HIV Coinfection Highly Prevalent in Patients with Hepatitis C, B

Greater education programming needed for patients at-risk for HIV infection.

A high prevalence of anti-HIV antibodies was found in patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) in a recent study.

The cross-sectional study included donated serum samples from 409 HBV and HCV patients (126 HBV+ and 283 HCV+) referred to the Viral Hepatitis Ambulatory Clinic in Brazil. The serum samples were tested for the presence of the hepatitis B surface antigen (HBsAg), as well as antibodies to HBV core (anti-HBc) and to HBsAg (anti-HBs), HCV (anti-HCV), and HIV (anti-HIV-1/2) using commercial enzyme immunoassays.

The anti-HIV, HBsAg, anti-HBc, anti-HBs, anti-HBcIgM, anti-HBe, HBeAg, and anti-HCV antibodies were measured, and the anti-HCV positive samples were tested for viral RNA and genotype.

The results of the study showed that anti-HIV antibody prevalence was 10.31%, confidence interval (CI 95%:5.1-15.5) (12/126) and 4.59% (CI 95%: 2.1-7.0) (13/283) in HBV and HCV patients, respectively. The mean ± standard deviation (SD) viral load for HCV-RNA was 5.14 ± 1.64 IU/mL and the genotypes were (HCV-1, n = 163; HCV-2, n = 1, HCV-3, n = 14; and HCV-5, n = 2).

Nearly 40% of HCV patients detected anti0HBs reactive sera, and 26% showed anti-HBc reactive sera.

Within the HBV group, factors associated with the presence of anti-HIV antibodies included: male gender, sexual orientation, marital status, history of hepatitis treatment, tattooing, oral sex, STDs, and partners with hepatitis or HIV.

Those in the HCV group with factors that were associated with the presence of anti-HIV antibodies included: female gender, marital status, previous history of STDs, anal intercourse, and numerous sexual partners.

The study had some limitations because of the cross-sectional design of the casual relationship between the time of exposure and subsequent infection couldn’t be established. Additionally, biases within the study population may have occurred because of the convenience sampling.

Also, during in-person interviews, individuals may not have answered honestly in regards to their sexual practices and drug abuse. The study results reinforce the need for educational programs that focus on HIV infection, especially in patients with HBV and HCV.