Katwesigye Elizabeth, Seremba Emmanuel, Semitala Fred, Ocama Ponsiano
Department of Medicine, Mulago Hospital and Makerere University College of Health Sciences, Kampala, Uganda.
Department of Medicine, Mulago Hospital, Kampala, Uganda.
Afr Health Sci. 2017 Dec;17(4):974-978. doi: 10.4314/ahs.v17i4.4.
Co-infection with hepatitis B (HBV) and hepatitis D (HDV) is common among human immunodeficiency virus (HIV) infected individuals in developing countries and it aggressively accelerates progression of liver disease to cirrhosis and other complications. There is scarcity of data on HDV in sub-Saharan Africa .We investigated the sero-prevalence and factors associated with HDV antibody among HIV/HBV co-infected patients attending a large urban HIV clinic in Uganda.
We screened 189 HIV/HBV co-infected individuals for anti-HDV immunoglobulin G (IgG) and performed logistic regression to determine the associated factors. Socio-demographic, clinical data, immunological status, and liver fibrosis (as determined by the Aspartate transaminase to platelet ratio index and transient elastography) were included.
Participants were predominately young and of sound immunologic status (median age 40 years, median CD4 440 cells/µl). 98% were on ART regimens containing anti-HBV active medications (95.2% were on TDF/3TC while 4.8% on 3TC containing regimen). Median duration on ART was 36 months (IQR 22-72). Anti-HDV was detected in 6/198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis.
The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban cohort.
在发展中国家，乙型肝炎病毒（HBV）和丁型肝炎病毒（HDV）合并感染在人类免疫缺陷病毒（HIV）感染者中很常见，并且会加速肝病进展为肝硬化和其他并发症。撒哈拉以南非洲地区关于HDV的数据匮乏。我们调查了乌干达一家大型城市HIV诊所中HIV/HBV合并感染患者中HDV抗体的血清流行率及相关因素。
我们对189名HIV/HBV合并感染个体进行了抗HDV免疫球蛋白G（IgG）筛查，并进行逻辑回归分析以确定相关因素。纳入了社会人口统计学、临床数据、免疫状态和肝纤维化（通过天冬氨酸转氨酶与血小板比值指数和瞬时弹性成像确定）。
参与者主要为年轻人且免疫状态良好（中位年龄40岁，中位CD4细胞计数440个/μl）。98%的人接受含有抗HBV活性药物的抗逆转录病毒治疗方案（95.2%接受替诺福韦酯/拉米夫定，4.8%接受含拉米夫定的方案）。抗逆转录病毒治疗的中位持续时间为36个月（四分位间距22 - 72个月）。在198人中检测到6人抗HDV阳性，占3.2%（95%置信区间1.14 - 6.92%），与男性性别以及HIV诊断后超过5年的病程相关。
在乌干达城市队列中，HIV/HBV合并感染患者中HDV抗体的血清流行率较低。
