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.

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。

Effects of Hepatitis B Virus Co-Infection and Antiretroviral Therapy on Disease Progression among HIV Patients Treated at the Buea Regional Hospital, Southwest Region, Cameroon: A Case-Control Study

In the era of “test and treat”, when AIDS-defining events have been drastically reduced, chronic liver disease associated with viral hepatitis and antiretroviral therapy (ART) remains an important cause of non-AIDS morbidity and mortality among HIV-infected patients. Compared to the general population, HIV-infected patients are about 10-times at risk of hepatitis B virus infection. Additionally, several antiretroviral regimens are hepatotoxic. Therefore, effective monitoring and management of ART and HBV co-infection are essential to ending the AIDS epidemic and eliminating viral hepatitis by 2030. This was a hospital-based, matched (age and sex) case-control study. HIV patients (case patients) on ART for at least six months and “healthy” controls aged 18 years and older were enrolled. Blood samples were collected for immuno-hematologic indices and transaminases measurements. Data were presented as counts, percentages, median (IQR) and means (SD), and a p-value 1.5) and mild (0.6 - 1.5) liver fibrosis based on the APRI score was 0.5% and 8%, respectively. Significant fibrosis (>3.25) was 0.9%, while 18.4% had inconclusive fibrosis (1.45 - 3.25) based on the FIB-4 score. HIV/HBV co-infected patients had a higher occurrence of liver fibrosis (APRI: 0.5% vs FIB-4: 0.9%). Co-infections with HBV increase the risk of liver-related morbidity in HIV patients. Therefore, screening for serological markers of chronic HBV infection and hepatic transaminase levels in HIV patients remains crucial in the continuum of care.

Progression of Platelet Counts in Treatment Naïve HIV/HCV Co-Infection

Background: Previous research has suggested an association between infection with hepatitis C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet counts. This study estimates platelet count changes over time in HIV/HCV co-infected participants and compares them with the changes in platelet count among HIV mono-infected participants to test if HIV/HCV co-infection is associated with lower platelet counts. Methods: This retrospective cohort study included all HIV treatment naive patients from four sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort with platelet count measurements between 2002 and 2009. We conducted a mixed effects linear regression modeling the mean change in platelet count per year while adjusting for age, sex, race, baseline CD4 cell count, and site. Index date was the first platelet count after 2002, and participants were censored upon initiation of treatment for HIV or HCV. Results: There were 929 HIV/HCV co-infected and 3558 HIV mono-infected participants with a mean follow-up time of 1.2 years. HIV/HCV co-infected participants had on average a slighter lower platelet count at baseline (234,040 vs. 242,780/μL;p-value = 0.004), and a more rapid mean reduction per year (7230 vs. 3580/μL;p-value 0.001) after adjusting for age, sex, baseline CD4 count. Conclusions: In treatment naive participants, HIV/HCV co-infection is associated with a more rapid decline in platelet count compared with HIV mono-infection.

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。

Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4+ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

HIV-tuberculosis co-infection in an Indian scenario:The role of associated evidence of immunosuppression

Objective:To determine the relationship between tuberculosis and the degree of immunosuppression as determined by CD4 count.The impact of immunosuppression on the severity of tuberculosis was also studied.Methods:A retrospective analysis was performed in patients newly diagnosed with HIV infection and antiretroviral therapy(ART)-naive patients with known HIV seropositivity.All patients were diagnosed with active tuberculosis between January 2008 and December 2010,based on review of their medical records.Patients on chemoprophylaxis for opportunistic infection were excluded.Pattern and severity of tuberculosis,associated stigmata of immunosuppression,and CD4 counts were noted.Results:Of 140 patients satisfying the inclusion criteria.52 had mild tuberculosis with no other evidence of immunosuppression,52 had tuberculosis of variable severity with associated evidence of immunosuppression,and 36 had severe tuberculosis with no other evidence of immunosuppression.The CD4 count was highest in the first group[【109.2±99.9) cells/μL]and least in the second group[(58.4±39.8) cells/μL], and the difference was statistically significant(P=0.004).No statistical difference was observed in the CD4 count between those with mild tuberculosis and those with severe tuberculosis. Conclusions:In developing countries with a high prevalence of tuberculosis in the general population,the possibility of incidental tuberculosis in patients with HIV should always be considered.CD4 count does not appear to influence the severity of tuberculosis.The presence of concomitant evidence of immunosuppression in the form of category B and C conditions is indicative of underlying immunosuppression and associated with a significantly lower CD4 count.

