title: HIV, Hepatitis B, and Hepatitis C in Zambia.
abstract: OBJECTIVE
  Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART).
  
  
  METHODS
  We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV Ab) at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection.
  
  
  RESULTS
  Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2%) were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4%) were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be <40 years (84.4% vs. 61.4%; P=0.01) when compared to those who were not coinfected. Patients with active hepatitis B were more likely to have mild to moderately elevated AST/ALT (40-199 IU/L, 15.8% vs. 5.4%; P=0.003). Highly elevated liver enzymes (>200 IU/L) was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5). We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease.
  
  
  CONCLUSIONS
  HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.
authors: Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia.
authors: Kenneth C
authors: KC
authors: Kapembwa
authors: Jason D
authors: JD
authors: Goldman
authors: Shabir
authors: S
authors: Lakhi
authors: Yolan
authors: Y
authors: Banda
authors: Kasonde
authors: K
authors: Bowa
authors: Sten H
authors: SH
authors: Vermund
authors: Joseph
authors: J
authors: Mulenga
authors: David
authors: D
authors: Chama
authors: Benjamin H
authors: BH
authors: Chi