Prevalence of hepatitis B and C Prevalence of hepatitis B and C viruses among human viruses among human immunodeficiency virus infected immunodeficiency virus infected children in Northern Nigeria.children in Northern Nigeria.

Pennap GRI, Yahuza, AJ and Abdulkarim, ML Microbiology Unit Nasarawa State University Keffi, Nigeria

IntroductionIntroductionHBV, HCV and HIV are considered endemic in Africa. Despite their biological differences they share common routes of transmission and similar risk factors. Liver disease due to chronic hepatitis (HBV and HCV infection) has become a public health problem especially in those infected with HIV. HIV is also known to increase the pathological effect of hepatitis viruses and potentiates reactivation of latent infection as a result of reduced immunity. The preponderance of coinfection with hepatitis B and C viruses in Sub Saharan Africa is threatening the gains of ART. Careful studies of these interactions are important for informed approach to providing clinical care, public health initiatives and guiding future research.

AimAimDue to the importance of hepatitis chronicity and its effect in HIV infection, this study was mooted to: •Determine the prevalence of HBV and HCV in HIV infected children•Determine probable risk factors of infection,

Materials and MethodsMaterials and MethodsCross-sectional studyStudy populationEthical clearanceHealth talk and informed consentSociodemographic information – questionnaireSample collectionVenipuncture – Serum

◦ storage (-40 C) thawing (room temperature) Screening procedure--- HBsAg and anti-HCV Rapid Test

strips ( according to the Manufacturer’s instructions).

Results and DiscussionResults and Discussion200 participantsGeneral prevalence – 14.0% HBV prevalence – 3.0% HCV prevalence– 11.0% Vertical transmission???? Relatively low HBV NPI vaccine uptake Occult HBV(HBsAg –ve but HBV DNA +ve) HCV relatively high Ability to induce seroconversion of the other –

chronology of infection determines dominant virus( Dawurung et al. 2012)

Results and Discussion Results and Discussion contd.contd.Examples of similar studies in Nigeria: HBV – 7.7% , 6.6% HCV - 5.2% HBV + HBV – 0%

Figure 1:Seroprevalence of Hepatitis B surface Figure 1:Seroprevalence of Hepatitis B surface and anti HCV among HIV infected children in and anti HCV among HIV infected children in relation to sexrelation to sex

Figure 2: Seroprevalence of HBV and HCV in Figure 2: Seroprevalence of HBV and HCV in relation to Agerelation to Age

Figure 3: Seroprevalence of Hepatitis B and C virus Figure 3: Seroprevalence of Hepatitis B and C virus among the infected children in relation to history of among the infected children in relation to history of blood transfusionblood transfusion

Figure 4: Seroprevalence of Hepatitis B and C Figure 4: Seroprevalence of Hepatitis B and C viruses among the infected children in relation viruses among the infected children in relation to scarificationto scarification

Figure 5: Seroprevalence of HBV among HIV Figure 5: Seroprevalence of HBV among HIV infected children in relation to history of HBV infected children in relation to history of HBV vaccinevaccine

ConclusionConclusionStudy has shown the burden of coinfection

with HBV and HCV as 3.0% and 11.0% respectively.

No identifiable risk factor for HBV (statistically).

Not identifying risk factors has drawn attention to the probability of obscured risk factors or locality specific risk factors.

RecommendationRecommendationRoutine Screening for HBV and HCV in HIV

infected children Establish treatment protocol for coinfected

patients (to reduce hepatotoxicity)Strengthen Hepatitis B immunization

program

Future WorkFuture WorkLarger studies Longitudinal studies Inclusion of more probable risk factors ( viz-

a-viz sociocultural practices of the study area)

Molecular epidemiology( to capture Occult HBV)

AcknowledgementAcknowledgementWe wish to acknowledge with thanks the following:•Parents/guardians of participants •Management of Dalhatu Araf Specialist Hospital, Lafia •Dr DS Nyabam-- Statistician

ReferencesReferences• Anigilage et al.(2013). Prevalence, clinical and

immunovirological profile of HIV, HBV among children in Benue State. ISRN Pediatric 10:1155/2013/932697

• Ikpeme et al.(2013).Seroprevalence of HBV in HIV coinfected children and outcomes following HAART in Uyo, Nigeria . African Hlth Science. 13(4):955 -961

• Nwolisa et al.(2013). Prevalence of Hepatitis B coinfection among HIV infected children attending a care and treatment center Owerri, Nigeria. Pan Afr Med J. 14:89

• Sadoh et al.(2011). HIV coinfection with Hepatitis B and C viruses among Nigerian children in a ART treatmen program. SAJCH. 5(1) 7- 10.

It is pertinent to investigate hepatitis chronicity especially in regions endemic for HIV, HBV and HCV.

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