Hepatitis B & C virus infection in HIV seropositive individuals & their association with risk factors: A hospital-based study

Prevalence of viral hepatitis infection in India: A systematic review and meta-analysis

BACKGROUND

Nowadays, Viral Hepatitis can be comparable to the big three communicable diseases: tuberculosis, HIV/AIDS, and malarial infections. The main purpose of this study was to summarize the prevalence of viral Hepatitis in India from peer-reviewed articles published from February 2000 to February 2021.

MATERIALS AND METHODS

We conducted a systematic search on Science Direct, Scopus, Medline, PubMed, Web of Science, Google Scholar, and other open access journals. We evaluated all relevant papers that looked into the prevalence of viral Hepatitis systematically. Finally, 28 studies on viral Hepatitis published from February 2000 to February 2021 have been selected. These studies have been conducted across the northern, southern, central, eastern, and western regions of India.

RESULTS

Twenty-eight full-text publications were obtained and evaluated consisting of 45,608 research participants. Hepatitis A was found to range from 2.1% to 52.5%. Hepatitis B was found in a wide range of individuals, ranging from 0.87% to 21.4% of the population. Hepatitis C was found to range from 0.57% to 53.7%. The majority of the children were affected by hepatitis A, and 47.4% of third-trimester pregnant mothers were affected by hepatitis E. Diabetes, hospital admission, history of jaundice, history of surgeries, and heterosexual contact were the leading modes of acquiring HBV and HCV infections. As a result of its great magnitude, this disease poses a severe threat to the national healthcare system.

CONCLUSION

Effective public health measures are urgently needed to minimize the burden of viral Hepatitis and eliminate the disease.

Proportion of syphilis and hepatitis B and C virus infections among the Integrated Counselling and Testing Centre attendees of a tertiary care hospital

Introduction

Human Immunodeficiency Virus (HIV) affects the immune system of the body, causing a breakdown in its normal defenses and leaving it vulnerable to a host of life-threatening diseases. High-risk behaviors and routes of transmission for sexually transmitted infections such as syphilis, hepatitis B and hepatitis C are identical with HIV. This study was conducted to assess the proportion of syphilis and hepatitis B and C virus infections in HIV-positive and HIV-negative individuals, and their association with socioeconomic and other factors in Integrated Counselling and Testing Centre (ICTC) attendees, and to determine the association of absolute CD4+ T-lymphocyte count with these co-infections in HIV-positive individuals.

Materials and Methods

The study was conducted in the Department of Microbiology of a tertiary care hospital. It included 100 HIV-positive individuals and 100 matched HIV-negative controls attending the ICTC. HIV-positive patients on antiretroviral therapy and patients with history of current/past treatment for chronic hepatitis infection were excluded from the study. Blood samples were tested for HIV, syphilis, and hepatitis B and C infections.

Results

The prevalence of syphilis, hepatitis B, and hepatitis C was observed in 3.5%, 2%, and 10% of patients, respectively. The frequency of hepatitis B virus (HBV) infection in HIV-positive and HIV-negative individuals was 1% and 3%, respectively. Hepatitis C virus (HCV) infection among HIV-positive and HIV-negative patients was 16% and 4%, respectively. Syphilis was seen in 7% of the HIV-infected patients. The mean CD4+ count for the HIV-positive patients with either syphilis, HBV, or HCV infections was 252 ± 137.5 cells/μl. Significant associations between HIV infection and education below high school, IV drug abuse, and multiple sexual partners were observed.

Conclusions

The HIV-infected patients were observed to be at an increased risk of acquiring syphilis and HCV co-infections through the shared routes of transmission. Routine screening of these patients for concurrent syphilis and viral hepatitis may aid in prompt diagnosis and treatment with improved outcomes, which in turn may decrease the further spread of these infections.

