All Title Author
Keywords Abstract


Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4+ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

DOI: 10.4236/ijcm.2016.74030, PP. 280-291

Keywords: Co-Infection, Hepatitis B, Hepatitis C, Human Immunodeficiency Virus, Acquired Immunodeficiency Syndrome, HIV, HBV, HCV, Alanine Aminotransferase, ALT, Highly Active Antiretroviral Therapy, HAART, Monoinfection, CD4+, Risk Factors for Co-Infection, Transmission, Hepatitis B Surface Antigen, HBVsAg

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

References

[1]  Cooley, L. and Sasadeusz, J. (2003) Clinical and Virological Aspects of Hepatitis B Co-Infection in Individuals Infected with Human Immunodeficiency Virus Type-1. Journal of Clinical Virology, 26, 185-193.
http://dx.doi.org/10.1016/S1386-6532(02)00117-8
[2]  Main, J. and McCarron, B. (2005) Hepatitis in HIV-Infected Persons. In: Thomas, H., Lemon, S. and Zuckerman, A., Eds., Viral Hepatitis, 3 Edition, Blackwell Publishing Ltd., Massachusetts, 769-779.
http://dx.doi.org/10.1002/9780470987131.ch50
[3]  Zhou, S., Zhao, Y., He, Y., Li, H., Bulterys, M. and Sun, X. (2010) Hepatitis B and Hepatitis C Seroprevalence in Children Receiving Antiretroviral Therapy for Human Immunodeficiency Virus-1 Infection in China, 2005-2009. Journal of Acquired Immune Deficiency Syndromes, 54, 191-196.
[4]  Koziel, M. and Peters, M. (2007) Viral Hepatitis in HIV Infection. The New England Journal of Medicine, 356, 1445-1454.
http://dx.doi.org/10.1056/NEJMra065142
[5]  Adewole, O.O., Anteyi, E., Ajuwon, Z., Wada, I., Elegba, F., Ahmed, P., et al. (2009) Hepatitis B and C Virus Co-In-fection in Nigerian Patients with HIV Infection. Journal of Infection in Developing Countries, 3, 369-375.
http://dx.doi.org/10.3855/jidc.245
[6]  Rockstroh, J. (2006) Influence of Viral Hepatitis on HIV Infection. Journal of Hepatology, 44, 25-27.
http://dx.doi.org/10.1016/j.jhep.2005.11.007
[7]  Schnuriger, A., Dominguezd, S., Guiguete, M., Harfoucha, S., Samria, A., Ouazeneh, Z., et al. (2009) Acute Hepatitis C in HIV-Infected Patients: Rare Spontaneous Clearance Correlates with Weak Memory CD4 T-Cell Responses to Hepatitis C Virus. AIDS, 23, 2079-2089.
http://dx.doi.org/10.1097/QAD.0b013e328330ed24
[8]  Christian, B., Okuma, J. and Hawkins, H. (2010) Prevalence of Hepatitis B and C Co-Infection and Response to Antiretroviral Therapy among HIV-Infected Patients in an Urban Setting in Tanzania. 17th Conference on Retroviruses & Opportunistic Infections (CROI 2010), San Francisco, 16-19 February 2010.
[9]  Rawizza, H., Ochigb, O.S., Chang, C., MeloniI, M., Oguche, S., Osinusi, I.K., et al. (2010) Prevalence of Hepatitis Co-Infection among HIV-Infected Nigerian Children in the Harvard. PEPFAR ART Program Conference on Retroviruses and Opportunistic Infections, San Francisco.
[10]  Kotzee, T., Pronyk, P., Vardas, E., Heyer, A. and Martinson, N. (2006) HIV and Hepatitis B Co-Infection in Southern Africa: A Review for General Practitioners. Southern African Journal of HIV Medicine, 7, 38-43.
[11]  Law, W.P., Duncombe, C.J., Mahanontharit, A., Boyd, M.A., Ruxrungtham, K., Lange, J.M., et al. (2004) Impact of Viral Hepatitis Co-Infection on Response to Antiretroviral Therapy and HIV Disease Progression in the HIV-NAT Cohort. AIDS, 18, 1169-1177.
http://dx.doi.org/10.1097/00002030-200405210-00010
[12]  Idoko, J., Meloni, S., Muazu, M., Hawkins, C., Bidang, B., Gwamzi, N., et al. (2007) Hepatitis B Virus Co-Infection Impacts Baseline HIV Parameters and HAART-Related Hepatotoxicity Risk in an HIV-Infected Nigerian Cohort. AIDS Prevention Initiative in Nigeria.
[13]  Otegbayo, J., Adewole, I., Taiwo, B., Akingbola, T., Odaibo, G., Adedapo, K., et al. (2008) Prevalence of Hepatitis B and C Seropositivity in a Nigerian Cohort of HIV-Infected Patients. Annals of Hepatology, 7, 152-156.
