Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

Seroprevalence of HBV and HCV among People Living with HIV in Burkina Faso and Diagnostic Performance of HIV/HCV/HBsAg Combined Rapid Test in Comparison with Architect Assays

Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the prevalence of HBV and HCV in people living with HIV and to evaluate the performance of a combined rapid test for the simultaneous detection of HIV, HBV, and HCV. Methods: This is a cross-sectional study that took place from February 2017 to November 2018 and included 139 HIV-infected individuals followed up at different medical centers in Ouagadougou, Burkina Faso. HBV and HCV serology tests were performed on-site using finger prick whole blood with HIV/HCV/HBsAg combined rapid test and then serum with two reference tests “Architect HBsAg Qualitative” and “Architect HIV Ag/Ab Combo”. Results: The mean age of the participants was 57 ± 8 years. Of the 139 participants, 10% (14/139) were HIV-1 positive, 71.9% (100/139) were HIV-2 positive, and 18.0% (25/139) were HIV-1/HIV-2 coinfected. The sensitivity and specificity of the HIV/HCV/HBsAg combined rapid test were 33.33% vs 99.11% and 20% vs 99.25% compared to Architect HBsAg Qualitative and Architect HIV Ag/Ab Combo, respectively. The Kappa and Youden Index values were 0.4262 and 0.3244 and 0.2707 and 0.1925, respectively, compared to each of the two reference tests. Conclusion: The results show that the HIV/HCV/HBsAg combined rapid test has poor diagnostic efficiency and should not be recommended for the diagnosis of these viruses.

Multiplex Rapid Test with Acceptable Diagnosis Performance as a Solution to Increase Diagnosis of Hepatitis B and C Viruses in Pregnant Women in an Area of High Prevalence of Both Hepatitis Viruses Associated with HIV

Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex? HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex? HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.

Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

河南商丘地区2016年至2020年孕妇HIV、HBV及梅毒感染情况调查

目的了解河南商丘地区2016年至2020年孕妇HIV、HBV及梅毒感染情况调查。方法对河南商丘地区医院2016年至2020年22458例孕妇资料进行调查并回顾性分析孕妇感染情况。结果22458例孕妇中HIV(97.94%)、梅毒(98.10%)和HBV(98.16%)孕期检测率相比较,差异无统计学意义(P>0.05);其中HBV检测阳性率(3.44%)高于HIV(0.18‰)和梅毒(0.94‰),差异有统计学意义(χ^(2)=773.445、724.007,P<0.001);不同年龄段、产检次数孕妇的HIV、梅毒、HBV感染阳性率不一(P<0.05)。结论孕妇HBV阳性率明显高于HIV和梅毒阳性率,且其阳性率与年龄和产检次数有关,临床需加强HIV、HBV及梅毒感染筛选,降低感染风险。

216例海洛因依赖者HBV、HCV、HIV感染状况分析

目的调查分析江西省吉安市海洛因依赖者中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)的感染情况。方法用酶联免疫吸附试验(ELISA)分别检测216例海洛因依赖者(静脉注射组121例、非静脉注射组95例)的血清标志物即:HBsAg、抗-HCV、抗-HIV,其中抗-HIV阳性者送江西省疾控中心确认实验室确认。结果216例海洛因依赖者的HBsAg阳性率为23.1%、抗-HCV阳性率为48.1%、抗-HIV阳性率为0.46%,IDU组与nIDU组进行比较HBsAg、抗-HCV、抗-HIV阳性率差异有显著意义或极显著意义。结论吸毒是HBV、HCV、HIV感染的高危险因素,静脉吸毒更是导致HBV、HCV、HIV高感染率的最主要因素。

HIV合并肝炎病毒感染肝功能相关指标及免疫功能变化分析

目的探讨HIV感染者合并肝炎病毒感染后,肝功能及淋巴细胞亚群的变化,为单纯性HIV感染和HIV合并肝炎病毒感染的研究提供相关依据。方法选取苏州市第五人民医院HIV感染者460例,用实时荧光定量PCR的方法检测乙肝DNA载量(HBV-DNA)和丙肝病毒RNA载量(HCV-RNA),以HBV-DNA含量大于500IU/mL为乙肝病毒感染,以HCV-RNA含量大于500IU/mL为丙肝病毒感染,将460例HIV感染者分为HIV单纯感染、HIV合并HBV、HIV合并HCV 3组。全自动生化分析仪检测3组HIV感染中血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰基转移酶(GGT-γ);应用流式细胞仪检测外周血淋巴细胞及亚群分布;同时用五分类血细胞分析仪检测外周血淋巴细胞的数量,采用双平台检测的方法得出CD4^(+)T淋巴细胞的绝对值。对数据进行性别、年龄、病毒载量、肝功能、淋巴细胞及亚群等多因素分析。结果(1)460例HIV感染者,单纯HIV感染为208例(45.2%),HIV合并HBV感染为173例(37.6%),HIV合并HCV感染为79例(17.2%),3组分布与性别、年龄构成差异无统计学意义(P>0.05)。(2)3组患者中HIV合并HBV组ALT、AST均高于其余两组,且差异存在统计学意义(P<0.05)。(3)CD3^(+)T细胞的比例和绝对计数HIV合并HBV组显著低于其余两组(P<0.05);而CD4^(+)T的比例则在HIV合并HBV组中最高,显著高于其余两组(P<0.05);CD8^(+)T的比例与CD4^(+)T相反,在HIV合并HBV组中最低(P<0.05)。(4)对CD4^(+)T细胞绝对计数值划分区间,可见单纯HIV感染的患者69%在<200个/μL的区间内,而其余两组均以200~400个/μL区间为主。结论HIV感染者合并肝炎病毒(HBV或HCV)感染后发生肝功能损害更为严重,同时合并感染后可能更高水平的增加淋巴细胞的激活,淋巴细胞亚群的变化更为复杂,导致机体免疫功能的多样化。

