Co-Infection Burden of Hepatitis C Virus and Human Immunodeficiency Virus among Injecting Heroin Users at the Kenyan Coast

Mwatelah, Ruth S.; Lwembe, Raphael; Osman, Saida; Ogutu, Bernhards; Aman, Rashid; Kitawi, Rose C.; Wangai, Laura Nyawira; Oloo, Florence; Kokwaro, Gilbert; Ochieng, Washingtone

doi:10.1371/journal.pone.0132287

Cited by 11 publications

(11 citation statements)

References 41 publications

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“…The IDU population, although small, shows a higher proportion of HCV mono-infections (93%) and HCV/HIV co-infection (72%). This finding is consistent with previous studies in Kenya 29 , 46 and elsewhere. 56 , 57 The use of unsafe injection practices has been linked with HCV and HIV infections among drug users.…”

Section: Discussionsupporting

confidence: 94%

“… 14 Anti-HCV prevalence among blood donors in Nairobi was 1.8%, 15 whereas among outpatients from three hospitals, an HBV surface antigen (HBsAg) positivity of 11.4% was documented. 28 An HIV prevalence of 18.7% was reported among IDUs in Nairobi 7 and 87.5% among injecting heroin users at the Kenyan coast, 29 whereas an HCV prevalence of 16.4% and HCV/HIV co-infection prevalence of 17.9% among the same heroin users was documented. 29 …”

Section: Introductionmentioning

confidence: 99%

“… 28 An HIV prevalence of 18.7% was reported among IDUs in Nairobi 7 and 87.5% among injecting heroin users at the Kenyan coast, 29 whereas an HCV prevalence of 16.4% and HCV/HIV co-infection prevalence of 17.9% among the same heroin users was documented. 29 …”

Section: Introductionmentioning

confidence: 99%

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Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Oyaro¹,

Wylie²,

Chen³

et al. 2018

South. Afr. j. HIV med.

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BackgroundDrug users act as reservoirs and transmission channels for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections to the general population worldwide. Periodic epidemiological studies to monitor the prevalence and genetic diversity of these infections to inform on interventions are limited.Objective of the studyThe objective of this study was to determine the predictors of HIV infection and genetic diversity of HBV and HCV among drug users in Kenya.Materials and methodsA cross-sectional study on previous drug use history among drug users was conducted in three Kenyan cities using a respondent-driven sampling method between January 2011 and September 2012. Blood samples were collected and analysed for the presence of HBV, HCV and HIV serological markers and to determine the genotypes of HBV and HCV.ResultsThe overall prevalence of HBV, HCV and HIV among drug users was 4.3%, 6.5% and 11.1%, respectively, with evidence of HBV/HIV, HCV/HIV and HBV/HCV/HIV co-infections. The HBV circulating genotypes were A1 (69%) and D6 (19%), whereas HCV genotypes were 1a (72%) and 4a (22%). Injection drug use was a significant predictor of HIV/HCV infections. Younger age (30 years; aOR (adjusted odds ratio) = 0.50, 95% CI (confidence interval): 0.33–0.76; p < 0.001) and early sexual debut (aOR = 0.54, 95% CI: 0.40–0.82; p < 0.05) were negatively associated with detection of any of the three infections. Injecting drug use was positively associated with HCV infection (aOR = 5.37, 95% CI: 2.61–11.06; p < 0.001).ConclusionThis high level of genetic diversity exhibited by HBV and HCV isolates requires urgent implementation of harm reduction strategies and continuous monitoring for effective management of the patients.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Oyaro¹,

Wylie²,

Chen³

et al. 2018

South. Afr. j. HIV med.

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“…A HCV prevalence of 14% among the HIV infected was demonstrated. Previous studies from selected population groups have shown that HCV prevalence ranges from 0.7 % to 0.9 % among blood donors; 3.9% among patients with symptoms of liver disease (Ochwoto et al, 2016); 1.0% (Chen et al, 2011;Harania et al, 2008); 22% and 16, 4% among IDUs (Mwatelah et al, 2015;Muasya et al, 2008); 0.76 among informal settlements (Kerubo et al, 2015).The findings of the current study seems consistent with that of High risk population group like IDUs . This is quite informative, since in Kenya, the assumptions have been HCV is mostly higher among most at risk populations.…”

