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ORIGINAL ARTICLE
Year : 2011  |  Volume : 3  |  Issue : 3  |  Page : 269-274

HIV, hepatitis B, and hepatitis C in Zambia

Kenneth C Kapembwa1, Jason D Goldman2, Shabir Lakhi1, Yolan Banda3, Kasonde Bowa4, Sten H Vermund5, Joseph Mulenga6, David Chama6, Benjamin H Chi7
1 Department of Internal Medicine, School of Medicine, University of Zambia; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
2 Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
3 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
4 Department of Surgery, School of Medicine, University Teaching Hospital, Lusaka, Zambia
5 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; Institute of Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
6 Zambia National Blood Transfusion Service, Lusaka, Zambia
7 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; Department of Obstetrics and Gynecology, School of Medicine, University of Alabama, Birmingham, AL, USA

Correspondence Address:
Kenneth C Kapembwa
Department of Internal Medicine, School of Medicine, University of Zambia; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.83534

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Objectives : Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART). Materials and Methods: We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV Ab) at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection. Results: Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2%) were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4%) were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be <40 years (84.4% vs. 61.4%; P=0.01) when compared to those who were not coinfected. Patients with active hepatitis B were more likely to have mild to moderately elevated AST/ALT (40-199 IU/L, 15.8% vs. 5.4%; P=0.003). Highly elevated liver enzymes (>200 IU/L) was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5). We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease. Conclusions: HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.


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