Article Sidebar
Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
HBV/HIV co-infection: The dynamics of HBV in South African patients with AIDS
Abstract
virus (HBV) and human immunodeficiency virus (HIV) infections,
and their co-infection requires special management, we aimed
to assess the serological and molecular characteristics of HBV in
patients with AIDS.
Design. This was a cross-sectional, case control study, which
enrolled 200 patients with AIDS and 200 HIV-negative controls.
HBV serology was done in all participants and HCV serology
in participants with a hepatitis B core antibody (anti-HBc) only
serological pattern. Nested HBV polymerase chain reaction (PCR)
and HBV viral load assays were used for HBV molecular detection.
Results. Hepatitis B surface antigen (HBsAg) prevalence was
3-fold higher while the ‘anti-HBc only’ pattern was 6-fold higher in
the AIDS group compared with the controls. Mean HBV viral load
was significantly higher in HBsAg-positive patients with CD4+
cell counts <100 cells/ìl than in patients with CD4+ cell counts of
100-200 cells/ìl (p=0.019). There were markedly reduced hepatitis
B surface antibody (anti-HBs) titres in the AIDS group compared
with the controls (p=0.002). A significant proportion of AIDS
patients with an ‘anti-HBc only’ pattern had CD4+ cell counts <100
cells/ìl (p=0.004). Occult HBV prevalence was 3.5% in the AIDS
group compared with 1% in the controls (p=0.092). When occult
HBV infection was taken into consideration, the overall HBV
prevalence became 10% in the AIDS group and 3% in the control
group.
Conclusion. We showed an increased HBV prevalence in patients
with AIDS and identified a CD4+ cell count <100 cells/ìl as a
major risk factor for the ‘anti-HBc only’ pattern and increased
HBV replication. These data have significant public health
implications for HBV in developing countries, especially in areas
where antiretroviral (ARV) guidelines do not cater for HBV/HIV
co-infection.