溶血、脂肪血及保存条件对HBV DNA、HIV RNA核酸检测的影响

目的:标本溶血、脂肪血、不同保存条件对于血液HBV DNA、HIV DNA核酸检测结果的影响。方法:使用罗氏检测试剂,分别在4℃、25℃、37℃、-30℃下保存的12-30倍LOD浓度HBV DNA与HIV DNA标本,标本在4h、24h、48h、72h、1周通过6混样模式进行核酸检测,溶血标本Hb浓度范围分别为97g/L、34g/L、17g/L、8g/L、5g/L、3g/L,TG浓度范围分别为7.93mmol/L、3.80mmol/L、2.63mmol/L、1.83mmol/L、1.49mmol/L,1组如溶血正常对照样本进行核酸检验。结果:HBV DNA检测的血液样本,保存在温度37℃环境下,放置72h与1周测定循环阈值Ct要明显比其他的时间段高(P<0.05);溶血与脂肪血标本,表现为Hb的浓度处在97g/L状态,在HBV DNA、HIV DNA无法检出,而脂肪血的标本,TG的指标在≤7.93mmol/L以内范围,在各项检测的结果上均为未见明显的差异(P>0.05)。结论:罗氏检测试剂对血液标本中HBV DNA、HIV DNA核酸检验,若是常温下进行放置,能够在4周内任意时间进行相关指标测定,不会影响结果的准确性,同时Hb<34g/L,TG≤7.93mmol/L时对于核酸检测的结果无明显影响。

Seroprevalence and Risk Factors of Syphilis Infection among Antiretroviral Therapy Naive HIV Patients at the Cape Coast Teaching Hospital, Ghana

Diagnosis of sexually transmitted infections is very important considering the spread of HIV and the extensive use of highly active antiretroviral therapy worldwide. This will assist in planning of treatment schedule in controlling these infections. The study therefore aimed at determining the prevalence of syphilis in HIV positive antiretroviral therapy naive patients in Cape Coast and the associated risk factors involved in infection. A cross-sectional study was carried out using initial HIV rapid and confirmation tests, and then Venereal Disease Research Laboratory test with the Ultra Rapid Test Kits for syphilis. Demographic data, risky sexual behaviours capable of co-transmission of both HIV and Syphilis, were also collected through the use of questionnaires. In all, 150 HIV positive antiretroviral naive subjects were studied and 15 (10%) were positive for VDRL test, with females (6.00%) and males (4.00%), who were mainly within the age group of 20 - 39 years. A significant number of males (p = 0.019) and females (p = 0.015) participants were not smoking with a fewer number of the females (p = 0.002) having multiple sexual partners. Also a smaller number of those who were infected with the bacteria (p = 0.004) did not support the control of sexually transmitted infection (p = 0.022). The result showed that co-infection of Syphilis in HIV positive antiretroviral therapy naive patients persists in the Cape Coast Metropolis, which is an indication of prominence of STIs that require further study on a larger scale to ascertain the extent of co-infection and to formulate policy for treatment to help minimize the rate of infection.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

Prevalence of Syphilis and HIV Diseases among Some Universities＇ Students in Mongolia

Our country level registered communicable diseases in 2014, 45.6% of them are STD （Sexually Transmitted Diseases）. And 43.3% of the affected people by STD are aged between 15-24 years which demonstrated that they have more risky sexual behavior. This study aimed to identify level of prevalence of HIV and Syphilis within university students, to investigate their risky sexual behavior, and to treat them including their sexual partners. The survey included over 1,500 students for screening tests for HIV/Syphilis was performed locally using On Site TM Rapid Test Kits. Through the test not revealed any HIV case, only 40 （2.6%） students diagnosed by syphilis. Screening and confirmation tests for syphilis were performed locally using RPR （Rapid Plasma Reagin） and TPHA （Treponema Palladium Hem agglutination Assay）, respectively. The test revealed the diagnosis for first time for 22 （55 %） of those 40 patients with syphilis and 18 （45%） are defined as the control of STD. Therefore, 28 （70%） of them manifested symptoms of STD, only 25 （89.2%） of them previously tested and 9 （32.1%） have not treated at all. The test revealed the diagnosis for first time for 22 （55 %） of those 40 patients with syphilis and 18 （45%） are defined as the control of STD. Finally, above 40 patients are entirely included in treatment with their partners and registered of STD can be controlled.

