Abstract
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HIV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV coinfected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive for both HBV and HCV. There were no remarkable differences between HIV infected and HIV-HBV co-infected
patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HBV co-infected patients than HIV patients and this was statistically significant (17.5 iu/ml vs. 15.0 iu/ml, p value0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients.
The differences were however not statistically significant (p value- 0.114 and 0.644 respectively). HIV- HBV co-infection in HIV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women shouldbe screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Keywords: HIV, hepatitis B, pregnancy, Nigeria
Résumé
LE VIH et VHB partagent les mêmes modes de transmission qui incluent le sang et les routes verticales. Bien que, le parcours naturel du VIH n’alterne pas le VHB, le taux des décès lies au foi est plusieurs fois plus élevé parmi les personnes Co-infectes du HIV/VHB. Les médecins apportent des soins aux individus séropositifs incluant les femmes enceintes, ont besoin de la sensibilisation de ce fléau. Ces deux années d’étude commença en Janvier 2006, parmi les femmes enceintes séropositives vues au Centre Universitaire Hospitalier, Ibadan, Nigeria. Durant cette étude, 721 Cas ont été détectés ayant l’infection du virus de l’hépatite B. Soixante quatre cas des femmes (8.9%) étaient positives pour le HBsAg, 14(1.9%) étaient positive au VHC et 642 (89.2%) étaient négative au VHB et VHC. Un patient était positif au VHB et VHC. Ils n’y avaient pas de différences remarquables entre les infectées du VIH et coinfection du HIV-VHB dans les mesures hématologiques, albumine et bilirubine. Alanine transaminase était cependant élevé chez les VIH-VHB patients Co-infectés que les VIH seulement et ceci était statistiquement significatif (17.5 iu/ml vs. 15.0 iu/ml, p - 0.009). En Plus, Le taux des cellules CD4 étaient plus bas et la masse virale était bas marginalement plus élevé chez les patients positif au virus de l’hépatite B. Les différences n’étaient pas statistiquement significatives (p - 0.114 et 0.644 respectivement). La co-infection VIH- VHB chez les femmes enceintes séropositives n’est pas de proportions négligeables comme démontré dans cette étude. Ainsi, Les femmes enceintes séropositives doivent être examines pour le VHB et assistées pour évaluer les soins désirés a prévenir la souffrance et la transmission verticale.
Correspondence: Dr. Olubukola Adesina, Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: bukiadewole@yahoo.com, bukiadewole@hotmail.com
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