Prevalence and impact of hepatitis B and C among HIV infected patients in Guinea-Bissau

Start date: 24 February, 2011 End date: 4 February, 2012 Project type: Master's Thesis (prior to 2018) Project code: A12030 Countries: Guinea-Bissau Institutions: Aarhus University Hospital, Denmark Grant recipient: Bo Langhoff Hønge Total grant: 10,000 DKK



Background: Co-infection with the human immunodeficiency virus (HIV) and viral hepatitis B (HBV) and C (HCV) may lead to accelerated hepatic disease progression with higher rates of liver cirrhosis and liver-related mortality compared to HBV or HCV mono-infection. In this study we aimed to estimate the prevalence and impact of HBV and HCV among HIV infected patients in Bissau, Guinea-Bissau.

Methods: In this cross sectional study we included 576 patients from an HIV clinic in the period 28th of April – 30th of September. All patients were interviewed, had a clinical exam performed and had a blood sample taken. Patient samples were tested for HBV and HCV with a chemolumination test (Architect, Abbott).

Results: In total 91.3 % of the patients had serological evidence of present or previous HBV infection. The prevalence of HBV surface antigen (HBsAg) was 16.3 % and this was most frequent in the age group of 30-39 years. The HBsAg positive patients had a lower median CD4 count and higher levels of liver enzymes (ALT and AST). A history of receiving blood transfusions was significantly associated with positive HBV serology. Antibodies against HCV (anti-HCV) were positive in 4.0 % of the patients and most frequent among patients > 50 years. The only clinical sign associated with HBsAg and anti-HCV positivity was no hair in patients´ axillaries.

Discussion: The prevalence of HBV and HCV were comparable to other West African studies. Due to the silent nature of HBV and HCV, diagnosis cannot rely on clinical suspension, and a highly sensitive test should be used for the screening of HIV infected patients.