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Hepatitis B and HIV co-infection in South Africa: just treat it!
Abstract
There are an estimated 350 million hepatitis B carriers worldwide. The prevalence of mono-infection with hepatitis B in South Africa has been estimated at approximately 10% for the rural population and 1% in urban areas.1,2 The transmission routes of hepatitis B and HIV are similar, but hepatitis B is more efficient. Co-infection with HIV and hepatitis B is therefore not unusual. Recent studies have shown that the prevalence of HIV/HBV co-infection (using HBV surface antigen (HBsAg) as a marker for HBV) in South Africa ranges from 4.8% to 17%, depending on the population studied.
The guidelines for the South African HIV Comprehensive Care, anagement and Treatment (CCMT) programme do not include viral hepatitis studies.6 Hepatitis B serology is usually done only if serum aminotransferases are evaluated in the absence of another known cause (e.g. tuberculosis and concomitant medications). The clinical sequelae of HIV/HBV co-infection are multiple and can cause an increase in morbidity and mortality. Awareness of HBV/HIV co-infection with appropriate diagnosis and management is imperative for improved care of our HIV patients.
