Prevalence and Clinical and Immunoviralogical Profile of Human Immunodeficiency Virus-Hepatitis B Coinfection among Children in an Antiretroviral Therapy Programme in Benue State, Nigeria.

ISRN pediatrics Pub Date : 2013-04-03 Print Date: 2013-01-01 DOI:10.1155/2013/932697
Emmanuel Ademola Anigilaje, Ayodotun Olutola
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引用次数: 34

Abstract

Background. Nigeria has the world largest burden of paediatric HIV and is also highly endemic for Hepatitis B virus (HBV). However, relatively little is known regarding the prevalence of HBV-HIV coinfections among Nigerian children. Methods. A retrospective study among treatment naive HIV-infected children attending the pediatric clinic of the APIN Plus/Harvard PEPFAR program of the Federal Medical Centre, Makurdi, between June 2008 and June 2012. Results. The mean age of the 395 subjects studied was 7.53 ± 4.23 years. Thirty-one subjects (7.8%) were positive for HBV. No subject was HIV-HBV-HCV triply infected. Significantly higher HIV-HBC coinfections were found, in older subjects (11-15 years), subjects that did not receive nor complete Hepatitis B vaccinations, and subjects that had a severe immunosuppression of < 15% with respective P values of 0.00, 0.01, and 0.00. HIV-HBV co-infection did not significantly impact on other baseline characteristics including, gender, WHO clinical stage, median absolute CD4 count, mean viral load, median ALT, and hepatotoxicity. Conclusion. A high seroprevalence of HBV among this cohort of HIV-infected children contributes to the calls for pre-ART screening for HBV and the necessary paradigm shift in the ART nucleoside backbone to include agent(s) more dually effective against HIV and HBV.

尼日利亚贝努埃州抗逆转录病毒治疗项目中儿童人类免疫缺陷病毒-乙型肝炎合并感染的流行率和临床及免疫病毒学特征
背景尼日利亚是世界上儿童艾滋病负担最大的国家,也是乙型肝炎病毒(HBV)的高度流行地。然而,对尼日利亚儿童中HBV-HIV合并感染的流行率知之甚少。方法。2008年6月至2012年6月,在马库尔迪联邦医疗中心APIN Plus/哈佛PEPFAR项目儿科诊所接受治疗的未接受治疗的HIV感染儿童中进行的一项回顾性研究。后果395名受试者的平均年龄为7.53±4.23岁。31名受试者(7.8%)HBV呈阳性。没有受试者是三重感染的HIV-HBV-HCV。在老年受试者(11-15岁)、未接种或未完全接种乙型肝炎疫苗的受试者以及严重免疫抑制<15%的受试人中发现了显著更高的HIV-HBC合并感染,其P值分别为0.00、0.01和0.00。HIV-HBV合并感染对其他基线特征没有显著影响,包括性别、世界卫生组织临床分期、中位绝对CD4计数、平均病毒载量、中位ALT和肝毒性。结论在这群HIV感染儿童中,HBV的高血清流行率促使人们呼吁对HBV进行ART前筛查,并在ART核苷骨架中进行必要的范式转变,以包括对HIV和HBV更双重有效的药物。
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