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

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.

Current status of human immunodeficiency virus and hepatitis C virus (HIV/HCV) co-infection in Cameroon: Sero-prevalence, risk factors and correlation with markers of liver function and CD4 cells rate in patients diagnosed in three hospital settings

“…These seroprevalence rates are significantly higher and therefore in discordance with results obtained by previous researchers in hospital settings in Cameroon, as far as HCV infection is concerned (Noubiap et al, 2013;Noubiap et al, 2015;Luma et al, 2016b). This might be in part due to the robustness of the screening test.…”

“…Previous studies attempted to investigate the epidemiology of HCV infection either in sentinel surveillance conditions (e.g. pregnant women, maintenance haemodialysis, patients attending health facilities for care), or among first time blood donors (Halle et al, 2009;Noubiap et al, 2013;Noubiap et al, 2015;Luma et al, 2016a;Ankouane et al, 2016).…”

Increased liver injury in patients with chronic hepatitis and IgG directed against hepatitis E virus

“…The liver is considered as an immune tolerant tissue, but, nevertheless, low-level infections such as occult B infection have been associated with serious liver diseases such as cirrhosis or even HCC (Pollicino et al, 2004[20]). Other viruses, including RNA viruses (HCV, measles virus) are known to generate low levels of persistent infections with serious consequences (Alazawi et al, 2010[1]; Noubiap et al, 2015[18]; Rima and Duprex, 2005[22]). Such type of persistence has not been observed so far but it is doubtful that this hypothesis has been explored with sufficient conviction.…”

Hepatitis C in Cameroon: What is the progress from 2001 to 2016?

“…The prevalence of HCV was shown to vary from 4.8% in Edea [10] , 1.3% in Douala [11] , to 3.2-4.8% in Yaoundé [12,13] . In addition, several cases of coinfection with HIV and HBV were reported [11,14,15] .…”

“…In a recent study by Noubiap et al [14] , 531-HIV infected patients were screened for the presence of antibodies to HCV (HCV-Ab) and HBV surface antigen (HBsAg) in order to estimate the seroprevalence and identify risk factors associated with HBV or HCV coinfection in HIVinfected subjects. The analysis was carried out in five regions including Center, North West, East, South, and South West in persons aged between 14 and more than 50 years.…”