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Background: Hepatitis B virus (HBV) co-infection
with HIV is becoming a major challenge due to shared routes of transmission.
The burden is apparent in regions with widespread use of antiretroviral
treatment, which led to the enhanced emergence of liver-related diseases and
mortality. Though there are conflicting results about the effect of chronic HBV
infection on response to highly active antiretroviral therapy (HAART) (CD4+ cell count and HIV viral load, HIV RNA copies/ml), HAART is known to cause
immune mediated HBV specific liver damage after it reconstitutes cell-mediated immunity. The
relationship of different HAART regimes with immune recovery is an area of research
interest. Objective: It is in order to determine the
changes in immune recovery during HBV infection in the setting of HAART among
HIV positive individuals attending care and treatment services. Methods: Two cohorts of
co-infected patients were analyzed from data of one to seven months
retrospectively. The first group (n = 380) was antiretroviral
drug naive and the second cohort (n = 380) was on HAART for the entire period.
The study was conducted in one referral hospital and six health centers. Data
were gathered from 760 patients using their intake form, their follow-up form
and their medical records supplemented by data from a structured questionnaire.
HBV infection was determined by using HBsAg rapid and confirmatory tests and CD4 cells were enumerated
Background: Vertical transmission of HIV among women who
have no access to ART is estimated to be 25% - 35% in Africa. Objective: The
aim of the study was to assess the time of MTCT of HIV-1 the efficacy of ART on
prevention of mother-to-child transmission (MTCT) of HIV-1 in two hospitals.
Methods: Prospective cohort study was conducted from November 2011 to May 2012.
A total of 162 participants, 81 mothers (24 non-breastfeeding and 57
breastfeeding) and 81 infants were involved in the study. Venous blood from
mothers and heel blood (dried blood spot) from infants were collected and
processed in Adama Regional laboratory. All dried blood spot specimens of
infants reactive on ELISA test were assessed by DNA-based polymerase chain
reaction tests (DNA PCR) to determine HIV infection. Data were entered and
analysed using SPSS version 19 computer software. Results: Five infants were
infected with HIV at the end of this study. The overall rate of vertical
transmission of HIV was 6.2%. Maternal viral load at delivery was independently
associated with both inutero and intra-partum transmission (OR = 27.0, 95% CI,
3.5 - 210, p = 0.001). Maternal viral
load at 6 weeks of birth and low infant birth weight was associated with
intra-partum transmission among breastfeeding mothers (OR = 25.5, 95% CI,
1.14 - 572, p = 0.04) and (OR = 29.6,
95% CI, 3.2 - 273, p = 0.004),
respectively. There were 40% MTCT of HIV among non ARV drug users and only 3.9%
among those used ARV drugs during their current pregnancy. Conclusion:
Strategies planned to reduce maternal viral load during pregnancy can be
successful in substantially reducing vertical transmission of HIV. In addition,
other contributing factors for MTCT of HIV-1 should be controlled.