Prevalence of Hepatitis B and Hepatitis C Coinfections in an Adult HIV Centre Population in Gaborone, Botswana

Premal Patel Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana; Baylor International Pediatric AIDS Initiative, Houston, Texas; Department of Pediatrics, Retrovirology/Global Health Section, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas

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Stephanie Davis Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana; Baylor International Pediatric AIDS Initiative, Houston, Texas; Department of Pediatrics, Retrovirology/Global Health Section, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas

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Michael Tolle Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana; Baylor International Pediatric AIDS Initiative, Houston, Texas; Department of Pediatrics, Retrovirology/Global Health Section, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas

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Vincent Mabikwa Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana; Baylor International Pediatric AIDS Initiative, Houston, Texas; Department of Pediatrics, Retrovirology/Global Health Section, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas

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Gabriel Anabwani Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana; Baylor International Pediatric AIDS Initiative, Houston, Texas; Department of Pediatrics, Retrovirology/Global Health Section, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas

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The objective of this study was to assess the prevalence of hepatitis B and hepatitis C coinfections in human immunodeficiency virus (HIV) -infected adults at an HIV center in Gaborone, Botswana. A retrospective review was performed of charts of currently active HIV-infected adult patients in the Family Model Clinic (FMC) of the Botswana-Baylor Children's Clinical Center of Excellence (BCOE) in Gaborone, Botswana, for the results of serum hepatitis B surface antigen (HBsAg) and antihepatitis C IgG tests performed between January 1, 2005 and December 15, 2009. Of 308 active FMC patients, 266 underwent HBsAg serology testing within the period of study. The HBsAg coinfection prevalence was 5.3% (14/266); 2 of 252 patients had at least one positive antihepatitis C IgG serology, a 0.8% prevalence. Hepatitis B coinfection is relatively common in HIV-infected adults at our center in Botswana, whereas hepatitis C coinfection is rare. In this setting, where the diagnosis of hepatitis B coinfection with HIV has implications for choice of first-line antiretroviral therapy and prevention of perinatal hepatitis B transmission, broader sampling to establish the true population prevalence of hepatitis B coinfection and the desirability of adding screening to HIV management should be considered. These findings provide little justification for adding hepatitis C coinfection screening to the management of HIV infection in Botswana.

Author Notes

*Address correspondence to Michael A. Tolle, Botswana-Baylor Children's Clinical Centre of Excellence, Hospital Way, Plot 1836, Gaborone, Botswana. E-mail: tolle@bcm.edu

Authors' addresses: Premal Patel, Michael Tolle, Vincent Mabikwa, and Gabriel Anabwani, Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana, E-mails: premal33@gmail.com, tolle@bcm.edu, vmabikwa@baylorbotswana.org.bw and ganabwani@baylorbotswana.org.bw. Stephanie Davis, Johns Hopkins School of Public Health, Baltimore, MD, E-mail: sd135626@gmail.com.

Reprint requests: Michael Tolle, Botswana-Baylor Children's Clinical Centre of Excellence, Hospital Way, Plot 1836, Gaborone, Botswana, E-mail: tolle@bcm.edu.

  • 1.

    Modi AA, Feld JJ, 2007. Viral hepatitis and HIV in Africa. AIDS Rev 9: 2539.

  • 2.

    Kiire CF, 1996. The epidemiology and prophylaxis of Hepatitis B in sub-Saharan Africa: a view from tropical and subtropical Africa. Gut 38 (Suppl 2): S5S12.

    • Search Google Scholar
    • Export Citation
  • 3.

    Opaleye OO, Zakariyahu TO, Tijani BA, Bakarey AS, 2010. HBV, HCV co-infection among blood donors in Nigeria. Indian J Pathol Microbiol 53: 182183.

    • Search Google Scholar
    • Export Citation
  • 4.

    Diarra A, Kouriba B, Baby M, Murphy E, Lefrere JJ, 2009. HIV, HCV, HBV and syphilis rate of positive donations among blood donations in Mali: lower rates among volunteer blood donors. Transfus Clin Biol 16: 444447.

    • Search Google Scholar
    • Export Citation
  • 5.

    Bwogi J, Braka F, Makumbi I, Mishra V, Bakamutumaho B, Nanyunja M, Opio A, Downing R, Biryahwaho B, Lewis R, 2009. Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey. Afr Health Sci 9: 98108.

    • Search Google Scholar
    • Export Citation
  • 6.

    Tagny C, Diarra A, Yahaya R, Hakizimana M, Nguessan A, Mbensa G, Nébié Y, Dahourou H, Mbanya D, Shiboski C, Murphy E, Lefrère J, 2009. Characteristics of blood donors and donated blood in sub-Saharan Francophone Africa. Transfusion 49: 15921599.

    • Search Google Scholar
    • Export Citation
  • 7.

    Burnett R, Francois G, Kew M, Leroux-Roels G, Meheus A, Hoosen AA, Mphahlele MJ, 2005. Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: a call for further investigation. Liver Int 25: 201213.

    • Search Google Scholar
    • Export Citation
  • 8.

