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.

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