Section: Discussionsupporting

confidence: 89%

Sero-Mapping of HBV, HCV, HSV2 and Syphilis Across Regions in Kenya

2019

JBAH

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Hepatitis B and C,herpes Simplex Virus 2 and syphilis are important infections that share common modes of transmission. The global burden of these infections and their occurrence as co-infection of HIV in high risk population groups calls for more attention in control and management. While HIV has been a program priority disease in many low resource settings, hepatis B and C have not had as much attention. Yet there is substantial indication that transmission of hepatitis, herpes virus 2 and syphilis is on the increase. This study aimed at determining the prevalence of hepatitis B, hepatitis C, Herpes simples virus 2 and syphilis and their distribution across different regions in Kenya. Samples were collected from HIV positive study participants in 11 counties (out of total 47) distributed in 7 out of the 8 regions (provinces).A total of 1829 samples were tested for the 4 infections and their distribution analysised. Mapping of the infection was presented by study sites and regions. Overall prevalence of HSV2 was the highest (at 50%) followed by that of HBV (29%) and HCV and Syphilis (14% repectively). Majority of study participants (71%) had co-infections while the rest of the study participants (29%) had none of the four infections. Western and Nyanza regions of the country had higher prevalence of HBV (above 31%). Sero-prevalence of HCV across the regions ranged between 8 to 19 percent. Syphilis sero-prevalence was highest in western and Nyanza region (Range 18% to 26%) compared to other regions (4% to15%), the lowest prevalence was in Central region. Distribution of HSV2 indicated Nairobi was leading at 62%, Central at 48.5% and Rift Valley at 47.5%. Lowest prevalence of HSV2 was at eastern region with an average of 29%. There was significant relation between infections and study sites. Since routine testing for HBV, HCV and HSV is not readily available, there is need to develop a strategy for prevention and control of these infections. Integration of services would be an important consideration in this regard.

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“…Hepatitis C patients were found to be illiterate, it shows that lack of knowledge about the disease and its precautions become a strong cause for disease. In this study, there is an increase of HCV infection as compared to the study which was done by Sacks-Davis R 17 in the entire Coast which showed a prevalence of 16.7%.We have shown that there is increased diversity along the coastal strip centers like Mtwapa which is part of Kilifi town both are under Muslim welfare association (MEWA).…”

Section: Discussionmentioning

confidence: 47%

Untitled

2020

JHVRV

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Background: Hepatitis C virus is a major global health problem estimated to infect over 170 million people globally with the most common route ofinfection being injecting drug use (IDU). Treatment for HCV infection has traditionally been shown to be genotype specific; however the available drugs are still expensive and out of reach in many developing countries. To improve on monitoring, there is need to continuously document the genotypic burden and epidemiology in different populations arises.Objectives: This study aimed to determine the circulating genotypes and link the data to the socio-demographics of injecting drug users in Kilifi County along the Kenyan coastline.Methods: Using a random sampling method, this was a cross-sectional prospective study conducted among 127 injecting drug users, whereby ethical clearance was sought from Kenyatta National Hospital/ University of Nairobi Ethical and Research review committee (KNH/UON-ERC), and Reference number P366/07/2017 on 25 th September 2017. Serology for HCV was done followed by nucleic acid amplification and eventual genotyping. Sociodemographic data was collected using questionnaire administered at the sites.Results: A total of 28 (23 males and 5 females) samples out of 127 samples were positive for HCV giving a prevalence of 22.1%. The modal age group was 25-49 years. Of the positive samples, 11 were amplified by PCR, all from the male IDUs. Prevalent genotypes included genotype 1a (13%) and genotype 4a (87%). Both genotype 1a and 4a were only found in males. Conclusion:Although it is the first time to report HCV4a in Kilifi town and Mtwapa as compared to Watamu and Malindi which had both HCV1a and HCV4a. Tourists born in countries where HCV prevalence is high are supposed to be screened before accessing entry to Kilifi County. No clinical trial was conducted. The study reveals the burden of HCV infection among IDUs inKilifi County. The Government should formulate policies for intervention on testing and treatment of HCV in Kilifi County targeting IDUs in order to minimize spread to other populations.

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Co-Infection Burden of Hepatitis C Virus and Human Immunodeficiency Virus among Injecting Heroin Users at the Kenyan Coast

Cited by 11 publications

References 41 publications

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Sero-Mapping of HBV, HCV, HSV2 and Syphilis Across Regions in Kenya

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