Preliminary investigation on the prevalence of malaria and HIV co-infection in Mae Sot District, Tak Province of Thailand

Objective: To preliminarily investigate the prevalence of HIV co-infection in patients with malaria in Mae Sot District, Tak Province of Thailand.Methods: The study was a retrospective study on blood samples collected from a total of 256 patients with malaria(all species and severity) who attended Mae Tao clinic for migrant workers, Tak Province during 2005-2007(148 samples) and 2010-2012(108 samples). Malaria diagnosis was performed based on microscopic examination of patients' blood smears. Chemiluminescent microparticle immunoassay and gel particle passive agglutination were employed for the detection of HIV antigen in patients' plasma. Results: Plasmodium falciparum(P. falciparum) and Plasmodium vivax(P. vivax) are the two predominant malaria species with the ratio of about 1: 1 to 1.5:1. Most of the P. falciparum cases were presented with acute uncomplicated signs and symptoms with highest parasitemia of 1 045 000 asexual parasites/μL bloods. The prevalence of malaria and HIV co-infection during 2005-2007 was 1.35%(2/148 cases, 1 each for P. falciparum and P. vivax co-infection), but was increased to 2.78%(3/108 cases, 2 and 1 for P. falciparum and P. vivax co-infection, respectively) during 2010-2012.Conclusions: The increasing trend of prevalence of malaria and HIV co-infection in Mae Sot, Tak province was of a great concern on either pharmacodynamics or pharmacokinetics aspect. The study in a larger numbers of malaria patients in different endemic areas throughout the country with different time periods is underway.

Hepatitis B Virus Co-Infection: Yet Another Reason for Early Initiation of Treatment in HIV Infected Individuals

Background: Hepatitis B virus (HBV) co-infection with HIV is becoming a major challenge due to shared routes of transmission. The burden is apparent in regions with widespread use of antiretroviral treatment, which led to the enhanced emergence of liver-related diseases and mortality. Though there are conflicting results about the effect of chronic HBV infection on response to highly active antiretroviral therapy (HAART) (CD4+ cell count and HIV viral load, HIV RNA copies/ml), HAART is known to cause immune mediated HBV specific liver damage after it reconstitutes cell-mediated immunity. The relationship of different HAART regimes with immune recovery is an area of research interest. Objective: It is in order to determine the changes in immune recovery during HBV infection in the setting of HAART among HIV positive individuals attending care and treatment services. Methods: Two cohorts of co-infected patients were analyzed from data of one to seven months retrospectively. The first group (n = 380) was antiretroviral drug naive and the second cohort (n = 380) was on HAART for the entire period. The study was conducted in one referral hospital and six health centers. Data were gathered from 760 patients using their intake form, their follow-up form and their medical records supplemented by data from a structured questionnaire. HBV infection was determined by using HBsAg rapid and confirmatory tests and CD4 cells were enumerated by using laboratory registers and patient cards. Bivariate and multivariate logistic regressions were done by using SPSS Version 18 and Epi info Version 3.5. Results: Poor immune recovery due to HBV infection was improved after initiation of HAART. Before the initiation of HAART, the mean CD4 cell count of HBV infected individuals was lower than that of non-HBV infected ones, 234/mm3 and 384/mm3, respectively (p 0.05). Individuals co-infected with HBV had experienced delayed recovery of immune cells (CD4 cell count). However, after, on average, more than two years of therapy, the association is reversed. In addition to HBV infection, CD4 cell count of patients on chronic HIV care/pre-ART was decreased by older age, living in rural areas and previous opportunistic infections. Conclusion: HBV infection has different outcomes between pre-ART and ART-initiated individuals. In the former cohort, HBV infection causes significant delays in immune recovery which is reversed after initiation of anti-HIV treatment. HBV co-infection has a significant and immediate negative effect on CD4 cell counts and immune recovery before HAART but such effects slowly subside after initiation of the treatment. As a result, HBV infection is another issue to consider for swift initiating of HAART for HIV infected individuals in long-term care.

