)
| | - Tsehaye Asmelash Dejen
- Department of Medical Microbiology and Immunology, Institute of Biomedical Science, College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia.
| | - Rashmi Belodu
- Department of Medical Microbiology and Immunology, Institute of Biomedical Science, College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia.
| | - Konjit Getachew
- Department of Medical Microbiology and Immunology, Institute of Biomedical Science, College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia.
| | - Muthupandian Saravanan
- Department of Medical Microbiology and Immunology, Institute of Biomedical Science, College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia.
| | - Araya Gebreyesus Wasihun
- Department of Medical Microbiology and Immunology, Institute of Biomedical Science, College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia.
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Mtengezo J, Lee H, Ngoma J, Kim S, Aronowitz T, DeMarco R, Shi L. Knowledge and Attitudes toward HIV, Hepatitis B Virus, and Hepatitis C Virus Infection among Health-care Workers in Malawi. Asia Pac J Oncol Nurs 2016; 3:344-351. [PMID: 28083551 PMCID: PMC5214867 DOI: 10.4103/2347-5625.195921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The highest prevalence of HIV infection occurs in Sub-Saharan Africa and hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence are the second highest in Sub-Saharan Africa including Malawi. Health-care workers (HCWs) play an important role in the prevention of, response to, and management of these infectious diseases. There is, however, no published research about the level of knowledge and attitudes toward HIV, HBV, and HCV infection among Malawian HCWs. The purpose of this study was to explore and determine the knowledge of and attitudes toward HIV, HBV, and HCV among a targeted population of Malawian HCWs. Methods: A cross-sectional community-based participatory research with 194 HCWs was completed employing health survey method. The project was a collaborative effort between nursing faculties in the USA and Malawian. A one-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in knowledge and attitude among three subgroups of HCWs. Results: Of 194 of Malawian HCWs surveyed, 41% were support staff, 37% were nursing students, and 22% were health-care professionals. Both health-care professionals and support staff had high knowledge scores related to HIV/AIDS, and their attitudes were mainly positive. However, a series of one-way ANOVAs revealed significant differences in knowledge and attitude toward HIV/AIDs, HBV, and HCV among HCWs (P < 0.01). The majority had less knowledge about HBV and HCV and more negative attitudes toward hepatitis. Conclusions: This study highlights the ongoing need for reducing negative attitudes toward HIV, HBV, and HCV; and providing health education among HCWs, especially focusing on HBV and HCV prevention. The findings of the research project can be used to develop interventions addressing low HBV- and HCV-related knowledge and attitudes.
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Affiliation(s)
- Jasintha Mtengezo
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA; College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Haeok Lee
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA; College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Jonathan Ngoma
- General Medicine, Kamuzu Central Hospital, Lilongwe, Malawi; General Medicine, College of Medicine, Blantyre, Malawi
| | - Susie Kim
- College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Teri Aronowitz
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Rosanna DeMarco
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Ling Shi
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
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Olawumi HO, Olanrewaju DO, Shittu AO, Durotoye IA, Akande AA, Nyamngee A. Effect of hepatitis-B virus co-infection on CD4 cell count and liver function of HIV infected patients. Ghana Med J 2015; 48:96-100. [PMID: 25667557 DOI: 10.4314/gmj.v48i2.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen. Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co-infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.
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Affiliation(s)
- H O Olawumi
- Department of Haematology, University of Ilorin, Ilorin, Nigeria
| | - D O Olanrewaju
- Department of Haematology and Blood Transfusion, Ambrose Alli University, Ekpoma, Nigeria
| | - A O Shittu
- Department of Haematology, University of Ilorin, Ilorin, Nigeria
| | - I A Durotoye
- Department of Haematology, University of Ilorin, Ilorin, Nigeria
| | - A A Akande
- Department of Chemical Pathology and Immunology, University of Ilorin, Ilorin, Nigeria
| | - A Nyamngee
- Department of Microbiology and Parasitology, University of Ilorin, Ilorin, Nigeria
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Merchant RC, DeLong AK, Liu T, Baird JR. Factors Influencing Uptake of Rapid HIV and Hepatitis C Screening Among Drug Misusing Adult Emergency Department Patients: Implications for Future HIV/HCV Screening Interventions. AIDS Behav 2015; 19:2025-35. [PMID: 26036465 DOI: 10.1007/s10461-015-1103-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this randomized, controlled trial among 957 English- or Spanish-speaking drug misusing adult emergency department (ED) patients, we determined if a tailored brief intervention (BI) increased uptake of rapid HIV/HCV screening, and identified factors associated with greater screening uptake. Rapid HIV/HCV screening uptake was greater in the control than the BI arm (45 vs. 38 %; p < 0.04). Screening uptake depended on elapsed study time and which research staff member offered testing. In the control arm, uptake was lowest for those spending <30 or ≥90 min in the study. In the BI arm, screening uptake generally increased over time. Tailored BI content specifically addressing participant HIV/HCV knowledge, HIV/HCV risk behaviors, or need for HIV/HCV screening was not associated with greater screening uptake. These study findings suggested factors that should be considered when designing future ED-based screening initiatives, such as elapsed study time, who offers testing, and the content of interventions.
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Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy Street, Claverick Building, Providence, RI, 02903, USA.
