Seroprevalence of hepatitis B virus and hepatitis C virus co-infection among people living with HIV/AIDS visiting antiretroviral therapy centres in Nepal: a first nationally representative study

Abstract

Objectives: To assess the prevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) co-infections among people living with HIV (PLHIV) in Nepal. Methods: A sample of 677 PLHIV representing key affected populations (KAP) in Nepal, who were undergoing antiretroviral (ART) therapy in ART clinics around the country, were voluntarily enrolled in the study. Rapid kit-based testing followed by ELISA for validation was performed, focusing on HBV surface antigen (HBsAg) and antibodies against HCV (anti-HCV). A multivariate logistic regression model was used to identify factors associated with HBV and HCV co-infection. Results: HCV and HBV co-infection among the 677 PLHIV was found to be 19% (95% confidence interval (CI) 16.6-22.7%) and 4.4% (95% CI 3.1-6.6%), respectively. The Eastern Region had the highest percentage of HCV infection (48%). The age group with the highest rates of co-infection was 30-39 years (58% and 70%, respectively, for HCV and HBV co-infection). After adjusting for confounding, males were more likely to have HBV co-infection than females (adjusted odds ratio (AOR) 4.61, 95% CI 1.42-14.98). Similarly, PLHIV who were male (AOR 5.7, 95% CI 2.06-15.98), had a secondary level of education (AOR 3.04, 95% CI 1.06-8.70), or who were drug users (AOR 28.7, 95% CI 14.9-55.22) were significantly more likely to have HCV co-infection. Conclusion: This first ever national assessment of HIV, HBV, and HCV co-infection performed among PLHIV in Nepal demonstrates that HCV and HBV infections are a health threat to this population and that interventions are required to mitigate the effects of co-infection and to prevent further morbidity and mortality.

Epidemiological Profile and Risk Factors for Acquiring HBV and/or HCV in HIV-Infected Population Groups in Nepal

“…A study carried out in Nepal during 2010-2011 reported that the prevalence of HBV and HCV confections among the HIV-positive population was 4.4% and 19%, respectively [ 23 ]. Those reported rates are both significantly higher than those of our current study.…”

Role of unsafe medical practices and sexual behaviours in the hepatitis B and C syndemic and HIV co-infection in Rwanda: a cross-sectional study

“… 4 10–15 Such data are especially scarce in developing countries with high burden of each of these infections, such as Rwanda. 12 16 In 2015, Rwanda DHS showed that the prevalence of HIV in the general population was 3%, with a higher prevalence in urban than rural areas (6% vs 2.4%, respectively). 17 Recent studies on HBV in Rwanda revealed that the prevalence of hepatitis B surface antigen (HBsAg) among people screened was 3.9%, 18 19 while the prevalence of anti-HCV was between 6.2% and 6.6% with viremia of 52%.…”

Late Response of Antiretroviral Therapy in an HIV-1-Infected Patient due to Hepatitis B and C Coinfections: The First Case Report in Nepal

“…Also, 7.1% of HBV, 18.1% of HCV, and 0.5% of HBV/HCV infection living with HIV were observed in people who inject drugs [12]. The first nationally representative cross-sectional study on people living with HIV and female sex workers revealed 4.4% of HBV, 19% of HCV, and 1% of HBV/HCV coinfection [15]. However, the prevalence of HCV could be higher than that of HBV coinfection in HIV-infected patients due to the availability of HBV vaccines.…”