Coinfection of Hepatitis B and Hepatitis C Virus in Patients With Human Immunodeficiency Virus

Background Coinfection of viral hepatitis and human immunodeficiency virus (HIV) is not uncommon in Pakistan. Coinfection of hepatitis B virus (HBV) and hepatitis C virus (HCV) with HIV is associated with a poor prognosis. The current study evaluated the occurrence of coinfection of HBV/HIV and HCV/HIV in Peshawar, Khyber Pakhtunkhwa, Pakistan.  Methodology  A prospective, observational study was conducted at Khushal Medical Center and Hayatabad Medical Complex (HMC) between February 2019 and April 2020. All patients with confirmed HIV positive serum samples aged above 18 years were eligible to apply for anonymous screening for hepatitis B and C virus markers. Sociodemographic data including patient's age, gender, marital status, occupation, employment status, and body mass index among others were documented on a predefined proforma. The presence of viral markers of HBV and HCV in HIV patients was the primary outcome of the study.  Results Out of the total of 650 HIV patients, 78 (12%) had coinfection with hepatitis virus. The mean age was 42.40 ± 10.96 years. Sixty-three (80.77%) patients had coinfection with hepatitis B virus infection while 15 (19.23%) had hepatitis C coinfection. No cases of triple infections were identified. It was found that patients infected with HIV/HBV were more frequent in the age group of 30 to 45 years (36; 85.71%) while the HIV/HCV patients were older, i.e. 72.72% were older than 45 years (p<0.001). The sexual route was strongly associated with HIV/HBV group compared to HIV/HCV group [51 (89.47%) vs. six (10.53%); p<0.0001].  Conclusion The current study highlighted the rate of coinfection of HBV and HCV in HIV-infected individuals in Pakistan. We found that four-fifths of patients had coinfection with HBV while only one-fifth had coinfection with HCV. These findings are consistent with the published literature revealing that HIV/HBV and HIV/HCV are common in developing countries. Young sexually active individuals are at a significantly higher risk of acquiring HIV/HBV infection than HIV/HCV. We advocate screening for these hepatitis viral markers in patients with HIV infection as well as their sexual partners. Further large-scale, multicentre, and multistate studies should be conducted to determine the burden of these communicable diseases.

SEROPREVALENCE OF HIV, HBV, AND HCV AMONG INDIVIDUALS ATTENDING ICTC OF A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

Introduction: Hepatitis B and Hepatitis C share common transmission routes with HIV and coinfection with either can lead to adverse clinical outcomes in patients. This study planned to estimate confections with HBV and HCV among HIV positive subjects at a single Integrated Testing and Counselling Center (ICTC) in Kashmir valley. Methods: The study employed a cross-sectional study design from 2017 to 2019. After pretest counselling all subjects underwent HIV testing as per National AIDS Control guidelines. HIV positive subjects were included in this study. Samples of HIV positive subjects were then tested for HBV by ELISA detecting HbsAg whereas HCV was diagnosed by Anti HCV antibodies and HCV-RNA. Data was entered in excel and analyzed using SPSS. Means and percentages were calculated for relevant variables. Results:Atotal of 20070 subjects were tested during the study period of which 34 (0.169%) were HIVpositive. Around 60% positive subjects were males. Co-infection with HBV was detected in 11.7% subjects whereas 8.8% had an HCV coinfection. One subject had coinfection with both HBV and HCV. There was no signicant association of coinfection with gender or age Conclusion:Considering the adverse impact of coinfection on disease course and outcome, screening for HBVand HCVshould be a component in diagnostic workup of all HIVpositive subjects followed by linkage with specialized treatment services

Comparative evaluation of liver, spleen, and kidney stiffness in HIV-monoinfected pediatric patients via shear wave elastography

Background/aim

This study aimed to evaluate the stiffness of the liver, spleen, and kidneys in HIV-monoinfected children via shear wave elastography (SWE).

Materials and methods

Twenty-one HIV-monoinfected children and 37 healthy subjects were included in this study. Livers, spleens, and kidneys of the participants were examined via ultrasound and SWE. Patients were divided into two groups according to the presence of pathologic ultrasonographic findings. Routine laboratory tests were also recorded. Stiffness of these organs was compared between patients and control groups.

Results

Liver transaminases, blood urea, and creatinine levels were normal in all subjects. Ultrasonographic examination revealed hepatosplenomegaly (n = 1, 4.7%), grade 1 hepatosteatosis (n = 1, 4.7%), and hepatosteatosis and minimal heterogeneity of the liver (n = 1, 4.7%). Ultrasonographic features were normal in 18 patients. Stiffness of the liver, spleen, and kidneys of all HIV-monoinfected children with normal laboratory parameters was significantly higher than in healthy subjects. Eighteen patients with normal ultrasonographic findings also had higher stiffness values when compared to control subjects.

Conclusion

Stiffness of the liver, spleen, and kidneys in HIV-monoinfected children was increased. SWE can be used in the detection of early parenchymal changes even in patients with normal laboratory parameters and ultrasonographic findings.