Kapembwa Kenneth C, Goldman Jason D, Lakhi Shabir, Banda Yolan, Bowa Kasonde, Vermund Sten H, Mulenga Joseph, Chama David, Chi Benjamin H
Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia.
J Glob Infect Dis. 2011 Jul;3(3):269-74. doi: 10.4103/0974-777X.83534.
Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART).
We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV Ab) at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection.
Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2%) were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4%) were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be <40 years (84.4% vs. 61.4%; P=0.01) when compared to those who were not coinfected. Patients with active hepatitis B were more likely to have mild to moderately elevated AST/ALT (40-199 IU/L, 15.8% vs. 5.4%; P=0.003). Highly elevated liver enzymes (>200 IU/L) was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5). We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease.
HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.
撒哈拉以南非洲地区需要艾滋病毒和病毒性肝炎合并感染的流行病学数据，以指导肝炎筛查和优化抗逆转录病毒治疗（ART）的卫生政策。
我们在赞比亚卢萨卡的一家三级医院对323名符合ART治疗条件的艾滋病毒感染成人进行了乙肝表面抗原（HBsAg）和丙肝抗体（HCV Ab）筛查。我们收集了基本的人口统计学、医学和实验室数据，以确定合并感染的预测因素。
在323名登记患者中，32名（9.9%；95%CI=6.7-13.2%）HBsAg呈阳性，而4名（1.2%；95%CI=0.03-2.4%）HCV Ab呈阳性。与未合并感染的患者相比，合并乙肝感染的患者年龄更可能小于40岁（84.4%对61.4%；P=0.01）。活动性乙肝患者更可能出现轻度至中度升高的AST/ALT（40-199 IU/L，15.8%对5.4%；P=0.003）。肝酶高度升高（>200 IU/L）并不常见，两组之间无差异（3.4%对2.3%；P=0.5）。由于疾病患病率较低，我们无法确定丙肝感染的预测因素。
在这家三级医疗机构开始接受ART治疗的患者中，艾滋病毒和乙肝合并感染很常见。对于非洲南部的艾滋病毒感染者，应考虑进行乙肝的常规筛查。