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Allison K DeLong
- Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Tao Liu
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Janette R Baird
- Department of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy Street, Claverick Building, Providence, RI, 02903, USA
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Shevell L, Meriki HD, Cho-Ngwa F, Fuller C. Epidemiology of human immunodeficiency virus-1 and hepatitis B virus co-infection and risk factors for acquiring these infections in the Fako division of Southwest Cameroon. BMC Public Health 2015; 15:1066. [PMID: 26476872 PMCID: PMC4609073 DOI: 10.1186/s12889-015-2386-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 10/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background Past studies have demonstrated that a large population of Cameroonians are afflicted with human immunodeficiency virus (HIV) and/or hepatitis B virus (HBV) demonstrating a need for better prevention programs. We aim to describe the prevalence of HIV, HBV and HIV/HBV co-infection; examine the association between HIV and HBV; and determine risk correlates associated with HIV and HBV transmission in Southwest Cameroon. Methods A cross-sectional, community-based surveillance study was conducted among adults in five hospitals , one in each of the five health districts of the Fako division of the Southwest region of Cameroon. Participants underwent pre- and post-test counselling, a 30-question survey and blood draw for HIV and HBV serologic testing. To construct a final model, chi-squared tests and logistic regression were used to investigate associations. Results Among 761 participants, 40.32 % were male, mean age was 35.21 ± 12.42 years, and the prevalence of HIV, HBV and HIV/HBV co-infection was 10.69 % , 9.86 % , and 1.16 % , respectively. There was no association between HIV and HBV infection. However, there was a statistically significant crude associated (p-value < 0.05) between HIV and three high-risk sexual behaviour variables: condom use, number of lifetime sexual partners, and age at first sexual intercourse. After adjustment, HIV status continued to be associated with number of lifetime sexual partners (adjusted odds ratio (AOR) = 2.26; 95 % confidence interval (CI) =1.22–4.17) and age at first sexual intercourse (AOR = 2.63; 95 % CI =1.44–4.81). In contrast, none of the high-risk sexual behaviours was associated with HBV. Conclusions The prevalence of HIV and HBV was relatively high in the Southwest region of Cameroon, emphasizing the importance of intervention and treatment programs in this country. Additionally, the results from this study suggest that unlike HIV, HBV is not associated with sexual risk factors and may provide evidence that HBV is acquired through routes other than sexual transmission, warranting further investigation in this region.
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Affiliation(s)
- Lauren Shevell
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA.
| | - Henry Dilonga Meriki
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Fidelis Cho-Ngwa
- Department of Biochemistry and Microbiology, University of Buea, Buea, Cameroon.
| | - Crystal Fuller
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA.
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Noubiap JJN, Aka PV, Nanfack AJ, Agyingi LA, Ngai JN, Nyambi PN. Hepatitis B and C Co-Infections in Some HIV-Positive Populations in Cameroon, West Central Africa: Analysis of Samples Collected Over More Than a Decade. PLoS One 2015; 10:e0137375. [PMID: 26371878 PMCID: PMC4570762 DOI: 10.1371/journal.pone.0137375] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/14/2015] [Indexed: 01/15/2023] Open
Abstract
As people infected with the human immunodeficiency virus (HIV) in Sub-Saharan Africa live longer due to availability of antiretroviral treatment (ART), so is the rise of associated infections with their burdens on patients. But reliable data on the prevalence of co-infection with hepatitis B (HBV) or C (HCV) still remains sparse and many individuals with HIV do not know their co-infection status. This study attempted to estimate the seroprevalence and identify risk factors associated with hepatitis B and/or C co-infections in HIV-infected individuals from five Regions of Cameroon by screening 531 HIV infected subjects for the presence of HBV surface antigen (HBsAg) and antibodies to HCV (HCV-Ab). A Screening and a confirmatory Enzyme linked immunosorbent assay were used to detect presence of markers of infection. CD4 count levels were also examined. The results indicate that of the 531 participants, 68% were females and 32% males. Mean CD4 count was ~400 cells/μl. Seroprevalence rates for HBsAg and HCV-Ab were 23.7%, and 7.2%, respectively. Associations assessed using logistic regression revealed that HBsAg but not HCV-Ab positivity was linked to age, lower CD4 count and residing in an urban rather than in a rural setting. This high prevalence of co-infection with HBV raises the urgent need to systematically screen all newly diagnosed HIV cases for co-infection in Cameroon and other regions of sub-Saharan Africa where HIV accounts for the majority of the global infection, so as to improve management strategies for HBV infection and ART implementation.
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Affiliation(s)
| | - Peter V. Aka
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Aubin J. Nanfack
- Department of Pathology, New York University School of Medicine, New York, New York, United States of America
- Faculty of Medicine and Surgery, Department of Immunology and Applied Biotechnology, University of Rome Tor Vergatta, Rome, Italy
| | - Lucy A. Agyingi
- Serology Unit, Medical Diagnostic Center, Yaounde, Cameroon
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | | | - Phillipe N. Nyambi
- Department of Pathology, New York University School of Medicine, New York, New York, United States of America
- Veterans Affairs New York Harbor Healthcare Systems, New York, New York, United States of America
- * E-mail:
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35
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Essomba NE, Mbatchou Ngahane BH, Nida M, Temfack E, Mapoure Njankouo Y, Abeng RL, Fokalbo ZK, Achu Joko H, Mbenoun M, Meledie AP, Halle MP, Malongue A, Tchente C, Nana Njamen T, Halle Ekane G, Ngwane S, Barla E, Abena P, Ndobo P, Moungo Kuidjeu C, Adiogo D, Mouelle Sone A, Luma Namme H, Coppieters Y. [Clinical and immunological profile of HIV-infected patients at the initiation of antiretroviral therapy in Douala]. ACTA ACUST UNITED AC 2015; 108:255-61. [PMID: 26296430 DOI: 10.1007/s13149-015-0444-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 07/07/2015] [Indexed: 01/06/2023]
Abstract
The aim of this study was to describe the clinical and immunological profile of patients infected with HIV after initiation of antiretroviral therapy. Sociodemographic characteristics, clinical and immunological patients were recorded. Chi square test and Mann-Whitney were used to compare variables. The multivariate regression model identified risk factors. So that, 936 (56.2%) patients were in stages III and IV of the WHO and 65.2% at an advanced stage of the disease. Factors associated with initiation at an advanced stage, were male sex (p = 0.007) and time to diagnosis (p = 0.005). In 2/3 cases, treatment is started at an advanced stage of disease. It is therefore important to intensify awareness campaigns for early detection and encourage patients to ensure regular medical follow-up screening.
