Prevalence of hepatitis C and B virus among patients infected with HIV: a cross-sectional analysis of a large HIV care programme in Myanmar

Zaw, Sai Ko Ko; Tun, Sai Thein Than; Thida, Aye; Aung, Thet Ko; Maung, Win; Shwe, Myint; Aye, Mar Mar; Clevenbergh, P.

doi:10.1177/0049475513493416

Cited by 22 publications

(22 citation statements)

References 9 publications

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“…2 However, the prevalence of HIV/HBV co-infection was found lower than what has been reported in Rwanda (42.9%), Nigeria (11.9%), Ghana (11.7%), Burkina Faso (9.8%), and Myanmar (8.7%). 4,[19][20][21][22] In contrast, the prevalence of HBV in this study was higher than what has been reported in Uganda (4.1%), India (4.9%), and Australia (4.8%) among HIVinfected patients. 23,24 In this study, use of condoms and a high HIV viral load were significantly associated with HBV infection.…”

Section: Discussioncontrasting

confidence: 93%

Prevalence and Factors Associated With Hepatitis B and C Co-Infection Among HIV-1-Infected Patients in Kenya

Maina

Nyerere

Gicho

et al. 2017

EAHRJ

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Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the most chronic viral infections worldwide.Co-infections with HBV and HCV have become increasingly common among people living with HIV, resulting in a growing public health concern. The primary aim of our study was to determine the prevalence of HBV and HCV and their associated factors among HIV-1-infected patients attending the Ngong Sub-County Hospital comprehensive care clinic.Methods: After providing consent, a 5 mL blood sample was collected from each study participant visiting the comprehensive care clinic. The blood was screened for hepatitis B surface antigen and HCV antibodies using chemiluminescence immunoassay test according to the manufacturer's instructions. The CD4 T-cell counts were determined using FACSCalibre machine, while HIV-1 viral load was determined using the Abbott m2000rt System according to the manufacturer's instructions. A questionnaire was used to collect sociodemographic information and data on factors associated with HBV and HCV co-infections.Results: One hundred and ninety HIV-1-infected patients participated in this study: 150 (78.9%) women and 40 (21.1%) men.In the overall study population, the prevalence of HBV co-infection was 5.8% (95% CI, 2.6%-8.9%) and of HCV coinfection was 4.2% (95% CI, 1.6%-7.4%). However, no individual was co-infected with all 3 viruses. HCV was associated with antiretroviral treatment (OR 0.2; 95% CI, 0.0-0.8; P=.036), while HBV showed a significant association with condom usage (OR 0.3; 95% CI, 0.1-0.9; P=.039) and median viral load.

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Section: Discussioncontrasting

confidence: 93%

Prevalence and Factors Associated With Hepatitis B and C Co-Infection Among HIV-1-Infected Patients in Kenya

Maina

Nyerere

Gicho

et al. 2017

EAHRJ

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“…Rates of chronic HBV in HIV-infected individuals vary significantly between regions and risk based groups, reflecting different patterns of transmission (Figure 1) [5, 12–81] . For example in Vietnam, the prevalence of chronic HBV in HIV-infected individuals who inject drugs or who are sex workers (SW), is 28% and 15% respectively [50] .…”

Section: Epidemiologymentioning

confidence: 99%

HIV-hepatitis B virus coinfection

Singh¹,

Crane

Audsley

et al. 2017

Aids

176

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HIV infection has a significant impact on the natural history of chronic HBV infection, with increased levels of HBV DNA, accelerated progression of liver disease and increased liver-associated mortality compared to HBV mono-infection. Widespread uptake and early initiation of HBV-active antiretroviral therapy (ART) has substantially improved the natural history of HIV-HBV co-infection but the prevalence of liver disease remains elevated in this population. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease and seroconversion in HIV-HBV co-infection in the era of HBV-active ART and the effects of HIV directly on liver disease. We also review novel therapeutics for the management of HBV with a particular emphasis on clinical strategies being developed for an HBV cure and an HIV cure and their impact on HIV-HBV co-infected individuals.

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“…The National Tuberculosis Programme (NTP) and NAP recognize the importance of a joint response, and scaling up integrated HIV-TB activities is regarded as a priority. An additional threat to HIV key affected populations in Myanmar is co-infection with hepatitis B and C, with prevalence rates of HIV-HCV co-infection as high as 80% among PWID [4][5][6]. Moreover, with socioeconomic development in Myanmar, there is an increased concern about non-communicable diseases (NCDs).…”

Section: Introductionmentioning

confidence: 99%

Implications of differentiated care for successful ART scale‐up in a concentrated HIV epidemic in Yangon, Myanmar

Mesic

Fontaine²,

Aye

et al. 2017

Journal of the International AIDS Society

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Introduction: National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around the hospital and reliant on physicians, the country’s HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)-supported programmes and reports its outcomes.Methods: A descriptive cohort analysis of adult patients on antiretroviral treatment was performed. We assessed stability of patients as of 31 December 2014 and introduced an intervention of reduced frequency of physicians’ consultations for stable patients, and fast tract ART refills. We measured a number of saved physician’s visits as the result of this intervention. Main outcomes, remained under care, death, lost to follow up, treatment failure, were assessed on 31 December 2015 and reported as rates for different stable groups.Results: On 31 December 2014, our programme counted 16, 272 adult patients enrolled in HIV care, of whom 80.34% were stable. The model allowed for an increase in the average number of patients one medical team could care for – from 745 patients in 2011 to 1, 627 in 2014 – and, thus, a reduction in the number of teams needed. An assessment of stable patients enrolled on ART one year after the implementation of the new model revealed excellent outcomes, aggregated for stable patients as 98.7% remaining in care, 0.4% dead, 0.8% lost to follow-up, 0.8% clinical treatment failure and 5.8% with immunological treatment failure.Conclusions: Implementation of a differentiated model reduced the number of visits between stable clients and physicians, reduced the medical resources required for treatment and enabled integrated treatment of the main co-morbidities. We hope that these findings will encourage other stakeholders to implement innovative models of HIV care in Myanmar, further expediting the scale up of ART services, the decentralization of treatment and the integration of care for the main HIV co-morbidities in this context.

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Prevalence of hepatitis C and B virus among patients infected with HIV: a cross-sectional analysis of a large HIV care programme in Myanmar

Cited by 22 publications

References 9 publications

Prevalence and Factors Associated With Hepatitis B and C Co-Infection Among HIV-1-Infected Patients in Kenya

Prevalence and Factors Associated With Hepatitis B and C Co-Infection Among HIV-1-Infected Patients in Kenya

HIV-hepatitis B virus coinfection

Implications of differentiated care for successful ART scale‐up in a concentrated HIV epidemic in Yangon, Myanmar

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