Background
The global burden of
Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of
developing cirrhosis and hepatocellular cancer is associated with HBV DNA
levels. The main objective of the study was to determine proportion of
Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian
patients and factors associated with HBV viremia after at least 36 weeks
of lamivudine with or without tenofovir containing ART.
Methods
Hepatitis B and HIV
co-infected patients who were ART-naïve or had received at least 9 months
of lamivudine-containing ART were enrolled in a cross-sectional study at
Korle-Bu Teaching Hospital. Demographic and clinical data were collected and
samples obtained for Hepatitis B serology, liver function tests and HBV DNA.
Factors associated with viremia were determined using univariate and
multivariate logistic regression analysis.
Results
Of 3108 HIV-infected
patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled.
Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were
ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced
patients had HBV DNA > 20 IU/mL. In multivariate analysis of all
patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT
(OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In
treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male
sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.
Conclusions
Majority of ART-naïve
(89 %) and 42 % of ART-experienced patients had detectable hepatitis
B viremia > 20 IU/mL. An abnormal serum ALT was significantly
associated with hepatitis B viremia in HBV and HIV co-infected patients
irrespective of treatment status. Baseline and on-treatment ALT may be a useful
non-invasive predictor of Hepatitis B viremia in resource-constrained countries
in sub-Saharan Africa where infection is endemic and viral load tests are not
widely available.
Full article at: http://goo.gl/cTjFtw
By: 
Margaret Lartey, Kwamena W. Sagoe, Adjoa Obo-Akwa, Ernest Kenu, Fizza S. Gillani,Hongmei Yang, Isaac Boamah, Timothy Flanigan, and Awewura Kwara
Margaret Lartey, Kwamena W. Sagoe, Adjoa Obo-Akwa, Ernest Kenu, Fizza S. Gillani,Hongmei Yang, Isaac Boamah, Timothy Flanigan, and Awewura Kwara
Department of
Medicine and Therapeutics, School of Medicine and Dentistry, College of Health
Sciences, University of Ghana, Accra, Ghana
Korle-Bu Teaching
Hospital, Accra, Ghana
Department of
Microbiology, School of Biomedical and Allied Health Sciences, College of
Health Sciences, University of Ghana, Accra, Ghana
Warren Alpert
Medical School of Brown University, Providence, RI USA
The Miriam
Hospital, Providence, RI USA
Department of
Biostatistics and Computational Biology, University of Rochester School of
Medicine and Dentistry, Rochester, NY USA
Timothy N. A. Archampong, Phone: 00233-203039841, Email: ku.ten.srotcod@aant.
More at: https://twitter.com/hiv insight
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