Human Immunodeficiency and Hepatitis B Viral Co-infection in Women Attending Antenatal Care Clinic in a Tertiary Health Institution in Nigeria

Background: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) infections are major global health problems with common modes of transmission. Objective: To determine the prevalence, demographic characteristics, risk factors and liver dysfunction among antenatal women with HIV and HBV co-infection. Methodology: A crosssectional study of 586 pregnant women. Socio-demographic data were collected and blood samples were collected and tested for HBsAg and HIV infection. The liver function test was conducted on those who tested positive to HBV alone and have HIV/HBV co-infection. Data were analyzed using SPSS version 18 statistical program. Result: The prevalence of patients with HIV and HBV co-infection was 0.3%. They are single and in the age group of 21-24. The mean value of total bilirubin and unconjugated bilirubin of the patients with HBV/HIV co-infection were significantly higher (p=0.037) than in those with hepatitis B virus infection alone. Conclusion: The study showed low HIV/HBV co-infection amongst antenatal women and confirmed the assertion that co-infection leads to significant impaired liver function. This should be kept very low or eradicated to reduce devastating complications of HIV/HBV co-infection.

Human immunodeficiency virus and HBV co-infection: independent entities, together by coincidence?

Background: To ascertain the prevalence of HBV among HIV-infected, treatment- naïve patients visiting a tertiary care centre in Jaipur, Rajasthan, India.Methods: An observation analytic study was done at a tertiary care centre affiliated to medical college with retrospective analysis of the hospital data of 30 calendar months. During this period routine diagnostic screening of HIV infection and HBV infection was offered to every suspected patient admitted in hospital and every pregnant woman visiting antenatal care clinic. Patients with documentary evidence of HIV infection and history of Hepatitis B vaccination in last 30 days are not screened for these infections at our centre. The HIV screening was done as per NACO guidelines. The HBV screening was done using commercially available enzyme linked immunosorbent assay kits (ELISA) for detection of surface antigen (HBsAg).Results: The study prevalence of HIV infection was 0.11% (40/35289). The prevalence was more in male (0.45%) than females (0.06%). HBV was not detected in any of the HIV positive patient in this study. The study prevalence of HIV among pregnant females was 0.05% (10/22026).Conclusions: In this study, prevalence of HIV infection was 0.11%. The study prevalence of HIV among pregnant females was 0.05%. Other than pregnant women, maximum positive cases (13/30, 43.33% positive cases) were in the age group of 25-34 years (sexually active group). No patient had HIV and HBV co-infection.

Treatment of hepatitis B virus (HBV) in the setting of HIV-HBV co-infection

Liver disease in individuals with HIV-HBV co-infection is now a major cause of mortality worldwide, including Asia. The pathogenesis of liver disease in this setting is multifactorial, but includes drug toxicity and immunological factors, such as immune restoration disease. Staging of chronic hepatitis B is important prior to commencement of anti-retroviral therapy and should include quantification of HBV DNA, and, where possible, an assessment of liver fibrosis, either by liver biopsy or non-invasive measurement. Earlier treatment of both HIV and HBV is now generally advocated, and treatment is usually life-long.