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Affiliation(s)
- N E Essomba
- Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun. .,Comité national de lutte contre le sida du Cameroun, Douala, Cameroun.
| | - B H Mbatchou Ngahane
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - M Nida
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - E Temfack
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - Y Mapoure Njankouo
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - R L Abeng
- Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - Z Kobe Fokalbo
- Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - H Achu Joko
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - M Mbenoun
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - A P Meledie
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - M P Halle
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun.,Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - A Malongue
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - C Tchente
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - T Nana Njamen
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - G Halle Ekane
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - S Ngwane
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - E Barla
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - P Abena
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - P Ndobo
- Hôpital de District de Bonassama, Douala, Cameroun
| | | | - D Adiogo
- Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - A Mouelle Sone
- Faculté de médecine et des sciences pharmaceutiques, BP 15253, Douala, Cameroun
| | - H Luma Namme
- Centre de traitement agréé de l'Hôpital général de Douala, Douala, Cameroun
| | - Y Coppieters
- École de santé publique, Université libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgique
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Akhtar A, Khan AH, Sulaiman SAS, Soo CT, Khan K. HBV and HIV co-infection: Prevalence and clinical outcomes in tertiary care hospital Malaysia. J Med Virol 2015; 88:455-60. [PMID: 26255632 DOI: 10.1002/jmv.24347] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 12/12/2022]
Abstract
According to WHO, Malaysia has been classified as a concentrated epidemic country due to progression of HIV infection in the population of injecting drug users. The main objectives of current study are to determine the prevalence of HBV among HIV-positive individuals in a tertiary care hospital of Malaysia and to assess the predictors involved in the outcomes of HIV-HBV co-infected patients. A retrospective, cross-sectional study is conducted at Hospital Palau Pinang, Malaysia. The collection of socio-demographic data as well as clinical data is done with the help of data collection form. Data were analyzed after putting the collected values of required data by using statistical software SPSS version 20.0 and P > 0.05 is considered as significant. Results show that the overall prevalence of HBV was 86 (13%) including 495 (74.5%) males and 169 (25.5%) females among a total of 664 HIV-infected patients. It was observed that there is a high prevalence of HIV-HBV co-infection in males 76 (11.4%) as compared to females 10 (1.5%) (P = 0.002). The median age of the study population was 39 years. The statistical significant risk factors involved in the outcomes of HIV-HBV co-infected patients were observed in the variables of gender, age groups, and injecting drug users. The findings of the present study shows that the prevalence of HBV infection among HIV-positive patients was 13% and the risk factors involved in the outcomes of HIV-HBV co-infected patients were gender, age, and intravenous drug users.
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Affiliation(s)
- Ali Akhtar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Penang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Penang, Malaysia
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Penang, Malaysia
| | - Chow Ting Soo
- Infectious Disease Unit, Hospital Palau Penang, Palau Penang, Malaysia
| | - Kashifullah Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Palau Penang, Malaysia
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Matthews PC, Beloukas A, Malik A, Carlson JM, Jooste P, Ogwu A, Shapiro R, Riddell L, Chen F, Luzzi G, Jaggernath M, Jesuthasan G, Jeffery K, Ndung’u T, Goulder PJR, Geretti AM, Klenerman P. Prevalence and Characteristics of Hepatitis B Virus (HBV) Coinfection among HIV-Positive Women in South Africa and Botswana. PLoS One 2015. [PMID: 26218239 PMCID: PMC4517770 DOI: 10.1371/journal.pone.0134037] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
There is progressive concern about the evolving burden of morbidity and mortality caused by coinfection with HIV-1 and hepatitis B virus (HBV) in sub-Saharan Africa, but the epidemiology and impact of this problem are not well defined. We therefore set out to assimilate more information about the nature of HBV/HIV coinfection in this region by undertaking a retrospective observational study of southern African adult women. We used samples from previously recruited HIV-1 positive women attending antenatal clinics in three settings in South Africa and Botswana (n = 950) and added a small cohort of HIV-negative antenatal South African women for comparison (n = 72). We tested for HBsAg and followed up HBsAg-positive samples by testing for HBeAg, HBV DNA, HBV genotype, presence of drug-resistance associated mutations (RAMs) and HDV. We identified HBsAg in 72 individuals (7% of the whole cohort), of whom 27% were HBeAg-positive, and the majority HBV genotypes A1 and A2. We did not detect any HDV coinfection. HBV prevalence was significantly different between geographically distinct cohorts, but did not differ according to HIV status. Among adults from South Africa, HBV/HIV coinfected patients had lower CD4+ T cell counts compared to those with HIV-monoinfection (p = 0.02), but this finding was not replicated in the cohort from Botswana. Overall, these data provide a snapshot of the coinfection problem at the heart of the HIV/HBV co-epidemic, and are important to inform public health policy, resource allocation, education, surveillance and clinical care.