[14]  Mandala, J., Torpey, K., Kasonde, P., Kabaso, M., Dirks, R., Suzuki, C., et al. (2009) Prevention of Mother-to-Child Transmission of HIV in Zambia: Implementing Efficacious ARV Regimens in Primary Health Centers. BMC Public Health, 9, 314.
http://dx.doi.org/10.1186/1471-2458-9-314
[15]  Yogev, R. and Chadwick, E. (2007) Acquired Immunodeficiency Syndrome (Human Immunodeficiency Virus). In: Kliegman, R., Behrman, R., Jenson, H. and Stanton, B., Eds., Nelson Textbook of Pediatrics, 18th Edition, Saunders Elsevier, Philadelphia, 1427-1442.
[16]  Mboto, C., Fielder, M., Davies-Russell, A. and Jewell, A. (2009) Prevalence of HIV-1, HIV-2, Hepatitis C and Co-Infection in the Gambia. West African Journal of Medicine, 28, 306-309.
http://dx.doi.org/10.4314/wajm.v28i1.48418
[17]  Yazigi, N. and Balistreri, W. (2007) Viral Hepatitis. In: Kliegman, R., Behrman, R., Jenson, H. and Stanton, B., Eds., Nelson Textbook of Pediatrics, 18th Edition, Saunders Elsevier, Philadelphia, 1680-1690.
[18]  Hoffmann, C.J. and Thio, C.L. (2007) Clinical Implications of HIV and Hepatitis B Co-Infection in Asia and Africa. The Lancet Infectious Diseases, 7, 402-409.
http://dx.doi.org/10.1016/S1473-3099(07)70135-4
[19]  Jan-Christian, W. (2010) Hepatitis B—Epidemiology, Transmission and Natural History. In: Mauss, S., Berg, T., Rockstroh, J., Sarrazin, C. and Wedemeyer, H., Eds., Hepatology, 2nd Edition, Flying Publisher, Wuppertal, 7-17.
[20]  Shepard, C., Simard, E., Finelli, L., Fiore, A. and Bell, B. (2006) Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiologic Reviews, 28, 112-125.
http://dx.doi.org/10.1093/epirev/mxj009
[21]  Francis, D., Favero, M. and Maynard, J. (1981) Transmission of Hepatitis B Virus. Seminars in Liver Disease, 1, 27-32.
http://dx.doi.org/10.1055/s-2008-1063927
[22]  Polizzotto, M., Wood, E., Ingham, H. and Keller, A. (2008) Reducing the Risk of Transfusion-Transmissible Viral Infection through Blood Donor Selection: The Australian Experience 2000 through 2006. Transfusion, 48, 55-63.
[23]  Dodd, R. (2000) Current Viral Risks of Blood and Blood Products. Annals of Medicine, 32, 469-474.
[24]  La Torre, G., Miele, L., Chiaradia, G., Mannocci, A., Reali, M., Gasbarrini, G., et al. (2007) Socio-Demographic Determinants of Coinfections by HIV, Hepatitis B and Hepatitis C Viruses in Central Italian Prisoners. BMC Infectious Diseases, 7, 100.
http://dx.doi.org/10.1186/1471-2334-7-100
[25]  Saravanan, S., Velu, V., Kumarasamy, N., Nandakumar, S., Murugavel, K.G., Balakrishnan, P., et al. (2007) Coinfection of Hepatitis B and Hepatitis C Virus in HIV-Infected Patients in South India. World Journal of Gastroenterology, 13, 5015-5020.
http://dx.doi.org/10.3748/wjg.v13.i37.5015
[26]  Sadoh, A., Sadoh, W. and Iduoriyekemwen, N. (2011) HIV Co-Infection with Hepatitis B and C Viruses among Nigerian Children in an Antiretroviral Treatment Programme. South African Journal of Child Health, 5, 7-10.
[27]  Telatela, S.P., Matee, M.I. and Munubhi, E.K. (2007) Seroprevalence of Hepatitis B and C Viral Co-Infections among Children Infected with Human Immunodeficiency Virus Attending the Paediatric HIV Care and Treatment Center at Muhimbili National Hospital in Dar-es-Salaam, Tanzania. BMC Public Health, 7, 338.
http://dx.doi.org/10.1186/1471-2458-7-338
[28]  Chukwuka, J., Ezechukwu, C. and Egbuonu, I. (2003) Cultural Influences on Hepatitis B Surface Antigen Seropositivity in Primary School Children in Nnewi. Nigerian Journal of Paediatrics, 30, 140-142.
[29]  Sulkowski, M.S., Thomas, D.L., Mehta, S.H., Chaisson, R.E. and Moore, R.D. (2002) Hepatotoxicity Associated with Nevirapine or Efavirenz-Containing Antiretroviral Therapy: Role of Hepatitis C and B Infections. Hepatology, 35, 182-189.
http://dx.doi.org/10.1053/jhep.2002.30319
[30]  Cheruvu, S., Marks, K. and Talal, A.H. (2007) Understanding the Pathogenesis and Management of Hepatitis B/HIV and Hepatitis B/Hepatitis C Virus Coinfection. Clinical Liver Disease, 11, 917-943.
