High rates of active hepatitis B and C co‐infections in HIV‐1 infected Cameroonian adults initiating antiretroviral therapy

• Published in: HIV medicine Vol. 11; no. 1; pp. 85 - 89
• Main Authors: Laurent, C, Bourgeois, A, Mpoudi‐Ngolé, E, Kouanfack, C, Ciaffi, L, Nkoué, N, Mougnutou, R, Calmy, A, Koulla‐Shiro, S, Ducos, J, Delaporte, E
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2010
• Subjects: Adenine - analogs & derivatives; Adenine - therapeutic use; Adult; Africa; Age Factors; Anti-HIV Agents - therapeutic use; Anti-Retroviral Agents - therapeutic use; antiretroviral therapy; Cameroon - epidemiology; Comorbidity; Female; HBV; HCV; Hepacivirus - immunology; Hepatitis B - epidemiology; Hepatitis B - immunology; Hepatitis B Surface Antigens - blood; Hepatitis B Surface Antigens - immunology; Hepatitis B virus; Hepatitis C - epidemiology; Hepatitis C - immunology; Hepatitis C Antibodies - blood; Hepatitis C Antibodies - immunology; Hepatitis C virus; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV-1; Human immunodeficiency virus 1; Humans; Male; Middle Aged; Multivariate Analysis; Organophosphonates - therapeutic use; Pregnancy; Retrospective Studies; Tenofovir; Transaminases - blood; Cameroon
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2009.00742.x

Objectives To investigate the presence of hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA in HIV‐infected patients initiating antiretroviral therapy in Cameroon. Methods Baseline blood samples from 169 patients were tested retrospectively for hepatitis B surface antigens (HBsAg), anti‐hepatitis B core (anti‐HBc), anti‐HCV and – if HBsAg or anti‐HCV result was positive or indeterminate – for HBV DNA or HCV RNA, respectively, using the Cobas Ampliprep/Cobas TaqMan quantitative assay (Roche Diagnostics GmbH, Mannheim, Germany). Results HBV DNA was detected in 14 of the 18 patients with positive or indeterminate HBsAg results [8.3% of the total study population, 95% confidence interval (CI) 4.6–13.5]. The median HBV viral load was 2.47 × 107 IU/mL [interquartile range (IQR) 3680–1.59 × 108; range 270 to >2.2 × 108]. Twenty‐one patients (12.4%, 95% CI 7.9–18.4) were found with HCV RNA (all with positive HCV serology). The median HCV viral load was 928 000 IU/mL (IQR 178 400–2.06 × 106; range 640–5.5 × 106). No patient was co‐infected with HBV and HCV. In multivariate analysis, HCV co‐infection was associated with greater age [≥45 years vs. <45 years, odds ratio (OR) 11.89, 95% CI 3.49–40.55, P<0.001] and abnormal serum alanine aminotransferase level [≥1.25 × upper limit of normal (ULN) vs. <1.25 × ULN, OR 7.81, 95% CI 1.54–39.66, P=0.01]; HBV co‐infection was associated with abnormal serum aspartate aminotransferase level (OR 4.33, 95% CI 1.32–14.17, P=0.02). Conclusions These high rates of active HBV and HCV co‐infections in HIV‐positive Cameroonian patients requiring antiretroviral therapy underline the need to promote: (i) screening for HBV and HCV before treatment initiation; (ii) accessibility to tenofovir (especially in HBV‐endemic African countries); and (iii) accessibility to treatment for HBV and HCV infections.