title: Overt and occult hepatitis B virus infection in adult Sudanese HIV patients.
abstract: OBJECTIVE
  Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa is complicated by co-infection with hepatitis B and C viruses (HBV and HCV), which share similar transmission routes. The aims of this study were to determine the prevalence of hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative HBV infection and of HCV infection among HIV-infected patients.
  
  
  METHODS
  A cross-sectional study was conducted among treatment-naïve HIV-positive adults in Khartoum State. HBV, HCV, and HIV infections were detected using immunoassays for HBsAg, hepatitis B core antibodies (anti-HBc), hepatitis C antibodies (anti-HCV), and HIV antibodies (anti-HIV), while real-time PCR was used to measure HBV DNA.
  
  
  RESULTS
  The mean age of the 358 patients was 35.2±9.3 years and the male to female ratio was 1.3:1.0. The mean alanine aminotransferase (ALT) level was 10.9±18.0 U/l. Evidence of 23, current or past HBV infection was detected in 62.8% of the patients. HBV DNA was detected in 96 patients (26.8%), 42 HBsAg-positive (11.7%) and 54 (15.1%) HBsAg-negative, indicating occult hepatitis B infection. Anti-HCV was detected in 1.7%.
  
  
  CONCLUSIONS
  Evidence of HBV infection was detected in 26.8% of HIV patients with HBsAg-negative infection, with viraemia detected in 15.1% of the patients. All HIV-infected patients should be screened carefully for HBV infection with HBsAg and anti-HBc IgG antibodies prior to starting antiretroviral therapy.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: Hatim
authors.initials: H
authors.lastname: Mudawi
authors.affiliation: Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
authors.forename: Waleed
authors.initials: W
authors.lastname: Hussein
authors.affiliation: Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
authors.forename: Maowia
authors.initials: M
authors.lastname: Mukhtar
authors.affiliation: Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
authors.forename: Mukhlid
authors.initials: M
authors.lastname: Yousif
authors.affiliation: Department of Medicine, College of Medicine, Bahri University, Khartoum, Sudan.
authors.forename: Omer
authors.initials: O
authors.lastname: Nemeri
authors.affiliation: Institute of Medical Virology, Justus-Liebig-University of Giessen, Giessen, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Glebe
authors.affiliation: Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa. Electronic address: Anna.Kramvis@wits.ac.za.
authors.forename: Anna
authors.initials: A
authors.lastname: Kramvis
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D015995:Prevalence; D019562:Viral Load; D014766:Viremia / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies
keywords: HBV detection; HBsAg-negative; Hepatitis C virus; Occult HBV infection; PCR