Seroprevalence of hepatitis B and C viruses and risk factors in HIV infected children at the felgehiwot referral hospital, Ethiopia

Abstract

BackgroundLiver hepatitis due to Hepatitis B (HBV) and hepatitis C virus (HCV) co-infection is the leading cause of morbidity and mortality in HIV infected children and it is more severe in resource poor settings. Data on seroprevalence of HBV and HCV among HIV infected children are scarce in Ethiopia. This study was conducted to determine seroprevalence and risk factors of HBV and HCV and its effect on liver enzyme among HIV-positive children aged 18 months to 15 years attending the paediatric HIV care and treatment clinic at Felege Hiwot referral hospital, Ethiopia.MethodsA cross-sectional study was conducted in May, 2014. Demographic and risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies were detected using an enzyme linked immunosorbent assay (ELISA). Alanine aminotransferase (ALT) levels were determined. The results were analyzed using descriptive and logistic regression.ResultsA total of 253 HIV positive children, boys (52.5%) and girls (47.5%) took part in the study. The median age of the children was 11 years. Overall, 19 (7.5%) of HIV infected children were positive either for HBsAg or anti-HCV antibodies. The seroprevalence of HBV and HCV were 2.0% and 5.5%, respectively. All HBsAg positive children were in older age groups (11-15years). Seroprevalence of HCV was higher in children from urban (7.7%) than rural (1.2%) residents (P = 0.02). Overall, 29 (12.1%) of children had elevated ALT. Of these, 31.5% were from HBsAg or anti-HCV antibody positive children whereas 9.8% were from hepatitis B or C virus negative children (P = 0.001). Multivariate logistic regression showed that being positive for HBsAg or anti-HCV antibody (AOR: 4.7(95% CI: 1.5-13.5) was significantly associated with elevated ALT.ConclusionHBV and HCV co-infections are common in HIV positive children. In HIV positive children, HBV and HCV co-infection were associated with elevate ALT. Routine screening for HBV and HCV in HIV infected children should be implemented.

Prevalence and Factors Associated with HIV and Hepatitis B and Hepatitis C Co Infection in Children Attended at the Hubert Koutoukou Maga National University Teaching Hospital (CNHU-HKM) of Cotonou

“…This result is close to the 0.46% rate reported by Kerubo et al in Kenya, and to the 0.7% rate reported by Chiekulie et al in Nigeria among adults [16,17]. Abera et al had reported a higher rate of 5.5% [5]. Only one patient involved in the study presented with a triple co-infection.…”

“…It is close to the one found out by several authors; this suggests a perinatal infection or an infection in early childhood of hepatitis among those children [5,6]. As the risk for transition from chronicity to HBV infection is higher in case of infection in early childhood, it is necessary to ensure prevention through immunization at birth in countries with high prevalence [19].…”

“…Transaminases increase has also been reported by Pol [13]. Abera et al had also identified a relationship between co-infection and elevated transaminases [5]. On the contrary, Baseke et al in Uganda, had not identified any disorder of transaminases in co-infected patients [18].…”

“…That rate is lower than the 16.9% reported in the adults in 2012 [4] but higher than the 9.62% reported in children of North-Benin in 2015 [8]. In Ethiopia, Abera et al had identified a significantly low rate of 2% [5]. In Nigeria, Emeka et al had reported a rate of HBV/HIV co-infection of 5.8% [6].…”

“…HIV infection worsens prognosis for liver diseases associated with HCV and HBV [2]. More specifically, HIV facilitates transition to chronicity and fast progression toward liver fibrosis and hepatocellular carcinoma (HCC) [4][5][6]. Viral hepatitis would increase the risk for HIV transmission from mother to child and HIV viremia.…”