Factors Associated with HIV/Tuberculosis Coinfection among People Living with HIV after Initiation of Antiretroviral Treatment in Lingwala Health Zone from 2021 to 2023

Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.

Prevalence of Human Immune Deficiency among Registered Tuberculosis Patients across Pakistan during 2013-2015<br/>—Prevalence of TB-HIV Co-Infection in Pakistan

The problem of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) co-infection becomes vital when it is seen in the context of under developed countries like Pakistan. Pakistan ranks 5th high burden countries for drug-susceptible and 6th among drug-resistant TB patients [1]. Objectives of the study were to assess the prevalence of TB-HIV Co-infection at the designated Sentinel Sites across Pakistan. A cross-sectional study is based on retrospective record review of routinely maintained TB program data at all 17 designated sentinel sites of TB Control Program from 2013-15. Among the screened TB patients 145 (0.66%) were found HIV reactive. The prevalence of HIV was higher (1.02%) in extra-pulmonary and male TB patients (1.23 %) as compared to pulmonary (0.55%) and female patients (0.09%). Scale up TB surveillance activities, integrating TB-HIV care services, active case finding among key affected populations will have a positive impact on TB-HIV co-infection and disease control.

First Nationwide Survey of the Prevalence of TB/HIV Co-Infection in Ghana

Background: To better understand the extent of the magnitude of tuberculosis (TB) and Human Immunodeficiency Virus (HIV) co-infection in Ghana, a baseline study was conducted to establish the national prevalence of the dual infection. The study aimed to determine the most prevalent HIV serotype (HIV-1 or HIV-2) in TB patients (new and old cases);genotype mycobacterial species causing TB/HIV co-infection and determine their drug susceptibility patterns. Methods: Sputum and dried blood samples were collected from 503 TB patients from 67 health facilities nationwide between December 2007 and November 2008. All samples were processed for mycobacterial and HIV testing using conventional and molecular methods. Results: A total of 517 paired sputum samples were received from 517 patients. A total 503 patients [335 (66.6%) males;168 (33.4%) females] had at least one culture positive sample. Majority (93.0%) of the patients were new cases while 7.0% were old cases. All 503 TB isolates were Mycobacterium tuberculosis complex. Of 503 blood samples, 74 were positive for HIV (14.7%), comprising 71 (14.1%) and 3 (0.6%) for HIV-1 and HIV-1 & 2 respectively;none was positive for HIV-2 alone. The seroprevalence of HIV in newly diagnosed TB patients and those already on treatment, was 69/468 (14.7%) and 5/35 (14.3%) respectively (p > 0.05). Differentiation of isolates from TB/HIV co-infected patients showed that 70/74 (94.6%) were Mycobacterium tuberculosis while 4/74 (5.4%) were Mycobacterium africanum. Monoresistance to isoniazid and rifampicin were 4/74 (5.4%) and 1/74 (1.4%) respectively;resistance to both drugs (multi-drug resistant-MDR) was not observed. Sixty nine (93.2%) isolates were susceptible to both drugs. Conclusion: The prevalence of HIV infection in TB patients was 14.7%. TB/HIV was common among the sexually active age group (25 - 34 years). Majority of the TB isolates were M. tuberculosis which were susceptible to both isoniazid and rifampicin. HIV-1 was the common serotype infecting TB patients in Ghana.

HIV/HCV Co-Infection—A Dual Neurocognitive Problem

Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV)-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.

