Abstract:
BACKGROUND: Tanzania is currently scaling-up access to anti-retro viral therapy
(ART) to reach as many eligible persons as possible. Hepatitis viral
co-infections are known to influence progression, management as well as outcome
of HIV infection. However, information is scarce regarding the prevalence and
predictors of viral hepatitis co-infection among HIV-infected individuals
presenting at the HIV care and treatment clinics in the country.
METHODS: A cross-sectional study conducted between April and September 2006
enrolled 260 HIV-1 infected, HAART naïve patients aged > or = 18 years presenting
at the HIV care and treatment clinic (CTC) of the Muhimbili National Hospital
(MNH). The evaluation included clinical assessment and determination of CD4+
T-lymphocyte count, serum transaminases and serology for Hepatitis A, B and C
markers by ELISA.
RESULTS: The prevalence of anti HAV IgM, HBsAg, anti-HBc IgM and anti-HCV IgG
antibodies were 3.1%, 17.3%, 2.3% and 18.1%, respectively. Dual co-infection with
HBV and HCV occurred in 10 individuals (3.9%), while that of HAV and HBV was
detected in two subjects (0.8%). None of the patients had all the three hepatitis
viruses. Most patients (81.1%) with hepatitis co-infection neither had specific
clinical features nor raised serum transaminases. History of blood transfusion
and jaundice were independent predictors for HBsAg and anti-HBc IgM positivity,
respectively.
CONCLUSION: There is high prevalence of markers for hepatitis B and C infections
among HIV infected patients seeking care and treatment at MNH. Clinical features
and a raise in serum alanine aminotransferase were of limited predictive values
for the viral co-infections. Efforts to scale up HAART should also address
co-infections with Hepatitis B and C viruses.