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Affiliation(s)
- Philippa C. Matthews
- Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford, United Kingdom
- * E-mail:
| | - Apostolos Beloukas
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Amna Malik
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom
| | - Jonathan M. Carlson
- Microsoft Research, eScience Group, Redmond, Washington, United States of America
| | - Pieter Jooste
- Paediatric Department, Kimberley Hospital, Kimberley, Northern Cape, South Africa
| | - Anthony Ogwu
- Botswana Harvard AIDS Institute Partnership, Botswana
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Roger Shapiro
- Botswana Harvard AIDS Institute Partnership, Botswana
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Lynn Riddell
- Integrated Sexual Health Services, Northampton General Hospital, Cliftonville, Northampton, United Kingdom
| | - Fabian Chen
- Department of Sexual Health, Royal Berkshire Hospital, Reading, United Kingdom
| | - Graz Luzzi
- Department of Sexual Health, High Wycombe Hospital, High Wycombe, Buckinghamshire, United Kingdom
| | - Manjeetha Jaggernath
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Gerald Jesuthasan
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford, United Kingdom
| | - Katie Jeffery
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford, United Kingdom
| | - Thumbi Ndung’u
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), University of KwaZulu-Natal, Durban, South Africa
- Max Planck Institute for Infection Biology, Chariteplatz, Berlin, Germany
- The Ragon Institute of MGH, MIT and Harvard University, Cambridge, Massachusetts, United States of America
| | - Philip J. R. Goulder
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Maria Geretti
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Paul Klenerman
- Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford, United Kingdom
- NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford, United Kingdom
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38
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Comparison of HBV-active HAART regimens in an HIV-HBV multinational cohort: outcomes through 144 weeks. AIDS 2015; 29:1173-82. [PMID: 26035319 DOI: 10.1097/qad.0000000000000686] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore factors associated with short and long-term hepatitis B virus (HBV) DNA suppression in a multinational cohort of HIV-HBV co-infected patients receiving HBV-active antiretrovirals. METHODS One hundred and fifteen HIV-HBV co-infected patients participating in one of the two global randomized clinical trials conducted by the Adult AIDS Clinical Trials Group of different antiretroviral regimens received either HBV monotherapy with either lamivudine or emtricitabine (N = 56), or HBV dual therapy with tenofovir disoproxil fumarate (TDF) + lamivudine or emtricitabine (N = 59). Associations of pretreatment characteristics with the primary (HBV DNA <200 IU/ml at 24 weeks) and longitudinal outcomes through 144 weeks were explored using logistic regression. HBV drug-resistance mutations were determined by pol sequencing in those with viral rebound. RESULTS The proportion with HBV DNA below 200 IU/ml was 60% (95% confidence interval 50-69%) at 24 weeks and 79% (95% confidence interval 69-88%) at 144 weeks. Pretreatment factors associated with the primary outcome were HBV DNA, CD4 T-cell count, and aspartate aminotransferase, but only pretreatment HBV DNA remained associated with long-term suppression (P < 0.0001). HBV therapy group was not significantly associated with the primary outcome at 24 weeks; however, longitudinally, a greater proportion in the dual-therapy group achieved HBV DNA below 200 IU/ml (P = 0.007). A higher proportion of hepatitis B e antigen-negative patients (n = 57) achieved HBV DNA below 200 IU/ml at any point, regardless of the therapy group. All 12 patients with emergence of lamivudine-resistant mutants were in the monotherapy group. CONCLUSIONS TDF-based dual HBV-active antiretroviral therapy is preferred to treat HIV-HBV co-infected patients. In resource-limited settings in which TDF may not be universally available, lamivudine or emtricitabine HBV monotherapy is a reasonable option in patients with low HBV replication.
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39
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Stabinski L, OʼConnor S, Barnhart M, Kahn RJ, Hamm TE. Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings. J Acquir Immune Defic Syndr 2015; 68 Suppl 3:S274-85. [PMID: 25768867 PMCID: PMC10426262 DOI: 10.1097/qai.0000000000000496] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Screening people living with HIV for hepatitis B virus (HBV) co-infection is recommended in resource-rich settings to optimize HIV antiretroviral therapy (ART) and mitigate HBV-related liver disease. This review examines the need, feasibility, and impact of screening for HBV in resource-limited settings (RLS). METHODS We searched 6 databases to identify peer-reviewed publications between 2007 and 2013 addressing (1) HIV/HBV co-infection frequency in sub-Saharan Africa (SSA); (2) performance of hepatitis B surface antigen (HBsAg) rapid strip assays (RSAs) in RLS; (3) impact of HBV co-infection on morbidity, mortality, or liver disease progression; and/or (4) impact of HBV-suppressive antiretroviral medications as part of ART on at least one of 5 outcomes (mortality, morbidity, HIV transmission, retention in HIV care, or quality of life). We rated the quality of individual articles and summarized the body of evidence and expected impact of each intervention per outcome addressed. RESULTS Of 3940 identified studies, 85 were included in the review: 55 addressed HIV/HBV co-infection frequency; 6 described HBsAg RSA performance; and 24 addressed the impact of HIV/HBV co-infection and ART. HIV/HBV frequency in sub-Saharan Africa varied from 0% to >28.4%. RSA performance in RLS showed good, although variable, sensitivity and specificity. Quality of studies ranged from strong to weak. Overall quality of evidence for the impact of HIV/HBV co-infection and ART on morbidity and mortality was fair and good to fair, respectively. CONCLUSIONS Combined, the body of evidence reviewed suggests that HBsAg screening among people living with HIV could have substantial impact on preventing morbidity and mortality among HIV/HBV co-infected individuals in RLS.