Role of HLA-A, HLA- B, HLA-DRB1 and HLADQB1 Alleles in HIV-1 Patients with Pulmonary Tuberculosis Co-Infection from Western India

We attempted to study the role of HLA HLA-A, B, DRB1 and DQB1 in HIV-1 patient’s co infected with pulmonary tuberculosis (PTB). A total of 102 HIV-1 + patients co-infected with pulmonary tuberculosis and 200 healthy controls were included in HLA analysis. HLA-A*, HLA-B* HLA-DRB1* and DQB1* typing was done molecularly by PCR- SSOP (Polymerase Chain reaction-Sequence Specific Oligonucleotide Probing) method using kit (Dynal Kit – Invitrogen). The frequencies of the HLA-A, B HLA-DRB,1 and DQB1 alleles were determined using standard software. The HLA alleles identified among HIV + ve/PTB + ve co-infected patients as compared with healthy controls showed a significantly increased frequency of HLA-B*08:01:01 in HIV + ve/PTB + ve co-infected patients when compared with healthy controls (p = 0.011, OR 3.335, 95% CI 1.35-8.18), Likewise HLA-DQB1*03:01:03 was significantly increased in HIV + ve/PTB + ve co-infected patients as against healthy controls (p < 0.0001, OR 107.5, 95% CI 6.195 - 1865.3). Similarly HLA-DQB*06:01:02 allele frequency was observed in HIV + ve/PTB + ve co-infected patients as against healthy controls (p = 0.003, OR 4.808, 95% CI 1.72-13.39), HLA-DQB1*03:01:01 (p = 0.045, OR 0.219, 95% CI 0.051 - 0.940), HLA-DQB1*06:01:01:01 (p = 0.012, OR 0.334, 95% CI 0.145 - 0.770), alleles in HIV + ve/PTB + ve co-infected patients when compared with healthy controls. We can be concluded that different HLA alleles may render susceptibility or protection to in different ethnic population.

Antiretroviral Therapy in HIV/HCV Co-Infection Italian Consensus Workshop

About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression;neurological, cognitive and renal damage;and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.

Evaluation of Tuberculosis Treatment Outcome of TB/HIV Co-Infection: A Four-Year Retrospective Cohort Study in HIV-Prevalent Setting of North Central Nigeria

Background: Despite the availability of highly effective treatment for decades, Tuberculosis (TB) remains a major health problem in Nigeria due to the increasing association between HIV and TB observed over the past three decades when HIV was discovered. However, the proportion of TB and or TB/HIV co-infected patients who have successful TB treatment outcome is not well known. This study determined the treatment outcome of TB/HIV co-infected patients with HIV negative patients in two states in Nigeria. Materials and Methods: A retrospective study of secondary data from eight Directly Observed Treatment Short (DOTS) course and Anti- Retroviral Therapy (ART) service providers in Benue and Federal Capital Territory (FCT), Nigeria, was carried out. The period under review covers January, 2010 to December, 2013. Results: Out of the total 5266 TB cases reviewed, the HIV prevalence rate was 52%. They were predominantly (53.3%) male with mean age of 34.4 years (SD = 15.1 years). More than two-third (72.5%) of HIV-negative patients had successful treatment compared to 1718 (62.7%) HIV-positive patients. Of the 2334 HIV co-infected patients, 19.5% defaulted, 11.5% had died, 5.6% were transferred out and 0.7% failed treatment compared to HIV-negative patients amongst whom 18.3% defaulted, 3.6% died, 3.9% were transferred out and 1.6% failed treatment (p Conclusion: The favourable treatment outcome of HIV-negative patients is more than that of HIV-positive patients and the most probable predictable factor responsible is the CD4 count of patient;indicating that TB/HIV co-infection has remained a major public health problem in Benue state and FCT. Hence there is the need for sustained strengthening and expansion of the national TB/HIV programmes.

