Limited data and few studies have shown the prevalence of Hepatitis B in the HIV infected population in South Africa, whether these patients are on appropriate antiretroviral therapy and the effect of Hepatitis B on liver function in co-infected persons. The objectives of this study were to determine the prevalence of Hepatitis B surface antigemia (HBsAg) in healthy HIV positive persons screened for a vaccine trial and the proportion of those eligible for antiretroviral therapy that were receiving optimal antiviral treatment, namely tenofovir and/or lamivudine. The relationship between Hepatitis B carriage and liver function was also determined in co-infected persons as measured by liver function tests. A cross sectional study was conducted from 30th August 2011 to 24th April 2013 to determine the prevalence of HIV /HBV co-infection in persons attending a clinical trial site in an urban clinical trials unit of Cape Town. Participants self-presented to the clinic and once consented were enrolled into the study and provided blood for HIV confirmatory test, Hepatitis B sAg, CD4, VL, full blood count, liver function and renal function tests. 638 participants were enrolled into this cross sectional study. 24 (3.8%) were Hepatitis B sAg positive, which was lower than expected. Of the 24 HIV/HBV co-infected participants, 19 (79 .2%) were on antiretroviral therapy, 14 (73. 7%) of these were on a tenofovir/lamivudine regimen the remaining 5 (26.3%) were not on a tenofovir regimen. Five of the co-infected participants were not on ARVs because their CD4 count was above the recommended South African guidelines for treatment i.e. greater than 350 1 QA6/l. Male participants were three times more likely to be HBsAg positive. Elevated Alanine aminotransferase (ALT) and Aspartate Aminotransferase (AST) were associated with HBsAg seropositivity. This study showed a lower HIV /HBV co-infection prevalence rate than reported from other locations in South Africa suggesting geographical variability. Appropriate guidelines are required to ensure that co-infected patients are identified and treated with the most appropriate anti-retroviral regimens. Screening for HBV is also recommended in HIV infected cohorts.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/13243 |
| Date | January 2014 |
| Creators | Reidy, Derval |
| Contributors | Coetzee, David |
| Publisher | University of Cape Town, Faculty of Health Sciences, Department of Public Health and Family Medicine |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MPH |
| Format | application/pdf |
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