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Affiliation(s)
- Lara Stabinski
- *United States Department of State, Office of the US Global AIDS Coordinator and Health Diplomacy, Washington, DC; †Division of Viral Hepatitis, National Center for HIV/AIDS, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA; ‡Office of HIV and AIDS, Bureau for Global Health, United States Agency for International Development, Washington, DC; §US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and ‖The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD
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Njai HF, Shimakawa Y, Sanneh B, Ferguson L, Ndow G, Mendy M, Sow A, Lo G, Toure-Kane C, Tanaka J, Taal M, D'alessandro U, Njie R, Thursz M, Lemoine M. Validation of rapid point-of-care (POC) tests for detection of hepatitis B surface antigen in field and laboratory settings in the Gambia, Western Africa. J Clin Microbiol 2015; 53:1156-63. [PMID: 25631805 PMCID: PMC4365211 DOI: 10.1128/jcm.02980-14] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/20/2015] [Indexed: 01/02/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a leading cause of death in sub-Saharan Africa (SSA). Point-of-care tests for hepatitis B surface antigen (HBsAg) could be an ideal tool for a large-scale HBV screening/treatment program in SSA. Using data from the PROLIFICA (Prevention of Liver Fibrosis and Cancer in Africa) program, we conducted a cross-sectional study to assess the diagnostic accuracy of three point-of-care tests (Determine, Vikia, and Espline) for the detection of HBsAg in the field or a laboratory setting in the Gambia. In the field, we used finger-prick whole blood for the Determine and Vikia tests and dried blood spots for the reference standard test (AxSYM HBsAg enzyme-linked immunosorbent assay [ELISA]). In the laboratory we used serum for the Determine, Espline, and reference test (Architect chemiluminescent microparticle immunoassay). Of 773 participants recruited at the community and 227 known chronic HBV carriers (1,000 subjects in total), 293 were positive for HBsAg. The sensitivity and specificity of the Determine test were 88.5% and 100% in the field and 95.3% and 93.3% in the laboratory setting, respectively. The sensitivity and specificity were 90.0% and 99.8% for the Vikia test (in the field) and 93.9% and 94.7% for the Espline test (in the laboratory). There was no evidence that one kit was better than another. Most of the patients with false-negative results (18/19) were classified as inactive chronic carriers. In summary, the three point-of-care tests had acceptable ranges of diagnostic accuracy. These tests may represent accurate, rapid, and inexpensive alternatives to serology testing for the screening of HBV infection at field level in SSA.
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Affiliation(s)
| | - Yusuke Shimakawa
- Medical Research Council Unit, the Gambia, Banjul, the Gambia Department of Epidemiology/Infectious Disease Control and Prevention, Hiroshima University, Hiroshima, Japan
| | - Bakary Sanneh
- National Public Health Laboratory, Banjul, the Gambia
| | - Lynne Ferguson
- Medical Research Council Unit, the Gambia, Banjul, the Gambia
| | - Gibril Ndow
- Medical Research Council Unit, the Gambia, Banjul, the Gambia
| | - Maimuna Mendy
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, Lyon, France
| | - Amina Sow
- Laboratoire de Bacteriologie Virologie, Université Cheikh Anta Diop, CHU Le Dantec, Dakar, Senegal
| | - Gora Lo
- Laboratoire de Bacteriologie Virologie, Université Cheikh Anta Diop, CHU Le Dantec, Dakar, Senegal
| | - Coumba Toure-Kane
- Laboratoire de Bacteriologie Virologie, Université Cheikh Anta Diop, CHU Le Dantec, Dakar, Senegal
| | - Junko Tanaka
- Department of Epidemiology/Infectious Disease Control and Prevention, Hiroshima University, Hiroshima, Japan
| | - Makie Taal
- National Public Health Laboratory, Banjul, the Gambia
| | | | - Ramou Njie
- Medical Research Council Unit, the Gambia, Banjul, the Gambia Laboratory Services and Biobank Group, International Agency for Research on Cancer, Lyon, France
| | - Mark Thursz
- Department of Hepatology, Division of Medicine, Imperial College, London, United Kingdom
| | - Maud Lemoine
- Medical Research Council Unit, the Gambia, Banjul, the Gambia Department of Hepatology, Division of Medicine, Imperial College, London, United Kingdom
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41
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Khuroo MS, Khuroo NS, Khuroo MS. Diagnostic accuracy of point-of-care tests for hepatitis C virus infection: a systematic review and meta-analysis. PLoS One 2015; 10:e0121450. [PMID: 25816332 PMCID: PMC4376712 DOI: 10.1371/journal.pone.0121450] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 02/01/2015] [Indexed: 12/11/2022] Open
Abstract
Background Point-of-care tests provide a plausible diagnostic strategy for hepatitis C infection in economically impoverished areas. However, their utility depends upon the overall performance of individual tests. Methods A literature search was conducted using the metasearch engine Mettā, a query interface for retrieving articles from five leading medical databases. Studies were included if they employed point-of-care tests to detect antibodies of hepatitis C virus and compared the results with reference tests. Two reviewers performed a quality assessment of the studies and extracted data for estimating test accuracy. Findings Thirty studies that had evaluated 30 tests fulfilled the inclusion criteria. The overall pooled sensitivity, specificity, positive likelihood-ratio, negative likelihood-ratio and diagnostic odds ratio for all tests were 97.4% (95% CI: 95.9–98.4), 99.5% (99.2–99.7), 80.17 (55.35–116.14), 0.03 (0.02–0.04), and 3032.85 (1595.86–5763.78), respectively. This suggested a high pooled accuracy for all studies. We found substantial heterogeneity between studies, but none of the subgroups investigated could account for the heterogeneity. Genotype diversity of HCV had no or minimal influence on test performance. Of the seven tests evaluated in the meta-regression model, OraQuick had the highest test sensitivity and specificity and showed better performance than a third generation enzyme immunoassay in seroconversion panels. The next highest test sensitivities and specificities were from TriDot and SDBioline, followed by Genedia and Chembio. The Spot and Multiplo tests produced poor test sensitivities but high test specificities. Nine of the remaining 23 tests produced poor test sensitivities and specificities and/or showed poor performances in seroconversion panels, while 14 tests had high test performances with diagnostic odds ratios ranging from 590.70 to 28822.20. Conclusions Performances varied widely among individual point-of-care tests for diagnosis of hepatitis C virus infection. Physicians should consider this while using specific tests in clinical practice.