    Nacro B, Dao B, Dahourour H, 2001. HBs antigen in children with suspicion of HIV infection. J Trop Pediatr 47: 303304.

  • 9.

    Combe P, La Ruche G, Bonard D, Ouassa T, Faye-Kette H, Sylla-Koko F, Dabis F, 2001. Hepatitis B and C infections, human immunodeficiency virus and other sexually transmitted infections among women of childbearing age in Cote d'Ivoire, West Africa. Trans R Soc Trop Med Hyg 95: 493496.

    • Search Google Scholar
    • Export Citation
  • 10.

    Sutcliffe S, Taha TE, Kumwenda NI, Taylor E, Liomba GN, 2002. HIV-1 prevalence and herpes simplex virus 2, hepatitis C virus, and hepatitis B virus infections among male workers at a sugar estate in Malawi. J Acquir Immune Defic Syndr 95: 493496.

    • Search Google Scholar
    • Export Citation
  • 11.

    Adewole OO, Anteyi E, Ajuwon Z, Wada I, Elegba F, Ahmed P, Betiku Y, Okpe A, Eze S, Ogbeche T, Erhabor GE, 2009. Hepatitis B and C virus co-infection in Nigerian patients with HIV infection. J Infect Dev Ctries 3: 369375.

    • Search Google Scholar
    • Export Citation
  • 12.

    Nagu TJ, Bakari M, Matee M, 2008. Hepatitis A, B and C viral co-infections among HIV-infected adults presenting for care and treatment at Muhimbili National Hospital in Dar es Salaam, Tanzania. BMC Public Health 19: 416.

    • Search Google Scholar
    • Export Citation
  • 13.

    Kew MC, Kassianides C, Berger EL, Song E, Dusheiko GM, 1987. Prevalence of chronic hepatitis virus infection in pregnant women living in Soweto. J Med Virol 22: 263268.

    • Search Google Scholar
    • Export Citation
  • 14.

    Vos GH, Rose EF, Marimuthu T, 1984. Hepatitis B antigen and antibodies in rural and urban southern African blacks. S Afr J Med 57: 868870.

  • 15.

    Lodenyo H, Schoup B, Ally R, Kairu S, Segal I, 2000. Hepatitis B and C virus infections and liver function in AIDS patients at Chris Hani Baragwanath Hospital, Johannesburg. East Afr Med J 77: 1315.

    • Search Google Scholar
    • Export Citation
  • 16.

    Firnhaber CS, Reyneke A, Schulze D, Malope B, Maskew M, Macphail P, Sanne I, Biscerglie A, 2008. The prevalence of hepatitis B co-infection in a South African urban government HIV clinic. S Afr Med J 98: 541544.

    • Search Google Scholar
    • Export Citation
  • 17.

    Wester W, Bussmann H, Moyo S, Avalos A, Gaolathe T, Ndwapi N, Essex M, MacGregor RR, Marlink R, 2006. Serological evidence of HIV-associated infection among HIV-1–infected adults in Botswana. Clin Infect Dis 14: 16121615.

    • Search Google Scholar
    • Export Citation
  • 18.

    Tedla Z, Nyirenda S, Peeler C, Agizew T, Sibanda T, Motsamai O, Vernon A, Wells CD, Samandari T, 2010. Isoniazid-associated hepatitis and antiretroviral drugs during tuberculosis prophylaxis in HIV-infected adults in Botswana. Am J Respir Crit Care Med 182: 278285.

    • Search Google Scholar
    • Export Citation
  • 19.

    Byskov AJS, Wouters M, Sathekge TJ, Swanepoel R, 1989. An outbreak of suspected water-borne epidemic non-A non-B hepatitis in northern Botswana with a high prevalence of hepatitis B carriers and hepatitis delta markers among patients. Trans R Soc Trop Med Hyg 83: 110116.

    • Search Google Scholar
    • Export Citation
  • 20.

    Mulwa JKM, 1994. Hepatitis B situation in Botswana. J Prev Med Hyg 35: 67.

  • 21.

    Nurse GT, Tanaka N, MacNab G, Jenkins T, 1973. Non-venereal syphilis and Australia antigen among the G/Wi and G-Ana San of the Central Kalahari Reserve, Botswana. Cent Afr J Med 19: 10.

    • Search Google Scholar
    • Export Citation
  • 22.

    Dibisceglie AM, Kew MC, Dusheiko GM, Berger EL, Song E, Paterson AC, Hodkinson HJ, 1986. Prevalence of hepatitis B virus infection among black children in Soweto. Br Med J (Clin Res Ed) 292: 14401442.

    • Search Google Scholar
    • Export Citation
  • 23.

    Madhava V, Burgess C, Drucker E, 2002. Epidemiology of chronic hepatitis C virus infection in sub-Saharan Africa. Lancet Infect Dis 2: 293302.

    • Search Google Scholar
    • Export Citation
  • 24.

    Kallestrup P, Zinyama R, Gomo E, 2003. Low prevalence of HCV antibodies in HIV-endemic area of Zimbabwe support sexual transmission as the major route of HIV transmission in Africa. AIDS 17: 14001402.

