Prevalence and associations with hepatitis B and hepatitis C infection among HIV-infected adults in South Africa

Abstract

We assessed prevalence and factors associated with hepatitis B in a cross-section of HIV-infected primary care and anti-natal clinic patients in South Africa and evaluated a rapid hepatitis B surface antigen (HBsAg) assay. We enrolled 998 patients; 88% were women, median age was 29 years, and median CD4 count was 354 cells/mm3. HBsAg ELISA, anti-hepatitis B core (HBc) antibodies, and hepatitis C virus antibody were positive among 4.2%, 37%, and 0.1% of subjects, respectively. Univariate and multivariate associations were assessed using logistic regression. Anti-HBc antibodies were associated with alcohol use, traditional medicines, and higher CD4. HBsAg positivity was associated with lower CD4. Compared to the HBsAg ELISA, a rapid HBsAg test had a sensitivity of 75.0% and specificity of 99.6%. In conclusion, we identified a moderate prevalence of both HBsAg and anti-HBc. Importantly, we found subjects with HBsAg positivity had lower CD4 counts.

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

“…However, the majority of these tests were evaluated under laboratory conditions using serum or plasma. Only a few studies assessed the performance of these tests using whole blood from venipuncture (9,12,16,17,19); none of them used capillary blood from finger prick in the field.…”

“…In 2012, a meta-analysis reported high performance of the Determine test, with a pooled sensitivity at 98.2% (95% credible interval [CrI], 94.7 to 99.9%) and a specificity at 99.9% (95% CrI, 99.3 to 100%) (6). However, other studies cast doubt on the Determine test's high sensitivity (13,15,16). Sensitivity was generally acceptable, ranging from 93.6 to 100% (except in one study [10]), in HIV-negative individuals (Table 5).…”

“…Taken together, HBsAg POC tests seem suitable for community-based and large-scale screening. However, most of the studies which validated their performance were done at the facility level and among specific populations, i.e., blood donors (8)(9)(10), hospital patients (11)(12)(13), or HIV-infected people (14)(15)(16)(17)(18). Although one study in France investigated the accuracy of HBsAg POC tests in the general population, the tests were performed in health centers using whole blood collected by venipuncture (19).…”

Prevalence of Hepatitis B Virus Infection and Associated Factors among HIV Positive Adults Attending ART Clinic at Hawassa Referral Hospital, SNNPR, Ethiopia

“…The association might be due to the fact that HIV/HBV co-infected individuals have weak immunity than those with HIV mono-infected individuals which will make them more prone to opportunistic infection. In addition wounds due to opportunistic infections may increase the chance of infection [25].…”

Sexually transmitted coinfections. HIV coinfections

“…Szubszaharai Afrikában, ahol a legnagyobb számú HIV-fertőzött él és a HVB is endé-miás, a HbsAg prevalenciája 8% körüli, az együttes fertő-zéseket 36%-ra teszik [4,5,6,7]. Dél-Afrikában HIVfertőzött egyénekben HbsAg-pozitivitást 4,2%-ban, antihepatitis B core (Hbc) ellenanyagot 37%-ban, hepatitis C-vírus (HCV) ellenanyagot 0,1%-ban találtak [8].…”