Coffie Patrick A, Tchounga Boris K, Bado Guillaume, Kabran Mathieu, Minta Daouda K, Wandeler Gilles, Gottlieb Geoffrey S, Dabis François, Eholie Serge P, Ekouevi Didier K
Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, BP V3 Abidjan, CHU de Treichville, Abidjan, Côte d'Ivoire.
Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.
BMC Infect Dis. 2017 Jul 4;17(1):466. doi: 10.1186/s12879-017-2568-5.
In West Africa where HIV-1 and HIV-2 co-circulate, the co-infection with hepatitis B virus (HBV) and hepatitis Delta virus (HDV) is not well described. This study aimed at estimating the prevalence of HBV and HBV/HDV co-infection according to HIV types and risk factors for HBV infection among West African HIV-infected patients.
A cross-sectional survey was conducted within the IeDEA West Africa cohort from March to December 2012 in Côte d'Ivoire (three sites), Burkina Faso and Mali (one site each). All HIV-infected adult patients on antiretroviral therapy (ART) or not who attended one of the participating HIV clinics during the study period and agreed to participate were included. Blood samples were collected and re-tested for HIV type discrimination, HBV and HDV serology as well as HBV viral load. Logistic regression was used to identify risk factors for HBV infection.
A total of 791 patients were included: 192 HIV-1, 447 HIV-2 and 152 HIV-1&2 dually reactive. At time of sampling, 555 (70.2%) were on ART and median CD4+ cell count was 472/mm (inter-quartile range [IQR]: IQR: 294-644). Sixty-seven (8.5%, 95% CI 6.6-10.6) patients were HBsAg positive without any difference according to HIV type (7.9% in HIV-1, 7.2% in HIV-1&2 dually reactive and 9.4% in HIV-2; p = 0.61). In multivariate logistic analysis, age ≤ 30 years old (adjusted odds ratio [aOR] 5.00, 95% CI 1.96-12.76), age between 31 and 49 years old (aOR 1.78, 95% CI 1.00-2.21) and male gender (aOR 2.15, 95% CI 1.25-3.69) were associated with HBsAg positivity. HBV DNA testing was performed in 36 patients with blood sample available (25 on ART) and 8 (22.2%) had detectable HBV DNA. Among the HBsAg-positive individuals, 14.9% (95% CI 7.4-25.7) were also positive for anti-HDV antibody without any difference according to HIV type (28.6% in HIV-1, 14.3% in HIV-2 and 0.0% in HIV-1&2 dually reactive; p = 0.15).
HBV and HBV/HDV co-infection are common in West Africa, irrespective of HIV type. Therefore, screening for both viruses should be systematically performed to allow a better management of HIV-infected patients. Follow-up studies are necessary to determine the impact of these two viruses on HIV infection.
在艾滋病毒1型和2型共同传播的西非地区，乙型肝炎病毒（HBV）和丁型肝炎病毒（HDV）的合并感染情况尚无详尽描述。本研究旨在评估西非艾滋病毒感染患者中，根据艾滋病毒类型和HBV感染风险因素，HBV及HBV/HDV合并感染的患病率。
2012年3月至12月，在西非IeDEA队列中开展了一项横断面调查，涉及科特迪瓦（三个地点）、布基纳法索和马里（各一个地点）。纳入了研究期间在参与研究的艾滋病毒诊所就诊且同意参与的所有接受或未接受抗逆转录病毒治疗（ART）的成年艾滋病毒感染患者。采集血样并重新检测艾滋病毒类型、HBV和HDV血清学以及HBV病毒载量。采用逻辑回归分析确定HBV感染的风险因素。
共纳入791例患者：192例艾滋病毒1型、447例艾滋病毒2型和152例艾滋病毒1型和2型双反应性患者。采样时，555例（70.2%）正在接受抗逆转录病毒治疗，CD4 + 细胞计数中位数为472/mm³（四分位间距[IQR]：IQR：294 - 644）。67例（8.5%，95%可信区间6.6 - 10.6）患者HBsAg呈阳性，按艾滋病毒类型无差异（艾滋病毒1型中为7.9%，艾滋病毒1型和2型双反应性患者中为7.2%，艾滋病毒2型中为9.4%；p = 0.61）。多因素逻辑分析显示，年龄≤30岁（调整优势比[aOR] 5.00，95%可信区间1.96 - 12.76）、年龄在31至49岁之间（aOR 1.78，95%可信区间1.00 - 2.21）和男性（aOR 2.15，95%可信区间1.25 - 3.69）与HBsAg阳性相关。对36例有血样可用的患者（25例接受抗逆转录病毒治疗）进行了HBV DNA检测，8例（22.2%）检测到可检测到的HBV DNA。在HBsAg阳性个体中，14.9%（95%可信区间7.4 - 25.7）抗HDV抗体也呈阳性，按艾滋病毒类型无差异（艾滋病毒1型中为28.6%，艾滋病毒2型中为14.3%，艾滋病毒1型和2型双反应性患者中为0.0%；p = 0.15）。
无论艾滋病毒类型如何，HBV及HBV/HDV合并感染在西非都很常见。因此，应系统地对这两种病毒进行筛查，以便更好地管理艾滋病毒感染患者。有必要开展随访研究以确定这两种病毒对艾滋病毒感染的影响。
