埃塞俄比亚费尔盖希沃特转诊医院HIV感染儿童的乙肝和丙肝病毒血清流行率及危险因素
Seroprevalence of hepatitis B and C viruses and risk factors in HIV infected children at the Felgehiwot referral hospital, Ethiopia.
作者信息
Abera Bayeh, Zenebe Yohanes, Mulu Wondemagegn, Kibret Mulugeta, Kahsu Getachew
机构信息
Department of Medical Microbiology, Parasitology and Immunology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
BMC Res Notes. 2014 Nov 25;7:838. doi: 10.1186/1756-0500-7-838.
BACKGROUND
Liver hepatitis due to Hepatitis B (HBV) and hepatitis C virus (HCV) co-infection is the leading cause of morbidity and mortality in HIV infected children and it is more severe in resource poor settings. Data on seroprevalence of HBV and HCV among HIV infected children are scarce in Ethiopia. This study was conducted to determine seroprevalence and risk factors of HBV and HCV and its effect on liver enzyme among HIV-positive children aged 18 months to 15 years attending the paediatric HIV care and treatment clinic at Felege Hiwot referral hospital, Ethiopia.
METHODS
A cross-sectional study was conducted in May, 2014. Demographic and risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies were detected using an enzyme linked immunosorbent assay (ELISA). Alanine aminotransferase (ALT) levels were determined. The results were analyzed using descriptive and logistic regression.
RESULTS
A total of 253 HIV positive children, boys (52.5%) and girls (47.5%) took part in the study. The median age of the children was 11 years. Overall, 19 (7.5%) of HIV infected children were positive either for HBsAg or anti-HCV antibodies. The seroprevalence of HBV and HCV were 2.0% and 5.5%, respectively. All HBsAg positive children were in older age groups (11-15 years). Seroprevalence of HCV was higher in children from urban (7.7%) than rural (1.2%) residents (P=0.02). Overall, 29 (12.1%) of children had elevated ALT. Of these, 31.5% were from HBsAg or anti-HCV antibody positive children whereas 9.8% were from hepatitis B or C virus negative children (P=0.001). Multivariate logistic regression showed that being positive for HBsAg or anti-HCV antibody (AOR: 4.7(95% CI: 1.5-13.5) was significantly associated with elevated ALT.
CONCLUSION
HBV and HCV co-infections are common in HIV positive children. In HIV positive children, HBV and HCV co-infection were associated with elevate ALT. Routine screening for HBV and HCV in HIV infected children should be implemented.
背景
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）合并感染所致的肝肝炎是HIV感染儿童发病和死亡的主要原因，在资源匮乏地区更为严重。在埃塞俄比亚，关于HIV感染儿童中HBV和HCV血清流行率的数据很少。本研究旨在确定埃塞俄比亚费莱格·希沃特转诊医院儿科HIV护理和治疗诊所中18个月至15岁HIV阳性儿童中HBV和HCV的血清流行率、危险因素及其对肝酶的影响。
方法
2014年5月进行了一项横断面研究。使用结构化问卷收集人口统计学和危险因素。采用酶联免疫吸附试验（ELISA）检测乙型肝炎表面抗原（HBsAg）和抗HCV抗体。测定丙氨酸转氨酶（ALT）水平。结果采用描述性分析和逻辑回归分析。
结果
共有253名HIV阳性儿童参与研究，其中男孩（52.5%）和女孩（47.5%）。儿童的中位年龄为11岁。总体而言，19名（7.5%）HIV感染儿童的HBsAg或抗HCV抗体呈阳性。HBV和HCV的血清流行率分别为2.0%和5.5%。所有HBsAg阳性儿童均为年龄较大的组（11 - 15岁）。城市儿童（7.7%）的HCV血清流行率高于农村儿童（1.2%）（P = 0.02）。总体而言，29名（12.1%）儿童的ALT升高。其中，31.5%来自HBsAg或抗HCV抗体阳性儿童，而9.8%来自乙型或丙型肝炎病毒阴性儿童（P = 0.001）。多因素逻辑回归显示，HBsAg或抗HCV抗体呈阳性（比值比：4.7（95%可信区间：1.5 - 13.5）与ALT升高显著相关。
结论
HBV和HCV合并感染在HIV阳性儿童中很常见。在HIV阳性儿童中，HBV和HCV合并感染与ALT升高有关。应在HIV感染儿童中开展HBV和HCV的常规筛查。
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