Sero-Prevalence of HBV & Associated Risk Factors among HIV Positive Individuals Attending ART Clinic at Mekelle Hospital, Tigray, Northern Ethiopia

BACKGROUND:

Because of the shared mean of transmission, hepatitis B virus (HBV) is one of an important cause of co-morbidity and mortality in peoples living with HIV/AIDS. Hence, the aim of this study was to determine the sero-prevalence of HBV infection and associated risk factors in HIV/AIDS positive individuals attending ART clinic at Mekelle hospital, Mekelle, Northern Ethiopia.

METHODS:

A cross sectional study was conducted from August to October 2014 in HIV/AIDS positive adult individuals. Socio-demographic data and other explanatory variables were collected from 508 study participants using pre-tested and structured questionnaire-based interviews. Serum hepatitis B surface antigen (HBsAg) was detected using commercially available rapid test and third generation enzyme-linked immunosorbent assay (ELISA). Bivariate and multivariate analysis, using SPSS V.20.0, were performed to assess the variables associated with HBV infection and P value less than 0.05 was considered as statistically significant.

RESULTS:

A total of 508 study participants, 305 females and 203 males were included in this study with the mean (+SD) age of 37.8 + 9.6. The sero-prevalence of HBsAg was 5.9 %. Male gender (AOR = 2.6, 95 % CI 1.2-5.7), multiple sexual partners (AOR = 4.2, 95 % CI 1.3-13.1) and CD4 count <200 cells/μl (AOR = 3.5, 95 % CI 1.1-11.2) were significantly associated with HBsAg positivity.

CONCLUSION:

The prevalence of HBsAg was similar to the general population. However, HIV/AIDS positive individuals with reduced CD4 count, <200 cells/μl, showed a significant association with HBsAg seropositivity. Therefore, we recommended, all HIV/AIDS positive individuals should be screened for HBsAg during their follow for better treatment outcome and minimize risks of HBV transmission.

Bivariate analysis of associated risk factors for HBV infection in Mekelle among HIV positive individuals

Variables	HBV sero status
	Total = 508	Yes = 30	No = 478	COR (95 % CI)	P value
	Total n (%)	+ve N (%)	−ve N (%)
Blood transfusion
No	467 (91.9)	27 (5.8)	440 (94.2)	1
Yes	41 (8.1)	3 (7.3)	38 (92.7)	1.3 (0.4–4.4)	0.690
Unsafe injection
No	475 (83.5)	26 (5.5)	449 (94.5)	1
Yes	33 (6.5)	4 (12.1)	29 (87.9)	2.4 (0.8–7.3)	0.128*
Multiple sexual partners
No	482 (94.9)	25 (5.2)	457 (94.8)	1
Yes	26 (5.1)	5 (19.2)	21 (80.8)	4.4 (1.5–12.5)	0.006*
Surgical history
No	408 (80.3)	20 (4.9)	388 (95.1)	1
Yes	100 (19.7)	10 (10)	90 (90)	2.2 (1.0–4.8)	0.058*
Tooth extraction
No	319 (62.8)	20 (6.3)	299 (93.7)	1
Yes	189 (37.2)	10 (5.3)	179 (94.7)	0.8 (0.4–1.8)	0.651
Abortion
No	475 (93.5)	29 (6.1)	446 (93.9)	1
Yes	33 (6.5)	1 (3)	32 (97.0)	0.5 (0.1–3.6)	0.478
Tattooing
No	447 (88)	27 (6)	420 (94)	1
Yes	61 (12)	3 (4.9)	58 (95.1)	0.8 (0.2–2.7)	0.728
Family having liver disease
No	468 (92)	28 (6)	440 (94)	1
Yes	40 (7.9)	2 (5)	38 (95)	0.8 (0.2–3.6)	0.800
CD4 count
<200 cells/μl	85 (16.5)	9 (10.6)	76 (89.4.)	3.9 (1.3–12.1)	0.018*
200–350 cells/μl	118 (23.2)	7 (5.9)	111 (94.1)	2.1 (0.6–6.7)	0.221
351–499 cells/μl	135 (26.6)	9 (6.7)	126 (93.3)	2.4 (0.8–7.2)	0.133*
≧500 cells/μl	170 (33.5)	5 (2.9)	165 (97.1)	1
ART status
Pre ART	65 (12.8)	2 (3.1)	63 (96.9)	1
ART	443 (87.2)	28 (6.3)	415 (93.7)	2.1 (0.5–9.1)	0.311
ART drugs
AZT,3T, Nuv	106 (24.5)	7 (6.6)	99 (93.4)	1.2 (0.5–3.4)	0.678
AZT,3T, Evf	58 (13.4)	6 (10.3)	52 (89.7)	2.0 (0.7–6.0)	0.200
TDF,3T, Nuv	101 (23.4)	6 (5.9)	95 (94.1)	1.1 (0.4–3.2)	0.849
TDF,3T, EFV	167 (38.7)	9 (5.4)	158 (94.6)	1

COR crude odds ratio

* Statistically significant at P < 0.2

Full article at:   http://goo.gl/fVPpuR

By:  Weldemhret L1, Asmelash T2, Belodu R2, Gebreegziabiher D2.

• 1Medical Microbiology Laboratory, Mekelle Hospital, Mekelle, Ethiopia.
• 2Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
• AIDS Res Ther. 2016 Feb 4;13:6. doi: 10.1186/s12981-016-0090-2. eCollection 2016. 

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