Cross-Sectional Study of Tuberculosis and HIV/AIDS Co-Infections among Patients Attending Directly Observed Treatment Centers in Bayelsa State, Nigeria

Introduction: Mycobacterium tuberculosis (TB) infects about one quarter of the global population and is transmitted via aerosols by coughing, sneezing, etc. Some socio-behavioral factors may predispose an individual to the disease. Methodology: The study used a cross-sectional design with random stratified sampling technique. Sputum samples from suspected TB patients totaling 600 were obtained from patients attending directly observed treatment (DOTs) centers from different local government areas in Bayelsa. The sputum samples were examined for tuberculosis using the Ziehl-Neelsen staining technique and Gene Xpert molecular method while HIV/AIDS tests were carried out with EDTA blood using the Alere HIV12 test kit and others. Results: The Prevalence of TB by Gene Xpert was 294 (49.0%) and by AFB 217 (36.1%), while TB/HIV co-infection was 94 (32.0%), RRMTB was 34 (11.9%) and HIV 249 (41.5%). Prevalence by age group showed the 20 - 39 years had the highest prevalence of TB 98 (47.0%), TB/HIV 35 (47.0%), RRMTB 17 (48.0%) and HIV 90 (57.0%). By gender the male had slightly higher prevalence of TB 109 (52.0%), TB/HIV 51 (54.0%), RRMTB 20 (56.0%) and HIV 126 (51.0%) than the female. Prevalence among smokers and alcoholics and subjects who engaged in both habits had high prevalence TB 109 (37.0%), TB/HIV 14 (40.0%), RRMTB 14 (40.0%) and HIV 72 (29.0%). For educational status those with tertiary and secondary education had similar high prevalence and for occupation, the self-employed and civil servants had similar elevated prevalence. The prevalence by local government area showed that Yenegoa had the highest with TB 235 (80.0%), TB/HIV 72 (76.6%), RRMTB 24 (68.5%) and HIV 202 (81.2%). Conclusion: An increase in the development of resistance by M. tuberculosis also contributes to the persistence of the disease as well as some socio-economic factors.

Effects of the Cytotoxic T-Cells on the Dynamics of Co-Infection of HIV-1 and Mycobacterium tuberculosis

Enhancement of the Human Immunodeficiency Virus (HIV) specific cytotoxic T-cells mechanisms in an HIV-1 and Mycobacterium tuberculosis (Mtb) co-infected individual seems to improve the clinical picture of an individual by reducing Acquired Immuno Deficiency Syndrome (AIDS) state progression rate. In this paper, we develop a system of deterministic differential equations representing the immune cells involved in an HIV-1 and Mtb co-infected individual. Results show that although the non-lytic arm of the HIV-1 cytotoxic T-cells affects the co-infection dynamics more than the lytic factors, a combination of both factors results in a more positive reduced progression to the AIDS state. This is due to the increased protection of the CD4+ T-cells by the CTL mechanisms by further reducing infections and replications by the HIV. Thus, HIV-1 specific CTLs mechanisms’ involvement is here recommended to be part of a solution to the HIV and Mtb co-infection problems.

Using Statistical Learning to Treat Missing Data: A Case of HIV/TB Co-Infection in Kenya

In this study, we investigate the effects of missing data when estimating HIV/TB co-infection. We revisit the concept of missing data and examine three available approaches for dealing with missingness. The main objective is to identify the best method for correcting missing data in TB/HIV Co-infection setting. We employ both empirical data analysis and extensive simulation study to examine the effects of missing data, the accuracy, sensitivity, specificity and train and test error for different approaches. The novelty of this work hinges on the use of modern statistical learning algorithm when treating missingness. In the empirical analysis, both HIV data and TB-HIV co-infection data imputations were performed, and the missing values were imputed using different approaches. In the simulation study, sets of 0% (Complete case), 10%, 30%, 50% and 80% of the data were drawn randomly and replaced with missing values. Results show complete cases only had a co-infection rate (95% Confidence Interval band) of 29% (25%, 33%), weighted method 27% (23%, 31%), likelihood-based approach 26% (24%, 28%) and multiple imputation approach 21% (20%, 22%). In conclusion, MI remains the best approach for dealing with missing data and failure to apply it, results to overestimation of HIV/TB co-infection rate by 8%.

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.