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Affiliation(s)
| | - Naira Sultan Khuroo
- Digestive Diseases Centre, Dr Khuroo Medical Clinic, Srinagar, Kashmir, J&K, India
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42
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Incidence of HIV and the prevalence of HIV, hepatitis B and syphilis among youths in Maputo, Mozambique: a cohort study. PLoS One 2015; 10:e0121452. [PMID: 25798607 PMCID: PMC4370560 DOI: 10.1371/journal.pone.0121452] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 02/01/2015] [Indexed: 01/03/2023] Open
Abstract
Background Prevalence of HIV in Mozambique among individuals aged 15–49 years is 11.5%. The HIV prevalence is higher in women than in men across the country, peaking at ages 25–29 years and 35–39 years, respectively. In this study, we aimed at determining the prevalence and incidence of HIV, prevalence of Hepatitis B (HBV), and prevalence of syphilis in youths. We also characterized a cohort of youths for future participation in phase I/II HIV vaccine trials. Methods The study was conducted at a youth clinic in Maputo Central Hospital from August 2009 to October 2011. Youths of both genders aged 18–24 years (n = 1380) were screened for HIV using a sequential algorithm of two immunochromatographic assays, HBV using an enzyme linked immunosorbant test, and syphilis using a treponemal immunochromatographic strip test. The HIV seronegative participants (n = 1309) were followed-up for 12 months with quarterly study visits. The clinical and behavioral data were collected using structured questionnaires. The HIV seroconversions were confirmed by a molecular assay. Results The study population was female dominant (76.8%). All participants had a formal education, with 44.6% studying for technical or higher education degrees. The mean age at sexual debut was 16.6 years (SD: ±1.74), with 85.6% reporting more than one sexual partner in life. The screening showed the prevalence of HIV, HBV, and syphilis at 5.1% (95% CI: 3.97–6.31), 12.2% (95% CI 10.5%–14.0%), and 0.36% (95% CI 0.15%–0.84%), respectively. The HIV incidence rate was found to be 1.14/100 person years (95% CI: 0.67–1.92). Retention rates were stable throughout the study being 85.1% at the last visit. Conclusion Incidence of HIV in this cohort of youths in Maputo was relatively low. Also, the prevalence of HIV and syphilis was lower than the national values in this age group. However, the HBV prevalence was higher than in previous reports in the country.
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Mugomeri E, Senauoane MB, Ruhanya V, Chin'ombe N, Nyandoro G. Occurrence of HBV/HIV coinfection by laboratory values in Roma, Lesotho. Germs 2015; 5:8-11. [PMID: 25763362 DOI: 10.11599/germs.2015.1065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 12/07/2014] [Accepted: 12/28/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study was an assessment of the coinfection status of patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in Lesotho, and this has been rarely reported. METHODS This was a retrospective study, in a laboratory setting, on HBV/HIV coinfection among 304 HIV-positive patients who were screened for HBsAg in St Joseph's Hospital records between March 2011 and December 2013. Demographic characteristics, HIV status, indications for HBsAg screening, HBsAg results and liver function test results including alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase were reviewed from the patient and laboratory registers. RESULTS In this study 10.5% of 304 HIV-positive patients had HBV/HIV coinfection. With respect to gender, males had a significantly higher (p=0.048) rate of HBV/HIV coinfection in this study. Increased levels of ALT (p=0.013) and AST (p=0.014) were significantly associated with HBV/HIV coinfection status. CONCLUSION Gender and liver function tests are important predictors for HBV/HIV coinfection. Screening for HBV coinfection in HIV-positive patients is recommended.
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Affiliation(s)
- Eltony Mugomeri
- MTech, Department of Pharmacy, National University of Lesotho, Maseru, Lesotho
| | | | - Vurayai Ruhanya
- MSc, Department of Medical Microbiology, University of Zimbabwe, Avondale, Harare, Zimbabwe
| | - Nyasha Chin'ombe
- PhD, Department of Medical Microbiology, University of Zimbabwe, Avondale, Harare, Zimbabwe
| | - George Nyandoro
- MSc, Department of Medical Microbiology, University of Zimbabwe, Avondale, Harare, Zimbabwe
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Dovonou CA, Amidou SA, Kpangon AA, Traoré YA, Godjedo TPM, Satondji AJ, Wachinou AP, Issa-Djibril FM, Fourn L, Zannou DM, Gandaho P. [Prevalence of hepatitis B in people infected with HIV in Parakou in Benin]. Pan Afr Med J 2015; 20:125. [PMID: 26097629 PMCID: PMC4462550 DOI: 10.11604/pamj.2015.20.125.6061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/24/2015] [Indexed: 12/14/2022] Open
Abstract
Introduction La co-infection avec l'hépatite B est l'un des défis majeurs de la prise en charge du VIH depuis l'amélioration de l'accès aux antirétroviraux en Afrique. La présente étude visait à estimer la prévalence de l'hépatite B chez les personnes séropositives au VIH à Parakou et décrire les facteurs associés. Méthodes Il s'agit d'une étude transversale menée de Mai 2011 à Juin 2012 dans le service de Médecine du CHU de Parakou. Ont été inclus tous les adultes séropositifs au VIH vus en consultation ou hospitalisés. Les données ont été collectées par interviews et dépouillement de dossiers médicaux. L'antigène HBs a été recherché par un test rapide et l'ALAT a été dosé. L'analyse des données a été faite avec le logiciel EpiInfo 3.5.1. Les proportions ont été comparées grâce au test de Chi-deux ou au test de Fisher au seuil de significativité de 5%. Un modèle de régression logistique multivariable a permis d'expliquer la prévalence de l'hépatite B. Résultats Sur les 744 sujets inclus on a dénombré 555 femmes. L’âge moyen était de 35,5 + 10,1 ans. La prévalence de l'hépatite B a été estimée à 16,9% (IC95: 14,3%-19,9%). Cette prévalence était plus élevée chez les sujets originaires du Borgou/Alibori et ceux au stade 4 de l'OMS. Conclusion La prévalence de la co-infection VIH/VHB au CHU Parakou est élevée. Le dispositif national de prise en charge et de prévention de l'hépatite B chez les personnes séropositives au VIH doit être renforcé.
