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尼日利亚南南地区乌约儿童中乙肝病毒和艾滋病毒合并感染的血清流行率以及高效抗逆转录病毒疗法(HAART)后的结果

Seroprevalence of HBV and HIV co-infection in children and outcomes following highly active antiretroviral therapy (HAART) in Uyo, South-South Nigeria.

作者信息

Ikpeme E E, Etukudo O M, Ekrikpo U E

机构信息

Department of Paediatrics, University of Uyo Teaching Hospital -PMB 1136 Uyo Akwa Ibom State, Nigeria.

Department of Internal Medicine University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.

出版信息

Afr Health Sci. 2013 Dec;13(4):955-61. doi: 10.4314/ahs.v13i4.14.

Abstract

BACKGROUND

Human Immunodeficiency Virus/Hepatitis B Virus (HIV/HBV) co-infection in Nigerian children has emerged as a major concern with the advent of HAART. Its impact on the immune system and liver has not been extensively studied in children.

OBJECTIVES

To determine the prevalence of HBV seropositivity among HIV positive children on HAART and its effect on immune response and liver enzymes.

METHODS

All consecutive HIV positive children aged two months to seventeen years on HAART constituted the study population. Age and gender; CD4+ count, ALT, creatinine and HBsAg were tested and documented at enrolment and 12months.

RESULTS

One hundred and seventy one patients were seen over this period. Seventy-two (43.4%) were males while 94 (56.6%) were females giving a male: female ratio of 1:1.3. The mean age of the patients was 63±43.4 months. Prevalence of HIV/HBV co-infection was 6.02% (95% CI 2.4-9.7). There was no significant effect of HBV status on elevation of ALT levels with 12 months of HAART. Co-infected patients had an odds ratio of achieving immune response of 0.14 (95% CI 0.02-0.79).

CONCLUSION

HIV/HBV co-infection rates in our children are comparable to other localities. ALT levels do not worsen with HAART and immune response of the co-infected children on HAART is lower.

摘要

背景

随着高效抗逆转录病毒治疗(HAART)的出现,尼日利亚儿童中的人类免疫缺陷病毒/乙型肝炎病毒(HIV/HBV)合并感染已成为一个主要问题。其对儿童免疫系统和肝脏的影响尚未得到广泛研究。

目的

确定接受HAART治疗的HIV阳性儿童中HBV血清学阳性的患病率及其对免疫反应和肝酶的影响。

方法

所有连续接受HAART治疗的2个月至17岁HIV阳性儿童构成研究人群。在入组时和12个月时检测并记录年龄、性别、CD4 +细胞计数、谷丙转氨酶(ALT)、肌酐和乙肝表面抗原(HBsAg)。

结果

在此期间共观察了171例患者。其中72例(43.4%)为男性,94例(56.6%)为女性,男女比例为1:1.3。患者的平均年龄为63±43.4个月。HIV/HBV合并感染的患病率为6.02%(95%可信区间2.4 - 9.7)。在接受12个月HAART治疗后,HBV状态对ALT水平升高无显著影响。合并感染患者实现免疫反应的比值比为0.14(95%可信区间0.02 - 0.79)。

结论

我们研究中儿童的HIV/HBV合并感染率与其他地区相当。接受HAART治疗时ALT水平不会恶化,且接受HAART治疗的合并感染儿童的免疫反应较低。

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