[31]  Lodenyo, H., Schoub, B., Ally, R., Kairu, S. and Segal, I. (2000) Hepatitis B and C Virus Infections and Liver Function in Aids Patients at Chris Hani Baragwanath Hospital, Johanneburg. East African Medical Journal, 77, 13-15.
[32]  Shire, N., Welge, J. and Sherman, K. (2006) Efficacy of Inactivated Hepatitis A Vaccine in HIV-Infected Patients: A Hierarchical Bayesian Meta-Analysis. Vaccine, 24, 272-279.
http://dx.doi.org/10.1016/j.vaccine.2005.07.102
[33]  Laurence, J. (2005) Hepatitis A and B Immu-Nizations of Individuals Infected with Human Immunodeficiency Virus. American Journal of Medicine, 118, 75S-83S.
[34]  Gandhi, R. (2005) Response to Hepatitis B Vaccine in HIV-1-Positive Subjects Who Test Positive for Isolated Antibody to Hepatitis B Core Antigen: Implications for Hepatitis B Vaccine Strategies. The Journal of Infectious Diseases, 191, 1435-1441.
http://dx.doi.org/10.1086/429302
[35]  Operskalski, E. and Andrea, K. (2011) HIV/HCV Co-Infection: Pathogenesis, Clinical Complications, Treatment, and New Therapeutic Technologies. Current HIV/AIDS Reports, 8, 12-22.
http://dx.doi.org/10.1007/s11904-010-0071-3
[36]  Nyirenda, M., Beadsworth, M., Stephany, P., Hart, C., Hart, I., Munthali, C., et al. (2008) Prevalence of Infection with Hepatitis B and C Virus and Coinfection with HIV in Medical Inpatients in Malawi. Journal of Infection, 57, 72-77.
http://dx.doi.org/10.1016/j.jinf.2008.05.004
[37]  Benhamou, Y., Bochet, M., Thibault, V., Di Martino, V., Caumes, E., Bricaire, F., et al. (1999) Long-Term Incidence of Hepatitis B Virus Resistance to Lamivudine in Human Immunodeficiency Virus-Infected Patients. Hepatology, 30, 1302-1306.
http://dx.doi.org/10.1002/hep.510300525
[38]  Hirsch, H.H., Kaufmann, G., Sendi, P. and Battegay, M. (2004) Immune Reconstitution in HIV-Infected Patients. Clinical Infectious Diseases, 38, 1159-1166.
http://dx.doi.org/10.1086/383034
[39]  Rouet, F., Chaix, M.L., Inwoley, A., Anaky, M.F., Fassinou, P., Kpozehouen, A., et al. (2008) Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African HIV Type-1-Infected Children. Clinical Infectious Diseases, 46, 361-366.
http://dx.doi.org/10.1086/525531
[40]  Oyedeji, G.A. (1984) The Present Day Epidemiology of Severe Protein-Energy Malnutrition in Nigeria. Clinical Pediatrics, 23, 623-628.
http://dx.doi.org/10.1177/000992288402301104
[41]  Blumberg, B. (1971) The Discovery of Australian Antigen and Its Relation to Viral Hepatitis. Vitro, 7, 223.
[42]  Kuo, G., Choo, Q., Alter, H. and Houghton, M. (1989) An Assay for Circulating Antibodies to a Major Etiologic Virus of Human Non-A, Non-B Hepatitis. Science, 244, 362-364.
http://dx.doi.org/10.1126/science.2496467
[43]  Wilber, J. (1993) Development and Use of Laboratory Tests for Hepatitis C Infection: A Review. Journal of Clinical Immunoassay, 16, 204-207.
[44]  Durowaye, M., Ernest, S. and Ojuawo, I. (2014) Prevalence of HIV Co-Infection with Hepatitis B and C Viruses among Children at a Tertiary Hospital in Ilorin, Nigeria. International Journal of Clinical Medicine Research, 1, 42-47.
[45]  Centers for Disease Control, US Department of Health and Human Services (1986) Classification System for Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus Infections. Annals of Internal Medicine, 105, 234-237.
http://dx.doi.org/10.7326/0003-4819-105-2-234
[46]  Snyder, J.D. and Pickering, L.K. (2010) Viral Hepatitis. In: Kliegman, R.M., Stanton, B., Geme, J.W., Schor, N.F. and Behrman, R.E., Eds., Nelson Textbook of Pediatrics, 19th Edition, Elsevier Inc., Philadelphia, 1324-1331.
[47]  Safrin, S. (2004) Antiviral Agents. In: Katzung, B.G., Masters, S.B. and Trevo, A.J., Eds., Basic and Clinical Pharmacology, 9th Edition, The McGraw-Hill Companies, Inc., China, 1117-1156.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

微信:OALib Journal