Noubiap Jean Jacques N, Aka Peter V, Nanfack Aubin J, Agyingi Lucy A, Ngai Johnson N, Nyambi Phillipe N
Serology Unit, Medical Diagnostic Center, Yaounde, Cameroon.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America.
PLoS One. 2015 Sep 15;10(9):e0137375. doi: 10.1371/journal.pone.0137375. eCollection 2015.
As people infected with the human immunodeficiency virus (HIV) in Sub-Saharan Africa live longer due to availability of antiretroviral treatment (ART), so is the rise of associated infections with their burdens on patients. But reliable data on the prevalence of co-infection with hepatitis B (HBV) or C (HCV) still remains sparse and many individuals with HIV do not know their co-infection status. This study attempted to estimate the seroprevalence and identify risk factors associated with hepatitis B and/or C co-infections in HIV-infected individuals from five Regions of Cameroon by screening 531 HIV infected subjects for the presence of HBV surface antigen (HBsAg) and antibodies to HCV (HCV-Ab). A Screening and a confirmatory Enzyme linked immunosorbent assay were used to detect presence of markers of infection. CD4 count levels were also examined. The results indicate that of the 531 participants, 68% were females and 32% males. Mean CD4 count was ~400 cells/μl. Seroprevalence rates for HBsAg and HCV-Ab were 23.7%, and 7.2%, respectively. Associations assessed using logistic regression revealed that HBsAg but not HCV-Ab positivity was linked to age, lower CD4 count and residing in an urban rather than in a rural setting. This high prevalence of co-infection with HBV raises the urgent need to systematically screen all newly diagnosed HIV cases for co-infection in Cameroon and other regions of sub-Saharan Africa where HIV accounts for the majority of the global infection, so as to improve management strategies for HBV infection and ART implementation.
由于抗逆转录病毒治疗(ART)的可及性,撒哈拉以南非洲感染人类免疫缺陷病毒(HIV)的人群寿命延长,与之相关的感染及其给患者带来的负担也在增加。但是,关于乙型肝炎(HBV)或丙型肝炎(HCV)合并感染患病率的可靠数据仍然很少,许多HIV感染者并不知道自己的合并感染状况。本研究试图通过对喀麦隆五个地区的531名HIV感染者进行HBV表面抗原(HBsAg)和抗HCV抗体(HCV-Ab)筛查,来估计HBV和/或HCV合并感染的血清学患病率,并确定相关危险因素。采用筛查和确证性酶联免疫吸附试验检测感染标志物的存在。同时也检测了CD4细胞计数水平。结果显示,531名参与者中,68%为女性,32%为男性。平均CD4细胞计数约为400个/μl。HBsAg和HCV-Ab的血清学患病率分别为23.7%和7.2%。采用逻辑回归评估的关联显示,HBsAg阳性而非HCV-Ab阳性与年龄、较低的CD4细胞计数以及居住在城市而非农村地区有关。HBV合并感染的高患病率凸显了在喀麦隆以及撒哈拉以南非洲其他地区(这些地区的HIV感染占全球感染的大多数)对所有新诊断的HIV病例进行合并感染系统性筛查的迫切需求,以便改进HBV感染的管理策略和ART的实施。