title: Prevalence and associations with hepatitis B and hepatitis C infection among HIV-infected adults in South Africa.
abstract: We assessed prevalence and factors associated with hepatitis B in a cross section of HIV-infected primary care and antinatal clinic patients in South Africa and evaluated a rapid hepatitis B surface antigen (HBsAg) assay. We enrolled 998 patients; 88% were women, median age was 29 years and median CD4 count was 354 cells/mm(3). HBsAg enzyme-linked immunosorbent assay (ELISA), anti-hepatitis B core (HBc) antibodies and hepatitis C virus antibody were positive among 4.2%, 37% and 0.1% of subjects, respectively. Univariate and multivariate associations were assessed using logistic regression. Anti-HBc antibodies were associated with alcohol use, traditional medicines and higher CD4 counts; HBsAg positivity was associated with lower CD4. Compared with the HBsAg ELISA, a rapid HBsAg test had a sensitivity of 75.0% and specificity of 99.6%. In conclusion, we identified a moderate prevalence of both HBsAg and anti-HBc. Importantly, we found that subjects with HBsAg positivity had lower CD4 counts.
authors.affiliation: Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa. choffmann@jhmi.edu
authors.forename: C J
authors.initials: CJ
authors.lastname: Hoffmann
authors.forename: D
authors.initials: D
authors.lastname: Dayal
authors.forename: M
authors.initials: M
authors.lastname: Cheyip
authors.forename: J A
authors.initials: JA
authors.lastname: McIntyre
authors.forename: G E
authors.initials: GE
authors.lastname: Gray
authors.forename: S
authors.initials: S
authors.lastname: Conway
authors.forename: N A
authors.initials: NA
authors.lastname: Martinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires