title: Characteristics of Hepatitis B Co-infection and Disease Evolution in HIV-Positive Paediatric Patients in Romania.
abstract: BACKGROUND
  Infection with hepatitis B virus (HBV) contributes to morbidity and mortality in people living with human immunodeficiency virus (HIV).
  
  
  OBJECTIVE
  The aim of the present study is to assess the influence of HBV co-infection in clinical characteristics and disease evolution among nosocomial HIV infected youth in Romania.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  We assessed HBsAg in 179 young people with nosocomial paediatric HIV infection. Demographic data, ALAT level, CD4-count, HIV-RNA, antiretroviral therapy and clinical behaviour were all statistically compared in patients who were HIV mono-infected and HBV-co-infected.
  
  
  RESULTS
  THE CHARACTERISTICS OF PATIENTS ARE AS FOLLOWS: sex ratio M/F: 55.3%, AIDS category 88%, median nadir CD4-count 126/mm(3). The prevalence of persistent HBsAg was 44.6%. The mortality rate was 11.1%, but no correlation with HBsAg was found. An average of three antiretroviral combinations is experienced by 97.7% of patients, including Lamivudine for over 5 years in 76% of cases and Tenofovir/Emtricitabine in 16.75% of patients. Patients under antiretroviral therapy achieved 53.07% sustained undetectable HIV-RNA and 40.78% restored immunity CD4-count >500/mm(3). ALAT enzyme was found to be high in 54.75% of patients.
  
  
  CONCLUSIONS
  During our research, we noticed that HBsAg was elevated in young people with HIV in Romania. Mortality rate was not statistically correlated to HBsAg. High ALAT levels are related with HBV, HDV co-infections, virological failure to antiretroviral treatment and the risk of death.
authors.affiliation: Department of Morphological Sciences, Dunarea de Jos University Faculty of Medicine and Pharmacy, Galati, Romania.
authors.forename: Manuela
authors.initials: M
authors.lastname: Arbune
authors.affiliation: Department of Pharmaceutical Sciences, Dunarea de Jos University Faculty of Medicine and Pharmacy, Galati, Romania.
authors.forename: Costinela
authors.initials: C
authors.lastname: Georgescu
keywords: HIV; Hepatitis B; Romania; antiviral agents