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Affiliation(s)
- Comlan Albert Dovonou
- Service de Médecine Interne, CHU de Parakou ; Département de Médecine et spécialités médicales de la Faculté de Médecine de l'Université de Parakou
| | - Salimanou Ariyoh Amidou
- Service de Médecine Interne, CHU de Parakou ; Centre d'Information de Prospectives et de Conseils sur les IST/VIH/Sida, Parakou
| | | | | | | | | | | | | | - Léonard Fourn
- Département de Santé Publique, Faculté des Sciences de la Santé Cotonou
| | | | - Prosper Gandaho
- Département de Médecine et spécialités médicales de la Faculté de Médecine de l'Université de Parakou ; Service de Psychiatrie, CHU de Parakou
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Fox JM, Newton R, Bedaj M, Keding A, Molyneux E, Carpenter LM, Martin F, Mutalima N. Prevalence of hepatitis C virus in mothers and their children in Malawi. Trop Med Int Health 2015; 20:638-642. [PMID: 25611121 PMCID: PMC4418396 DOI: 10.1111/tmi.12465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objectives Hepatitis C virus (HCV) prevalence is poorly mapped in the East African region; with the advent of novel HCV therapies, better epidemiological data are required to target the infection. We sought to estimate HCV prevalence in healthy Malawian mothers and assess mother-to-child transmission (MTCT); context is provided by reviewing previously published HCV prevalence data from the region. Methods Using ELISA screening and confirmatory blot, serological testing of 418 healthy Malawian mothers for HCV was performed. To examine MTCT, the children of any positive women were also tested for HCV; all children had malignant disease unrelated to hepatocellular carcinoma. We compared our results to published literature on HCV prevalence in Malawi and its neighbouring countries. Results Three of 418 women were HCV reactive by ELISA; two were confirmed positive by immunoblot (0.5%). One child of an HCV-infected mother was HCV seropositive. The literature review revealed HCV prevalence ranging from 0 to 7.2% in the region, being highest in Tanzania and specifically for cohorts of inpatients and HIV-co-infected people. The overall estimated prevalence of HCV in Malawi was 1.0% (95%CI 0.7–1.4) when all studies were included (including this one), but lower in healthy cohorts alone at 0.3% (95%CI 0.1–1.2). Conclusions This is the first study using confirmatory tests to examine HCV prevalence in healthy Malawian mothers; the prevalence was low. Future studies need to address the source of infection in healthy women.
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Affiliation(s)
- James M Fox
- Centre for Immunology and Infection, University of York, York, UK
| | - Robert Newton
- Epidemiology and Cancer Statistics Group, University of York, York, UK.,MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Marija Bedaj
- Centre for Immunology and Infection, University of York, York, UK
| | - Ada Keding
- York Trials Unit, University of York, York, UK
| | | | | | - Fabiola Martin
- Centre for Immunology and Infection, University of York, York, UK
| | - Nora Mutalima
- Epidemiology and Cancer Statistics Group, University of York, York, UK
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Moreira J. Barriers to simplified HIV treatment in low-resource settings. THE LANCET. INFECTIOUS DISEASES 2014; 14:1178-1179. [PMID: 25455981 DOI: 10.1016/s1473-3099(14)70985-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- José Moreira
- Instituto Nacional de Infectologia Evandro Chagas, Hospital Evandro Chagas, Manguinhos, Rio de Janeiro, CEP 21045-900, Brazil.
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Okwen MP, Reid S, Njei B, Mbuagbaw L. Hepatitis B vaccination for reducing morbidity and mortality in persons with HIV infection. Cochrane Database Syst Rev 2014; 10:CD009886. [PMID: 25300375 PMCID: PMC4830339 DOI: 10.1002/14651858.cd009886.pub2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B vaccine has been recommended for use in people living with HIV (PLHIV) mostly because of the similarities in routes of infection and their prevalence in the same geographic areas. PLHIV may not develop sero-protection after receiving standard hepatitis B vaccine due to their compromised immune status. OBJECTIVES To evaluate the efficacy of hepatitis B virus vaccine in PLHIV compared to placebo or no vaccine. SEARCH METHODS We searched 6 English language databases in July 2012, and updated the search in June 2013 and August 2014. We searched the grey literature, conference proceedings, specialised web sites, and contacted experts in the field. SELECTION CRITERIA Randomised controlled trials of hepatitis B vaccine compared to placebo or no vaccine, evaluating relevant outcomes of efficacy and safety. DATA COLLECTION AND ANALYSIS Two review authors independently sought and extracted data on study design, participants, hepatitis B infection, hepatitis B related morbidity and mortality, anti-HBs immunogenicity and adverse effects related to vaccines from published articles or through correspondence with authors. Data were analysed qualitatively. MAIN RESULTS One double-blind randomised controlled trial with 26 participants who were on antiretroviral therapy (ART), comparing hepatitis B vaccine to placebo conducted in Spain met our eligibility criteria and was included in this review. The study ran for three years and participants were followed up on a monthly basis. The study reported adequate humoral response to vaccine at 12 months and no local or systematic side effects in both intervention and control groups. This humoral response was lost when the participants stopped taking ART. The sample size of the study was small and the study was conducted in a high income setting unlike the areas of highest burden of hepatitis B and HIV co-infections. AUTHORS' CONCLUSIONS The evidence from this study is insufficient to support any recommendations regarding the use of hepatitis B vaccine in PLHIV. Neither does this evidence demonstrate that hepatitis B vaccine is unsafe in PLHIV. Further randomised controlled trials in high prevalence areas are required to generate evidence on the long term efficacy and safety of hepatitis B vaccine in PLHIV with and without ART. Different regimens and routes of administration should also be explored.
