Prevalence of hepatitis B and C and relationship to liver damage in HIV infected patients attending Joint Clinical Research Centre Clinic (JCRC), Kampala, Uganda
Prevalence of hepatitis B and C and relationship to liver damage in HIV infected patients attending Joint Clinical Research Centre Clinic (JCRC), Kampala, Uganda
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DOI：
10.4314/ahs.v15i2.3
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发表时间：
2015-01-01
影响因子：
1
通讯作者：
Mayanja-Kizza, Harriet
中科院分区：
文献类型：
--
作者：
Baseke, Joy;Musenero, Monica;Mayanja-Kizza, Harriet
背景：乙型和丙型肝炎病毒在世界范围内导致人类免疫缺陷病毒（HIV）阳性个体因肝脏疾病而死亡。乙型肝炎（HBV）和艾滋病毒主要具有相似的传播途径；而丙型肝炎（HCV）主要通过输血传播。人类免疫缺陷病毒增加了肝炎病毒的病理作用，并由于免疫力降低而加强了潜伏性肝炎感染的再激活。抗逆转录病毒（ARVs）药物使用的增加导致患者生存期延长，艾滋病毒阳性个体中肝脏疾病的明显增加。目的：本研究旨在确定乙型肝炎病毒、丙型肝炎病毒的流行情况、它们与艾滋病毒的共同感染情况及其对肝细胞功能的影响。方法：本研究是在联合临床研究中心（JCRC）对就诊的艾滋病毒阳性个体进行的横断面研究。患者在获得签署的知情同意或17岁以下儿童的同意后入组。采集血清标本，检测乙型肝炎表面抗原（HBsAg）、丙型肝炎特异性抗体和丙氨酸转氨酶（ALT）肝酶。结果：入组的89例患者中，20例（22.5%）至少有一种肝炎病毒，15例（16.9%）HBsAg检测呈阳性，5例（5.6%）HCV检测呈阳性，1例两种病毒均有。乙型肝炎在女性中的流行率（57人中有13人，22.8%）高于男性（32人中有2人，6.2%），而HCV在男性中的流行率（32人中有4人，12.5%）高于女性（57人中有1人，1.8%）。89例患者中有7例（7.9%）ALT升高，表明肝细胞损伤。在肝细胞损伤患者中，一人HBsAg检测呈阳性，另一人HCV特异性抗体检测呈阳性。结论：HBV在HIV阳性人群中感染率较高，以女性感染率较高。HCV的流行率低于HBV，男性感染者较多。乙型和丙型肝炎病毒合并感染不常见。这项研究揭示了HIV阳性个体中肝细胞损伤的高发率，尽管HBV或HCV感染引起的损伤比文献记载的低。从这项研究中，HBV和HCV在HIV阳性个体中的高流行率表明需要对HIV阳性个体进行肝炎病毒筛查。
Background: Hepatitis B and C viruses cause death due to liver disease worldwide among Human Immunodeficiency Virus (HIV) positive individuals. Hepatitis B (HBV) and HIV have similar routes of transmission primarily; sexual, intravenous injections and prenatal while hepatitis C (HCV) is transmitted mainly through blood transfusion. Human immunodeficiency virus increases the pathological effect of hepatitis viruses and potentiates re-activation of latent hepatitis infections as a result of reduced immunity. The increase in use of antiretroviral (ARVs) drugs has led to longer period for patient survival and apparent increase in liver disease among HIV positive individuals.Objective: This study aimed at determining the prevalence of HBV, HCV, their co-infection with HIV and their effect on liver cell functionMethod: This was a cross sectional study conducted at the Joint Clinical Research Centre (JCRC) among HIV positive individuals attending the clinic. Patients were enrolled after obtaining a signed informed consent or assent for children below 17 years. Serum samples were collected for detection of Hepatitis B surface antigen (HBsAg), HCV specific antibodies and alanine aminotransferase (ALT) liver enzyme.Results: Of the 89 patients enrolled, 20 (22.5%) had at least one hepatitis virus, 15 tested positive for HBsAg (16.9%) and 5 for HCV (5.6%), one had both viruses. Hepatitis B was more prevalent among women (13 out of 57, 22.8%) than men, (2 out of 32, 6.2%), while HCV was higher among men (4 out of 32, 12.5%) than women (1 out of 57, 1.8%). Seven of 89 patients (7.9%) had elevated ALT, indicative of liver cell injury. Of these with liver cell injury, one individual tested positive for HBsAg and another one individual tested positive for HCV specific antibodies.Conclusion: The prevalence of HBV is high in HIV positive individuals with more women commonly infected. The Prevalence of HCV is lower than that of HBV with more men commonly infected. Co-infection of Hepatitis B and C viruses was uncommon. This study reveals a high prevalence of liver cell injury among HIV positive individuals although the injury due to HBV or HCV infection was lower than that which has been documented. From this study, the high prevalence of HBV and HCV among HIV positive individuals point to a need for screening of HIV positive individuals for the hepatitis viruses.