    • Search Google Scholar
    • Export Citation
  • 25.

    Patel P, Davis S, Tolle M, Anabwani G, 2010. The Family Medical Clinic (FMC) at the Botswana-Baylor Children's Clinical Centre of Excellence (BBCCCOE) in Gaborone, Botswana—A model of care. Proceedings of the 19th International AIDS Conference, July 18–23, 2010; Vienna, Austria.

    • Search Google Scholar
    • Export Citation
  • 26.

    Aberg J, Kaplan J, Libman H, Emmanuel P, Anderson J, Stone V, Oleske J, Currier J, Gallant J, 2009. IDSA guidelines: primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 49: 659.

    • Search Google Scholar
    • Export Citation
  • 27.

    Department of Health and Human Services, 2009. Panel on Antiretroviral Guidelines for Adults and Adolescents: Guidelines for the Use of Antiretroviral Agents in HIV-1–Infected Adults and Adolescents. Available at: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed September 6, 2010.

    • Search Google Scholar
    • Export Citation
  • 28.

    European AIDS Clinical Society, 2010. Guidelines Clinical Management and Treatment of Chronic Hepatitis B and Hepatitis C Coinfection in HIV-Infected Adults. Available at: http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf. Accessed September 6, 2010.

    • Search Google Scholar
    • Export Citation
  • 29.

    Ministry of Health Department of HIV/AIDS Prevention and Care, 2008. Botswana National HIV/AIDS Treatment Guidelines, 2008 Version. Available at: http://www.aidstarone.com/botswana_national_hivaids_treatment_guidelines_2008_version. Accessed September 6, 2010.

    • Search Google Scholar
    • Export Citation
  • 30.

    World Health Organization, 2008. Essential Prevention and Care Interventions for Adults and Adolescents Living with HIV in Resource-Limited Settings. Available at: http://www.who.int/hiv/pub/toolkits/Essential%20Prevention%20and%20Care%20interventioni%20Jan%2008.pdf. Accessed September 6, 2010.

    • Search Google Scholar
    • Export Citation
  • 31.

    Tolle MA, 2009. A package of primary health care services for comprehensive family-centred HIV/AIDS care and treatment programs in low-income settings. Trop Med Int Health 14: 663672.

    • Search Google Scholar
    • Export Citation
  • 32.

    Department of Health Republic of South Africa, 2010. The South African Antiretroviral Treatment Guidelines 2010. Available at: http://www.sanac.org.za/documents/2010%20ART%20Guideline-Short.pdf. Accessed August 10, 2010.

    • Search Google Scholar
    • Export Citation
  • 33.

    Firnhaber CS, Ive P, 2009. Hepatitis B and HIV co-infection in South Africa: just treat it. Southern African Journal of HIV Medicine 10: 1014.

    • Search Google Scholar
    • Export Citation
  • 34.

    World Health Organization, 2010. Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach, 2010 revision. Available at: http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf. Accessed September 6, 2010.

    • Search Google Scholar
    • Export Citation
  • 35.

    Thio CL, Locarnini S, 2007. Treatment of HIV/HBV coinfection: clinical and virologic issues. AIDS Rev 9: 4053.

  • 36.

    Nuesch R, Ananworanich J, Srasuebkul P, Klinbuayam W, Mahanontharit A, Jupimai T, Ruxrungtham K, Hirshcel B, 2008. Interruptions of tenofovir/emtricitabine-based antiretroviral therapy in patients with HIV/hepatitis B virus co-infection. AIDS 22: 152154.

    • Search Google Scholar
    • Export Citation
  • 37.

    Baleta A, 2010. Botswana reduces mother-to-child transmission of HIV. Lancet 375: 1954.

  • 38.

    Read JS, Cannon MJ, Stanberry LR, Schuval S, 2008. Prevention of mother-to-child transmission of viral infections. Curr Probl Pediatr Adolesc Health Care 38: 274297.

    • Search Google Scholar
    • Export Citation
  • 39.

    Puoti M, Torti C, Bruno R, Filice G, Carosi G, 2006. Natural history of chronic hepatitis B in co-infected patients. J Hepatol 44 (Suppl 1): S65S70.

    • Search Google Scholar
    • Export Citation
  • 40.

    Wang Z, Zhang J, Yang H, Li X, Wen S, Guo Y, Sun J, Hou J, 2003. Quantitative analysis of HBV DNA level and HBeAg titer in Hepatitis B surface antigen positive mothers and their babies: HBeAg passage through the placenta and the rate of decay in babies. J Med Virol 71: 360366.

    • Search Google Scholar
    • Export Citation
  • 41.

    Sangaré L, Sombié R, Combasséré AW, Kouanda A, Kania D, Zerbo O, Lankoandé J, 2009. Antenatal transmission of hepatitis B virus in an area of HIV moderate prevalence, Burkina Faso. Bull Soc Pathol Exot 102: 226229.

    • Search Google Scholar
    • Export Citation
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