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High rates of active hepatitis B and C co-infections in HIV-1 infected Cameroonian adults initiating antiretroviral therapy
|Published in||HIV Medicine. 2010, vol. 11, no. 1, p. 85-89|
|Abstract||OBJECTIVES: To investigate the presence of hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA in HIV-infected patients initiating antiretroviral therapy in Cameroon. METHODS: Baseline blood samples from 169 patients were tested retrospectively for hepatitis B surface antigens (HBsAg), anti-hepatitis B core (anti-HBc), anti-HCV and - if HBsAg or anti-HCV result was positive or indeterminate - for HBV DNA or HCV RNA, respectively, using the Cobas Ampliprep/Cobas TaqMan quantitative assay (Roche Diagnostics GmbH, Mannheim, Germany). RESULTS: HBV DNA was detected in 14 of the 18 patients with positive or indeterminate HBsAg results [8.3% of the total study population, 95% confidence interval (CI) 4.6-13.5]. The median HBV viral load was 2.47 x 10(7) IU/mL [interquartile range (IQR) 3680-1.59 x 10(8); range 270 to >2.2 x 10(8)]. Twenty-one patients (12.4%, 95% CI 7.9-18.4) were found with HCV RNA (all with positive HCV serology). The median HCV viral load was 928 000 IU/mL (IQR 178 400-2.06 x 10(6); range 640-5.5 x 10(6)). No patient was co-infected with HBV and HCV. In multivariate analysis, HCV co-infection was associated with greater age [ ≥ 45 years vs. <45 years, odds ratio (OR) 11.89, 95% CI 3.49-40.55, P<0.001] and abnormal serum alanine aminotransferase level [ ≥ 1.25 x upper limit of normal (ULN) vs. <1.25 x ULN, OR 7.81, 95% CI 1.54-39.66, P=0.01]; HBV co-infection was associated with abnormal serum aspartate aminotransferase level (OR 4.33, 95% CI 1.32-14.17, P=0.02). CONCLUSIONS: These high rates of active HBV and HCV co-infections in HIV-positive Cameroonian patients requiring antiretroviral therapy underline the need to promote: (i) screening for HBV and HCV before treatment initiation; (ii) accessibility to tenofovir (especially in HBV-endemic African countries); and (iii) accessibility to treatment for HBV and HCV infections.|
|Keywords||Adenine/analogs & derivatives/therapeutic use — Adult — Age Factors — Anti-HIV Agents/therapeutic use — Anti-Retroviral Agents/therapeutic use — Cameroon/epidemiology — Comorbidity — Female — HIV Infections/drug therapy/*epidemiology — Hiv-1 — Hepacivirus/immunology — Hepatitis B/*epidemiology/immunology — Hepatitis B Surface Antigens/blood/immunology — Hepatitis C/*epidemiology/immunology — Hepatitis C Antibodies/blood/immunology — Humans — Male — Middle Aged — Multivariate Analysis — Phosphonic Acids/therapeutic use — Pregnancy — Retrospective Studies — Transaminases/blood|
|Research group||Unité HIV (46)|
|LAURENT, C. et al. High rates of active hepatitis B and C co-infections in HIV-1 infected Cameroonian adults initiating antiretroviral therapy. In: HIV Medicine, 2010, vol. 11, n° 1, p. 85-89. doi: 10.1111/j.1468-1293.2009.00742.x https://archive-ouverte.unige.ch/unige:21075|