Seroprevalence and Associated Risk Factors of HBV Co-infection Among HIV Infected Children Enrolled into Care at Kilimanjaro Christian Medical Centre, Tanzania

Abstract

Sub-Saharan Africa remains the region most affected with HIV. The wide use of highly active anti-retroviral therapy has led to improvement in life expectancy among HIV infected individuals. However, hepatitis B virus related complications like liver cirrhosis and liver failure are now becoming common causes of morbidity and mortality in this group. The aim of this study was to determine the seroprevalence and risk factors of HBV/HIV co-infection among HIV infected children enrolled into care at Kilimanjaro Christian Medical Centre (KCMC). This cross sectional analytical study was conducted among 323 HIV infected children at KCMC between February 2013 and May 2013. Investigations included interviews, physical examination and HBsAg analysis. HIV serostatus and CD4 counts/percentages were obtained from patients records. In addition, information on hepatitis vaccine status was recorded. Among 323 HIV-infected children enrolled, 177 (54.8%) were males. The prevalence of hepatitis B virus and HIV co-infection was found to be 1.2% (n=4). Hepatitis B virus co-infection was not significantly associated with any of the sociodemographic or behaviour risk factors which were assessed. CD4 counts were significantly associated with hepatitis B virus status whereby children with CD4 counts less than 350 cells/mm3 were 14 times more likely to have hepatitis B virus co-infection as compared to those who had CD4 counts greater than 350 cells/mm3. All of the hepatitis B virus co-infected children had no records of hepatitis B virus immunization, though one was born during the period of universal infant's hepatitis B vaccination (<4 years old). The frequency of hepatitis B virus co-infection with HIV infection was low among HIV infected children in our set up. It is important to strengthen the implementation of the universal infant's hepatitis B virus vaccination. The screening of HIV infected children for hepatitis B virus co-infection is still important whenever possible with immunization of all HIV infected children and adolescents with negative HBsAg.

Prevalence of Hepatitis B and C Viruses among Human Immunodeficiency Virus Infected Children Attending an Antiretroviral Therapy Clinic in Lafia, Nigeria

“…They had a high prevalence with respect to blood transfusion as a probable risk factor for infection, likewise presence of scarification although none of these associations was statistically significant. Other researchers have made the same observations in Nigeria [10,12] Tanzania [18,20] and Ethiopia [4].…”

Opportunistic Infections

“…The prevalence of Hepatitis B and HIV co-infection in pregnant African women ranges from less than 1%-7% [34]. The seroprevalence in children may range between 1.2% and 29.7% from region to region [35].…”

“…This depends on the presence of HBeAg, the Hepatitis B viral load and genotype as well as the maternal CD4 count. Progression to chronicity depends on age of acquisition with 90% of infants and up to 50% of children aged 1-5 years old developing chronic hepatitis B after acute infection [34]. Adolescents with sexually acquired HIV infection run a higher risk than HIV negative adolescents of acquiring hepatitis B infection.…”