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Affiliation(s)
- Mbah P Okwen
- Centre for the Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Savanna Reid
- Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, Henderson, Nevada, USA
| | - Basile Njei
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lawrence Mbuagbaw
- Centre for the Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
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Lee H, Kim S, DeMarco R, Aronowitz T, Mtengezo J, Kang Y, Yang Y, Touch C, Fitzpatrick JJ. Recognizing global disparities in health and in health transitions in the 21st century: what can nurses do? Appl Nurs Res 2014; 28:60-5. [PMID: 25448054 DOI: 10.1016/j.apnr.2014.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 09/22/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine changes in patterns of health and disease in global context between rich countries (USA, Korea, South Africa) and poor countries (Cambodia, Malawi) by using the framework of epidemiology theory developed by Orman (1971, 2005), and to raise awareness of global health disparities thereby prompting actions to reduce such disparities. FINDINGS 1) Life expectancy has increased across all selected countries except South Africa; 2) Korea and the USA have substantially lower mortality rates than other countries; 3) Infant and maternal mortality are still high in the poor countries; 4) The major cause of mortality in the poor countries is still communicable disease with evidence of the onset of non-communicable disease; and 5) The health transition theory provides a description and explanation of the differences in progress in economic development between countries but fails to explain differences in health status within and between countries. CONCLUSIONS Life expectancy and mortality are enormously different among the five selected countries. This excessive health disparity is primarily due to the higher risk of communicable diseases in low-income countries. Social determinants of health are mainly responsible for the health disparities observed within and between countries. CLINICAL RELEVANCE Future health care development and global research priorities will not be the same for all countries because the pattern of health transitions in the developing countries is not the same as the developed countries. Actions to reduce global health disparities need to recognize the conditions and social context in which persons live. An effective strategic approach to global health equality should develop a shared system of values, priorities, and delivery infrastructures with the populations who are targeted, aligning delivery within the local social contexts.
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Affiliation(s)
- Haeok Lee
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA.
| | - Susie Kim
- Daeyang Luck College of Nursing, Lilongwe, Malawi
| | - Rosanna DeMarco
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA
| | - Teri Aronowitz
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA
| | | | - Younhee Kang
- College of Health Sciences, Ewha Womans University, South Korea
| | - Youngran Yang
- College of Nursing, Chonbuk National University, South Korea
| | - Chhan Touch
- Lowell Community Health Center/Metta Health Center, Lowell, MA, USA
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Jiao Y, Li N, Chen X, Zhang T, Li H, Li W, Huang X, Liu Z, Zhang Y, Wu H. Acute HIV infection is beneficial for controlling chronic hepatitis B. Clin Infect Dis 2014; 60:128-34. [PMID: 25205770 DOI: 10.1093/cid/ciu710] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Coinfection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) is common. Most studies have concentrated on the effects of chronic HIV infection on HBV infection; however, studies on the effects of acute HIV infection on HBV infection are especially important to elucidate the potential mechanisms leading to complications from HIV/HBV coinfection. METHODS We evaluated the HBV DNA, hepatitis B surface antigen (HBsAg), and hepatitis B "e" antigen (HBeAg) in stored serum samples from 25 men with chronic hepatitis B who had acquired acute HIV infection. RESULTS All of the 25 men had decreased HBV DNA levels during acute HIV infection. Three men converted from HBsAg positive before HIV infection to HBsAg negative during acute HIV infection, and 10 men converted from HBeAg positive before HIV infection to HBeAg negative during acute HIV infection. CONCLUSIONS These data suggest that the early effects of HIV infection improve the immune response against HBV.
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Affiliation(s)
- Yanmei Jiao
- Beijing You'an Hospital, Capital Medical University, China
| | - Ning Li
- Beijing You'an Hospital, Capital Medical University, China
| | - Xinyue Chen
- Beijing You'an Hospital, Capital Medical University, China
| | - Tong Zhang
- Beijing You'an Hospital, Capital Medical University, China
| | - Hongjun Li
- Beijing You'an Hospital, Capital Medical University, China
| | - Wei Li
- Beijing You'an Hospital, Capital Medical University, China
| | - Xiaojie Huang
- Beijing You'an Hospital, Capital Medical University, China
| | - Zhiying Liu
- Beijing You'an Hospital, Capital Medical University, China
| | - Yonghong Zhang
- Beijing You'an Hospital, Capital Medical University, China
| | - Hao Wu
- Beijing You'an Hospital, Capital Medical University, China
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Matthews PC, Geretti AM, Goulder PJR, Klenerman P. Epidemiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa. J Clin Virol 2014; 61:20-33. [PMID: 24973812 DOI: 10.1016/j.jcv.2014.05.018] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 05/22/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023]
Abstract
Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research.
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Affiliation(s)
- Philippa C Matthews
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK
| | - Philip J R Goulder
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Paediatrics, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Paul Klenerman
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK; NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
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