Prevalence of hepatitis viruses in an anti‐human immunodeficiency virus‐positive population from Argentina. Amulticentre study

Abstract

The objectives of this study were to investigate the prevalence of infections with hepatotrophic viruses in an anti-human immunodeficiency virus (HIV)-positive population from Buenos Aires and to compare it among the main risk groups for HIV infection. Four hundred and eighty-four consecutive patients attending the HIV outpatients clinic were studied: 359 men and 125 women, median age 29 years (range 16-67 years); 35.5% had presented acquired immune deficiency syndrome (AIDS)-defining conditions. Two hundred and thirty-four patients were intravenous drug users (IVDU), 99 had homosexual and 142 heterosexual preference, seven had received blood transfusions and two had no risk factors. Hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B core antigen (HBcAb) and to hepatitis C virus (anti-HCV) were investigated in all patients; antibodies to HBsAg (HBsAb) and IgG antibodies to hepatitis D virus (anti-HDV) in all HBcAb-positive patients; hepatitis B e antigen and antibodies to HBeAg (HBeAg) in all HBsAg-positive patients; IgG antibodies to hepatitis A virus (anti-HAV) in the first 307 patients; and IgG antibodies to hepatitis E virus (anti-HEV) in the first 91 patients. As control groups, contemporary voluntary blood donors were studied for prevalence of HAV, HBV, HCV and HEV. The percentages of HBcAb, HBsAg, anti-HCV and anti-HEV (58.5, 14.5, 58.5 and 6.6%, respectively) were significantly higher in anti-HIV-positive patients than in control groups (3.2, 0.5, 1.0 and 1.8%, respectively) (P = 0.000). The prevalence of HBcAb was significantly higher in IVDU (72.6%) than in heterosexuals (33.8%) (P = 0.0001) and in homosexuals (59.6%) (P = 0.0189). The percentage of HBsAg was significantly higher in IVDU (19.2%) than in heterosexuals (6.3%) (P = 0.0004). Anti-HCV was significantly higher in IVDU (92.3%) than in homosexuals (14.1%) and in heterosexuals (33.1%) (P = 0.000 in both cases). The prevalence of anti-HDV was relatively low (1.9%). There was no difference in the percentage of anti-HAV between HIV-positive and negative subjects. In conclusion, there is a high prevalence of HBV and HCV infections in HIV-positive patients from our area. Drug use is the main route of transmission, but prevalence of HCV in patients with, probably, sexually acquired HIV infection is also higher than in the control group. The increased prevalence of HEV infection in HIV-positive individuals is another provocative finding that warrants further study.

Serological markers and risk factors for hepatitis B and C viruses in patients infected with human immunodeficiency virus

“…The results of this study indicate that the frequency of HBV markers (38.6%) is similar to that found in other Latin American countries 6,13,20 .…”

“…In contrast, the frequency of anti-HCV in HIV patients (0.8%) is much lower than that found in previous reports from Brazil (Santos and São Paulo), Cuba and Argentina, where the seroprevalence of anti-HCV was 36.2%, 17.7%, 15.5%, and 58.5%, respectively 6,7,13,25 . The low frequency found in our study could be explained by the low incidence of intravenous drug use and the infrequent transfusions in this population, which are very different to those reported in the studies cited from Latin America where intravenous drug use 13,18,25 and past history of transfusion 7 were the main risk factors identified for HCV infection in HIV patients.…”

“…These data suggest that sexual intercourse is the most probable route hepatitis B exposure regardless of the fact that HBV was not considered as a STI by the subjects of this study (data not shown). In groups of HIV positive patients from Argentina, Brazil and Cuba, the frequencies of HBV markers were 58.5%, 38.6%, and 45.5%, respectively 6,13,20 . In these studies the most important risk factors were male sex, intravenous drug use and/or high risk sexual behaviors.…”

Prevalência ambulatorial em um hospital geral de marcadores para hepatites B e C em pacientes com infecção pelo vírus da imunodeficiência humana

“…Taxas mais altas têm sido observadas em estudos de coorte europeus (26,37) . Estudos de prevalência demonstram taxas de co-infecção por VHC-HIV em 4% a 15% entre HSH (6,29) , 60% a 90% entre usuários de drogas injetáveis (8,32,36) e aproximadamente 100% em hemofílicos que receberam concentrados de fatores de coagulação antes da introdução da inativação pelo calor, em 1987 (7,28) . Nos EUA, estima-se que em torno de 30% dos 800 000 indivíduos infectados pelo HIV estejam co-infectados pelo VHC (18,30) .…”

Host Immune Status and Response to Hepatitis E Virus Infection

“…Several studies found HIV-positive and AIDS patients to have an increased seroprevalence of anti-HEV IgG compared to those without HIV infection (295)(296)(297). Montella et al-controversially-interpreted their finding of higher HEV seroprevalence in Italian HIV-positive homosexual men than in HIV-negative homosexual men and injection drug users as "[confirmation of] the role of transmission through the fecal-oral route facilitated by sexual practices" (297).…”