High prevalence of hepatitis B and syphilis co-infections among HIV patients initiating antiretroviral therapy in the north-west region of Cameroon.
Hepatitis B virus (HBV) and syphilis co-infections contribute significantly to HIV-associated morbidity and mortality, but the burden of these diseases is not fully appreciated in sub-Saharan Africa, as prevalence data are scarce. Both infections often remain undiagnosed in resource-limited settings because routine testing is not a part of most of the national guidelines. Epidemiological studies provide important information on prevalence and risk factors for such co-infections and can provide guidance for clinical management and for the development of test strategies. We analysed data on baseline characteristics, CD4 cell counts, HBV and syphilis co-infection rates of 690 patients enrolling for antiretroviral therapy in rural Cameroon. The prevalence of both hepatitis B surface antigen (HBsAg, 12.6%, 95% CI 10.1-15.1) and treponemal antibodies (11.4%, 95% CI 8.9-13.7) was high, with significantly higher prevalences for both infections in men; detection of treponemal antibodies increased with age. Although liver enzyme elevations were common, they were not useful to identify HBsAg-positive patients. In this setting, routine serological screening for HBV and syphilis co-infection should be considered to avoid complications and ongoing transmission.
University Medical Center Hamburg, Department of Medicine/Infectious Diseases Unit, Martinistrasse 52, Hamburg 20251, Germany. a.zoufaly@uke.de
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A
Zoufaly
E F
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Onyoh
P M
PM
Tih
C N
CN
Awasom
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T
Feldt
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood; D018791:CD4 Lymphocyte Count; D002163:Cameroon / Q000453:epidemiology; D016009:Chi-Square Distribution; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013587:Syphilis / Q000150:complications / Q000453:epidemiology* / Q000821:virology
D044966:Anti-Retroviral Agents; D000907:Antibodies, Bacterial; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase