Pediatric HIV-HBV Coinfection in Lusaka, Zambia: Prevalence and Short-Term Treatment Outcomes.
Hepatitis B virus (HBV) is endemic in Africa, where it may occur as an HIV coinfection. Data remain limited on HIV-HBV epidemiology in Africa, particularly in children. Using programmatic data from pediatric HIV clinics in Lusaka, Zambia during 2011-2014, we analyzed the prevalence of chronic HBV coinfection (defined as a single positive hepatitis B surface antigen [HBsAg] test) and its impact on immune recovery and liver enzyme elevation (LEE) during the first year of antiretroviral therapy. Among 411 children and adolescents, 10.4% (95% confidence interval, 7.6-14.1) had HIV-HBV. Coinfected patients were more likely to have World Health Organization stage 3/4, LEE and CD4 <14% at care entry (all p < 0.05). During treatment, CD4 increases and LEE incidence were similar by HBsAg status. HBsAg positivity decreased (11.8% vs. 6.6%; p = 0.24) following HBV vaccine introduction. These findings support screening pediatric HIV patients in Africa for HBV coinfection. Dedicated cohorts are needed to assess long-term outcomes of coinfection.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA peebles.kathryn@gmail.com.
Kathryn
K
Peebles
Department of Pediatrics, University Teaching Hospital, Lusaka, Zambia.
Lweendo
L
Nchimba
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Roma
R
Chilengi
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Carolyn
C
Bolton Moore
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Mwangelwa
M
Mubiana-Mbewe
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Michael J
MJ
Vinikoor
D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D060085:Coinfection / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006514:Hepatitis B Surface Antigens; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome; D015024:Zambia / Q000453:epidemiology
D019380:Anti-HIV Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D000637:Transaminases
Developing Countries; HIV; Hepatitis B