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HIV, syphilis and hepatitis B coinfections in Mkushi, Zambia: a cross-sectional study.

ABSTRACT: ABSTRACT Background: Human Immunodeficiency Virus, syphilis and Hepatitis B Virus are major global public health problems, they are sexually transmitted infections with overlapping modes of transmission and affected populations. Objective: The aim of this study is to assess the seroprevalence of HIV 1, hepatitis B virus and syphilis coinfections among newly diagnosed HIV individuals aged 16 to 65 years, initiating on antiretroviral therapy, in Mkushi, Zambia. Methods: A total number of 126 sera were collected from HIV 1 infected patients attending Mkushi district hospital/ART clinic for antiretroviral therapy initiation. Hepatitis B surface antigen test and serologic test for syphilis were conducted between March and May 2018. Results: Of the 126 participants (out of 131 enrollments), Hepatitis B surface antigen (HBsAg) was detected with a prevalence of 9.5% among newly diagnosed HIV infected patients, while that of syphilis was as high as 40.5% in this same population group. Three patients recorded HIV coinfections with both syphilis and hepatitis B virus (2.4%) at the same time. After analysis, the results indicate that there was no significant association between gender for both dependent variables: HIV/syphilis or HIV/hepatitis B virus coinfections (alpha significance level > 0.05). Those who had a history of syphilis infection in the past were more likely than those who had none to be HIV-syphilis coinfected (53.6% vs 34%, respectively; odd ratio [OR] 2.236; 95% confidence interval [CI] 1.045 - 4.782). Conclusion: The high prevalence rates for HIV, HBV, and syphilis coinfections strongly indicate the need for HBV and syphilis screening for HIV infected individuals. Furthermore, the high number of patients previously treated for syphilis who retest positive for syphilis in this study calls for use of the Venereal Disease Research Laboratory test to identify true syphilis infection (titers ≥ 1:8 dilutions, strongly suggestive).

SUBMITTER: Katamba C

PROVIDER: S-EPMC7417957 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPeople with HIV infection in the United States are often affected by chronic viral hepatitis. These coinfected people with either HBV or HCV are at increased risk for serious, life-threatening complications. Coinfections with viral hepatitis may also complicate the delivery of anti-retroviral therapy (ART) by escalating the risk of drug-related hepatoxicity. According to the Centers for Disease Control and Prevention (CDC), approximately 10 percent of people with HIV in the United States also have HBV, and 25 percent also have HCV coinfection. With the advent of highly active antiretroviral therapy (HAART) and the increased life-expectancy of HIV patients, clinicians are more likely to be confronted with issues related to co-infection and the management challenges that they present, especially in resource-limited settings. The purpose of this analysis was to identify geographical clusters of HIV- (HBV/HCV) co-infection and compared to the geographical clusters of not co-infected using DC, Department of Health surveillance data. The results of the analysis will be used to target resources to areas at risk.MethodsHIV and Hepatitis surveillance data were matched among cases diagnosed between 1980 and 2016. HIV-hepatitis co-infected and the not co-infected spatial clusters were detected using discrete Poisson model. Kulldorff's spatial scan statistic method was implemented in the free software tool called SaTScan which has been widely adopted for detecting disease cluster. The analysis was conducted by tracts, but for visualization, ease of interpretation and assist in policy making the tract map was overlaid with the ward map using ArcGIS 10.5.1.ResultsBetween 1980 and 2016, there were 12,965 diagnosed cases of HIV, of which 2,316 HIV/Hepatitis matches were identified. Of the 2316 co-infected people living in DC, 25 percent (N = 590) of people had HBV, and 75 percent (N = 1,726) had HCV. Out of 12,965 diagnosed cases, remaining 10,649 did not have any co-infections (not co-infected). IDU (27.16 percent) and MSM (32.86 percent) were the highest mode of transmission for co-infected population. African-American were reported 83.64 percent (N = 1,937) among co-infection population. Three clusters were identified for both co-infected population in DC. The largest cluster radius for co-infected analysis covers wards 6, 7 and 8 as well as large parts of 2 and 5 (p < 0.001). Multiple clusters were identified for not co-infected population (p < 0.001). IDU (n = 450) was the highest mode of transmission for the co-infected clusters. For all clusters combined of not co-infected population highest mode of transmission were MSM (n = 2,534). This analysis also showed racial disparity, economic deprivation and lack of education were prominent in the co-infected clusters.ConclusionWe identified locations of high risk clusters where enhanced hepatitis and HIV prevention, treatment, and care can help combat the epidemic. The clusters radius expands into the neighboring state of Maryland as well. The findings from this analysis will be used to target area based public health policy and healthcare interventions for HIV-hepatitis. It is recommended based on the analysis that needle exchange programs can successfully control new HIV infections as well as hepatitis co-infections.

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HIV, syphilis and hepatitis B coinfections in Mkushi, Zambia: a cross-sectional study.

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