Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Public Health, College of Zemen Postgraduate, Dessie, Ethiopia.
BMC Infect Dis. 2024 May 1;24(1):460. doi: 10.1186/s12879-024-09355-4.
Existing research in Ethiopia has primarily focused on the individual epidemiology of HIV and HBV, often overlooking the intricate dynamics of co-infection. This study aims to address this gap by comprehensively exploring the prevalence of HBV and HIV co-infection and the associated factors influencing co-infection rates within the specific context of ART clinics. The existing study provides limited insights into the unique challenges posed by this dual infection in the Ethiopian population receiving ART.
An institutional-based cross-sectional study was conducted among people living with HIV aged 18 years and above attending ART clinics in northeast Ethiopia from April to May 2022. A sample size of 350(97% response rate) participants was selected by using a systematic random sampling method. Data were collected using a pre-tested interviewer-administered structured questionnaire. Data was entered into Epi Data version software and was exported to SPSS version 25 for further analysis. Descriptive statistics using Frequency, proportion, and summary measures were done. Binary logistic regressions were done to identify independent variables associated with HBV infection among HIV patients. A P-value less than 0.05 and adjusted odds ratio with a 95% confidence interval non-inclusive of one was considered statistically significant.
The prevalence of Hepatitis B Surface Antigen (HBsAg) was identified constituting 7.14% of the study population. Females [AOR] 0.14; 95% Confidence Interval [CI] [0.041-0.478]). Participants with an educational status of only reading and writing (AOR 8.7; 95% CI [1.143-66.5]). Single individuals (AOR 2.04; 95% CI [1.346-28.6]) were associated factors. Moreover, participants with a viral load exceeding 1000 copies/ml were 6.5 times more likely to be infected with HBV compared to those with undetectable viral loads (AOR 6.53, 95% CI [1.87-22.72]). Additionally, individuals with a CD4 count ranging from 351 to 500 cells/ml were 1.2 times more likely to be infected with HBV compared to those with a CD4 count of 500 cells/ml or above (AOR 10.4, 95% CI [1.28-85]).
The prevalence of HBV infection was found to be intermediate in HIV-infected patients in the study area. Being male, marital status of single and divorced, educational level was only read and written, current viral load of > 1000 copies/ml &<1000 copies/ml, and current CD4 < 250 cells/ml were found statistically associated factors for HBV infection. Thus, we recommend the provision of routine screening for HBsAg and appropriate treatment with accurate information on risk factors for HBV to improve quality of life and reduce morbidity.
在埃塞俄比亚，现有研究主要集中在 HIV 和 HBV 的个体流行病学方面，往往忽略了合并感染的复杂动态。本研究旨在通过全面探讨 ART 诊所中 HBV 和 HIV 合并感染的流行情况以及影响合并感染率的相关因素来解决这一差距。现有研究仅提供了有限的见解，无法了解在接受 ART 的埃塞俄比亚人群中，这种双重感染带来的独特挑战。
本研究为 2022 年 4 月至 5 月期间在埃塞俄比亚东北部的艾滋病毒感染者年龄在 18 岁及以上的 ART 诊所中进行的一项基于机构的横断面研究。采用系统随机抽样法抽取了 350 名（97%的应答率）符合条件的参与者。使用经过预测试的访谈者管理的结构化问卷收集数据。数据录入 Epi Data 版本软件，并导出到 SPSS 版本 25 进行进一步分析。使用频率、比例和汇总措施进行描述性统计。进行二元逻辑回归以确定与 HIV 患者 HBV 感染相关的独立变量。P 值小于 0.05 且调整后的比值比不包括 1 的 95%置信区间被认为具有统计学意义。
研究人群中发现乙型肝炎表面抗原（HBsAg）的流行率为 7.14%。女性 [AOR] 0.14；95%置信区间 [CI] [0.041-0.478]）。仅具有读写能力的教育程度的参与者 [AOR 8.7；95%CI [1.143-66.5]）。单身人士 [AOR 2.04；95%CI [1.346-28.6]）是相关因素。此外，病毒载量超过 1000 拷贝/ml 的参与者感染 HBV 的可能性是病毒载量不可检测的参与者的 6.5 倍（AOR 6.53，95%CI [1.87-22.72]）。此外，CD4 计数在 351 到 500 个细胞/ml 之间的个体感染 HBV 的可能性是 CD4 计数为 500 个细胞/ml 或更高的个体的 1.2 倍（AOR 10.4，95%CI [1.28-85]）。
研究区域发现 HIV 感染者中 HBV 感染的流行率处于中等水平。男性、单身和离异的婚姻状况、教育程度仅为读写、当前病毒载量>1000 拷贝/ml 和<1000 拷贝/ml、当前 CD4<250 个细胞/ml 是与 HBV 感染相关的统计学因素。因此，我们建议提供 HBsAg 的常规筛查，并根据 HBV 感染的危险因素提供适当的治疗和准确的信息，以提高生活质量并降低发病率。
