Prevalence and risk factors associated with HIV/hepatitis B and HIV/hepatitis C co-infections among people who inject drugs in Mozambique

Abstract

Background: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID. Methods: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who selfreported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited in two cross-sectional samples in Maputo and Nampula/Nacala, two large urban centers of Mozambique. Rapid screening of HIV, HBV (HBsAg) and HCV was performed on site. Data from participants in both cities were pooled to conduct RDS-weighted bivariate analyses with HIV/HBV and HIV/HCV co-infections as separate outcomes. Unweighted bivariate and multivariate logistic regression analyses were conducted to assess correlates of coinfection. Results: Among 492 eligible PWID, 93.3% were male and median age was 32 years [IQR: 27-36]. HIV, HBV and HCV prevalence were respectively 44.9% (95% CI:37.6-52.3), 32.8% (95% CI:26.3-39.5) and 38.3 (95% CI:30.6-45.9). Coinfections of HIV/HBV, HIV/HCV and HIV/HBV/HCV were identified in 13.1% (95% CI:7.2-18.9), 29.5% (95% CI:22.2-36.8) and 9.2% (95% CI:3.7-14.7) of PWID, respectively. Older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HBV co-infection. Living in Maputo city, have older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HCV coinfection.

Seroprevalence and Knowledge of Viral Hepatitis and HIV Among People Who Use Drugs Attending Methadone Therapy Clinic in Tanzania: A Cross-sectional Study.

“…The vast difference of rates between the later study and ours might be explained by the reasons that the later study was conducted from 2011-2013, immediately after commencement of MTC and harm reduction program in the country; therefore many clients were unaware of infection protection methods. Also, different study sites have different infection rates due to the urbanization effect which is a major factor for viral transmission (14)(15)(16).This effect has further been observed in the current study where the Kirumba area, which is in the Mwanza city center, comprised signi cantly more cases of viral hepatitis. Regarding HBV infection, the prevalence obtained from this study (3.5%) is lower than that of the general population in the country, which is estimated to be 4.1% (3).…”

Recognizing the hidden: strengthening the HIV surveillance system among key and priority populations in Mozambique

“…There has been a systematic approach to the use and dissemination of data for the development of abstracts for international conferences and manuscripts for international peer-reviewed journals of both INS staff and students interested in using the BBS data for their thesis and dissertation work. To date, sixteen manuscripts have been published or are under review in peer-reviewed journals [13][14][15][16][17][34][35][36][37][38][39][40][41][42][43][44], and six students have used BBS data for their dissertations (undergraduate, masters, and doctorate). These abstracts and manuscripts have benefited from systematic and ongoing support from INS leadership and partner organizations.…”

Seroprevalence of hepatitis B virus infection, anti-HCV antibodies and HIV and knowledge among people who use drugs attending methadone therapy clinic in Tanzania; a cross-sectional study

“…The vast difference of rates between the later study and ours might be explained by the reasons that the later study was conducted from 2011 to 2013, immediately after commencement of MTC and harm reduction program in the country; therefore many clients were unaware of infection protection methods. Also, different study sites have different infection rates due to the urbanization effect which is a major factor for viral transmission [ 14 – 16 ]. This effect has further been observed in the current study where the Kirumba area, which is in the Mwanza city center, comprised significantly more cases of viral hepatitis.…”