Pediatric HIV-HBV Coinfection in Lusaka, Zambia: Prevalence and Short-Term Treatment Outcomes.

Hepatitis B virus (HBV) is endemic in Africa, where it may occur as an HIV coinfection. Data remain limited on HIV-HBV epidemiology in Africa, particularly in children. Using programmatic data from pediatric HIV clinics in Lusaka, Zambia during 2011-2014, we analyzed the prevalence of chronic HBV coinfection (defined as a single positive hepatitis B surface antigen [HBsAg] test) and its impact on immune recovery and liver enzyme elevation (LEE) during the first year of antiretroviral therapy. Among 411 children and adolescents, 10.4% (95% confidence interval, 7.6-14.1) had HIV-HBV. Coinfected patients were more likely to have World Health Organization stage 3/4, LEE and CD4 <14% at care entry (all p < 0.05). During treatment, CD4 increases and LEE incidence were similar by HBsAg status. HBsAg positivity decreased (11.8% vs. 6.6%; p = 0.24) following HBV vaccine introduction. These findings support screening pediatric HIV patients in Africa for HBV coinfection. Dedicated cohorts are needed to assess long-term outcomes of coinfection.

[1]  B. Chi,et al.  Implementation of routine screening for chronic hepatitis B virus co‐infection by HIV clinics in Lusaka, Zambia , 2015, Journal of viral hepatitis.

[2]  R. Thimme,et al.  Natural history of chronic hepatitis B virus infection , 2015, Medical Microbiology and Immunology.

[3]  S. Ernest,et al.  Prevalence of HIV co-infection with Hepatitis B and C viruses among children at a tertiary hospital in Ilorin , Nigeria , 2014 .

[4]  E. Ikpeme,et al.  Seroprevalence of HBV and HIV co-infection in children and outcomes following highly active antiretroviral therapy (HAART) in Uyo, South-South Nigeria. , 2014, African health sciences.

[5]  G. Schutze,et al.  Seroprevalence of hepatitis B in a cohort of HIV-infected children and adults in Swaziland , 2013, International journal of STD & AIDS.

[6]  Ayodotun Olutola,et al.  Prevalence and Clinical and Immunoviralogical Profile of Human Immunodeficiency Virus-Hepatitis B Coinfection among Children in an Antiretroviral Therapy Programme in Benue State, Nigeria , 2013, ISRN pediatrics.

[7]  E. Nwolisa,et al.  Prevalence of Hepatitis B co-infection amongst HIV infected children attending a care and treatment centre in Owerri, South-eastern Nigeria , 2013, The Pan African medical journal.

[8]  P. Reiss,et al.  Hepatitis B Virus Prevalence and Vaccine Response in HIV-infected Children and Adolescents on Combination Antiretroviral Therapy in Kigali, Rwanda , 2012, The Pediatric infectious disease journal.

[9]  A. Kambugu,et al.  Hepatitis B virus infection in adolescents and young adults with human immunodeficiency virus infection in an urban clinic in a resource‐limited setting , 2012 .

[10]  L. Aurpibul,et al.  HIV and Hepatitis B Coinfection Among Perinatally HIV-infected Thai Adolescents , 2012, The Pediatric infectious disease journal.

[11]  Gretchen A. Stevens,et al.  Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. , 2012, Vaccine.

[12]  E. Cooper,et al.  Rapid assessment of pediatric HIV treatment in Zambia. , 2012 .

[13]  W. Sadoh,et al.  HIV co-infection with hepatitis B and C viruses among Nigerian children in an antiretroviral treatment programme , 2011 .

[14]  C. Rouzioux,et al.  Frequent occurrence of chronic hepatitis B virus infection among West African HIV type-1-infected children. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  G. Carosi,et al.  Hepatitis B virus and HIV coinfection in low-income countries: unmet needs. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  M. Matee,et al.  Seroprevalence of hepatitis B and C viral co-infections among children infected with human immunodeficiency virus attending the paediatric HIV care and treatment center at Muhimbili National Hospital in Dar-es-Salaam, Tanzania , 2007, BMC public health.

[17]  C. Thio,et al.  Clinical implications of HIV and hepatitis B co-infection in Asia and Africa. , 2007, The Lancet. Infectious diseases.

[18]  J. Ehrenberg,et al.  Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development , 2007, BMC public health.

[19]  P. Klenerman,et al.  Viral coinfections among African children infected with human immunodeficiency virus type 1. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.