Mohamed El-Ghitany*, Azza Galal Farghaly and Yasmine Mohammed Alkassabany
Background: Human immune deficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections constitute a global health concern. They share common modes of transmission, increasing the likelihood of co-infection. Co-infection accelerates viral replication, promotes the progression of chronic liver diseases and challenges antiviral therapy. There are no available data addressing the magnitude of chronic viral hepatitis co-infection in people living with HIV in Egypt. Nor is there a mandate for HCV/HBV screening. This cross-sectional study provides needed data on HBV and/or HCV co-infection in Egyptian people living with HIV.
Subjects and Methods: The study was conducted at the HIV clinic in Alexandria Fever Hospital. The investigation included 168 confirmed HIV cases. All cases were interviewed and tested for HCV-Ab and HBsAg by ELISA.
Results: There were 52 (31%) persons who were anti-HCV positive. 40 of them had detectable HCV RNA (76.9%). HIV/HCV co-infection was significantly higher among males (40.7%) compared to only (10.9%) among females (OR = 3). History of imprisonment (OR = 4.84, CI: 1.33-17.62), accidental puncture with protruding needle contaminated with blood (OR = 3.35, CI: 0.99-11.72), alcohol use (OR = 3.03, CI: 1.13-8.09) and male gender (OR = 2.96, CI: 0.99-8.88) were all significant predictors for HIV/HCV co-infection. On the other hand, HIV/HCV co-infection was inversely associated with high education level (OR = 0.28, CI: 0.10-0.76). HBsAg was detected in 4 (2.4%), anti-HBc was detected in 49 or 29.2% of HIV patients. Previous HBV infection (positive anti-HBc/negative anti-HBs) was significantly associated with a history of female genital mutilation circumcision, injection drug use, invasive procedures, non-specific fatigue and HCV-Ab seropositivity.
Conclusion: Egyptian people living with HIV have an increased frequency of HCV antibody and HCV infection compared to the general population indicating a higher risk of infection and suggest a higher risk of HCV exposure. Past or present HBV co-infections are also elevated. Routine screening of these viruses in the management protocol of people living with HIV in Egypt is recommended.
HBV, HCV, HIV, co-infection, epidemiology, risk factors
Tropical Health Department, High Institute of Public Health, Alexandria University, 165 ElHorreya Avenue, Alexandria, Tropical Health Department, High Institute of Public Health, Alexandria University, 165 ElHorreya Avenue, Alexandria, Tropical Health Department, High Institute of Public Health, Alexandria University, 165 ElHorreya Avenue, Alexandria