Hepatitis B and C infection at a large public sector hospital clinic: is it a burden?

Area of Science:

• Infectious Diseases
• Hepatology
• Public Health

Background:

• Co-infections with Hepatitis B (HBV) and Hepatitis C (HCV) significantly increase morbidity and mortality in Human Immunodeficiency Virus (HIV) infected individuals.
• Shared transmission routes necessitate expecting HBV and/or HCV co-infections in HIV patients.
• Zimbabwe's public health system does not routinely screen HIV-infected individuals for HBV and HCV prior to treatment, despite WHO guidelines.

Purpose of the Study:

• To determine the prevalence of HBV and HCV infections among HIV-infected adults attending a public sector clinic in Zimbabwe.
• To identify risk factors associated with HBV and HCV infections in this population.

Main Methods:

• An analytical cross-sectional survey was conducted from March to July 2012.
• Systematic random sampling of HIV-infected, antiretroviral therapy (ART)-naive adults was performed at Parirenyatwa Hospital Opportunistic Infection Clinic.
• Blood samples were tested for Hepatitis B surface antigen (HBsAg) and Hepatitis C virus antibodies (anti-HCV), with demographic and risk factor data collected.

Main Results:

• A total of 228 ART-naive adults were enrolled in the study.
• The prevalence of HBsAg positivity was 7.9% (18/228), and anti-HCV positivity was 0.9% (2/228).
• No participants were found to be co-infected with both HBV and HCV.

Conclusions:

• The prevalence of HBV infection has remained consistent during the HIV era in this Zimbabwean population.
• There is no significant prevalence of HCV infection in this public sector clinic serving a large population in Harare.
• Based on these findings, routine HCV screening is not recommended, but HBV screening prior to ART initiation may be warranted.