Trace Element Levels, Cytokine Profile and Immune Activation Status in Plasma among Repeat Blood Donors with Asymptomatic HIV-1, HBV and HCV Infection

Imbalance of essential trace elements viz. Zinc, Selenium, Iron, Copper and Magnesium has been reported to influence disease course in HIV-1, HBV and HCV infections by altering immune status. A study was taken up to examine plasma levels of Th1 (IFN-γ and IL-2) and Th2 (IL-4 and IL-10) categories of cytokines and immune activation markers (TNF-α, TNFR I and TNFR II) in an asymptomatic group of HIV-1, HBV and HCV infected blood donors in relation to trace elements. Plasma levels of Zn, Se and Mg were depressed in all the three groups of blood donors (P < 0.001 for all). Levels of Cu and Fe were depressed in HIV-1 infection (P < 0.001 for both), but elevated in HBV and HCV infections (P < 0.015 and < 0.001 for Cu and < 0.001 for Fe in case of HBV and HCV infections respectively). IL-2 and IFN-γ were depressed in all the three groups of blood donors (P < 0.001). IL-4 and IL-10 levels were elevated in HBV and HCV infections (P < 0.001 for both). Immune activation markers were elevated in all the three groups of blood donors (P < 0.001 for all). HIV-1 infection showed positive correlations between Cu and IL-2, Zn and IFN-γ, and in HBV infection while positive correlations were found between Mg and TNFR I and TNFR II and Se with TNFR II. HCV infection showed a positive correlation between Se and IFN-γ (P < 0.001), Mg and IL-4 (P = 0.02), Fe and IL-10 (P < 0.01). The present study reveals possible relationship between trace element level alterations and alterations in cytokine and immune activation levels in HIV-1, HBV and HCV infection.

Clinical, Biological, Immunological and Therapeutic Profile of Patients Co-Infected with HIV-HBV and/or HCV in Kinshasa, in the Democratic Republic of the Congo: Multicenter Cross-Sectional Study

Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.

海南省吸毒人员吸毒方式与HIV、HCV、HBV和梅毒感染调查分析

采用血清流行病学方法和行为问卷对 3市县戒毒所5 1 4名吸毒人员进行调查。结果 :单纯口吸者占 6 6 1 5 % ,静脉注射吸毒者占 33 85 % ,共用注射器占静脉吸毒者 2 4 71 % ,检出抗HIV、抗HCV、HBsAg和梅毒阳性率分别为 0 1 95 %、2 9 6 7%、2 2 85 %、7 0 3%。表明 :吸毒者是 4种传染病感染的高危人群 ,静脉 (共用针具 )吸毒方式对HIV、HCV感染较HBV。

2010～2011年广州地区输血传播HBV、HCV、HIV残余风险评估

目的评估广州地区输血传播HBV、HCV、HIV的残余风险,建立适合广州地区献血人群残余风险评估的数学模型。方法收集2010年1月～2011年12月551 047人次广州地区无偿献血者的基本资料及血液ELISA与核酸检测(NAT)的HBV、HCV、HIV数据,利用(WP/I)及WP/LTR模型分别评估重复献血者及初次献血者传播HBV、HCV、HIV的残余风险。结果 2010～2011年广州地区献血者HBV、HCV、HIV经ELISA后的残余风险分别为1/30 147、1/70 591、1/645 099;经NAT检测后的残余风险分别为1/46 643、1/723 526、1/1 254 770。结论广州地区重复献血者传播HBV、HCV、HIV的残余风险低于初次献血者;采用NAT检测后,献血者传播HBV、HCV、HIV的残余风险大大降低。

核酸扩增技术在献血者血液HBV DNA、HCV RNA及HIV-1 RNA筛查中的应用研究

目的探讨在我国无偿献血者的血液筛查中引进核酸扩增技术(NAT)的必要性,了解献血者血清学病毒标志物检测阴性、NAT检测阳性的感染状况。方法应用Roche PCR、PCR-微流芯片、实时荧光PCR方法对深圳市131 174人(次)血清学检测病毒标志物阴性的献血者进行HBV DNA、HCV RNA和HIV-1 RNA检测,对NAT阳性献血者追踪检测并做定量分析。结果HBV DNA阳性22例,阳性率为1/5 962,其中15例为抗-HBc阳性,阳性率为1/8 745;HCV RNA阳性1例,阳性率1/131 174;HIV-1 RNA未检出阳性。对14名HBV DNA阳性者的追踪发现,8人发生了血清转换现象。结论采用高灵敏度的NAT筛查献血者血液中的HBV和HCV,有助于提高输血及血液安全。