title: Hepatitis B, Hepatitis C and HIV-1 Coinfection in Two Informal Urban Settlements in Nairobi, Kenya.
abstract: BACKGROUND
  HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums.
  
  
  OBJECTIVE
  The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in urban slums in Nairobi.
  
  
  METHODS
  Blood samples were collected from residents of Viwandani and Korogocho between 2006 and 2007. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV-1. Statistical analysis was done using STATA.
  
  
  RESULTS
  Samples were successfully collected from 418 (32%) men and 890 (68%) females. The HIV-1, HBV and HCV prevalence was 20.4%, 13.3% and 0.76% respectively at the time of the study. Of the 268 (20.4%) HIV-1 positive participants, 56 (4.26%) had HBV while 6 (0.46%) had HCV. Of the 1041 HIV-1 negative participants, 117 (8.9%) had HBV while 4 (0.31%) had HCV. Only two people (0.15%) were co-infected with all the three viruses together.
  
  
  CONCLUSIONS
  The odds of getting hepatitis infection were higher in HIV-1 participants (for HBV OR 2.08,p<0.005 and for HCV OR 5.93, p<0.005). HIV prevalence rates were similar in both informal settlements. HIV infection was highest in age group 35-39 years and among the divorced/separated or widowed. Prevalence of all viruses was highest in those who did not have any formal education.
  
  
  CONCLUSIONS
  The HIV prevalence in these informal settlements suggests a higher rate than what is observed nationally. The prevalence rates of HBV are significantly higher in the HIV-1 positive and negative populations. HCV as well as triple HIV-1, HBV and HCV coinfection are uncommon in Korogocho and Viwandani. This clearly indicates the need for HIV-1 control programmes and hepatitis B virus vaccination to be promoted through public awareness as preventive strategy.
authors.affiliation: Institute of Tropical Medicine and infectious Diseases, Jomo Kenyatta University of Agriculture and technology, Nairobi, Kenya.
authors.forename: Glennah
authors.initials: G
authors.lastname: Kerubo
authors.affiliation: Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Samoel
authors.initials: S
authors.lastname: Khamadi
authors.affiliation: Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Vincent
authors.initials: V
authors.lastname: Okoth
authors.affiliation: African Population Health Research Centre, Nairobi, Kenya.
authors.forename: Nyovani
authors.initials: N
authors.lastname: Madise
authors.affiliation: African Population Health Research Centre, Nairobi, Kenya.
authors.forename: Alex
authors.initials: A
authors.lastname: Ezeh
authors.forename: Abdhalah
authors.initials: A
authors.lastname: Ziraba
authors.affiliation: African Population Health Research Centre, Nairobi, Kenya.
authors.forename: Ziraba
authors.initials: Z
authors.lastname: Abdalla
authors.affiliation: Centre for Infectious and Parasitic Disease Control Research, Kenya Medical Research Institute, Busia, Kenya.
authors.forename: Matilu
authors.initials: M
authors.lastname: Mwau
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D015497:HIV-1 / Q000276:immunology*; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D014505:Urban Population