Abstract:
Aims: To determine the prevalence of HBV co-infection in HIV-infected children and
compare the baseline laboratory profile of mono-infected and co-infected patients.
Study Design: This was a retrospective cohort study.
Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV
clinic of Jos University Teaching Hospital, Jos, Nigeria between January 2008 and
December 2012.Methodology: We reviewed the clinical records of 452 treatment-naïve children aged 2
months to 15 years confirmed to be HIV positive with Polymerase Chain Reaction (PCR)
for children <18 months or Western blot for children ≥18 months. The baseline laboratory
tests included: HBsAg, plasma viral load and alanine transaminase (ALT), CD4+T cell
count for children ≥5years or CD4+T cell % for children <5years.
Results: Three hundred and ninety-four (87.2%) were mono-infected with HIV while 58
(12.8%) were co-infected with HIV and HBV (HIV/HBV). At baseline, the median viral load
was 4.6 log copies/mL for mono-infected compared to 4.7 log copies/mL for HIV/HBV
(P=.48). The median CD4+T cell count was 366 cells/μL for mono-infected compared to
332 cells/μL for HIV/HBV (P=.64). The median CD4+T cell % was 19% for mono-infected
compared to 17% for HIV/HBV (P =.29). The median ALT level for the whole cohort was 23
IU/L for mono-infected compared to 26 IU/L for HIV/HBV (P=.15). However the median
ALT level for mono-infected children aged 11-15 years was 28IU/L compared to 43 IU/L for
co-infected children of same age (P =.008).
Conclusion: A high rate of hepatitis B co-infection was observed in HIV-infected children
at our centre; however more severe HIV disease was not observed. Older children coinfected
with HBV had significantly higher ALT levels compared to their mono-infected
counterparts. Early detection is therefore necessary in order to develop an appropriate
treatment plan for children co-infected with HIV and HBV.
