Seroprevalence of Hepatitis B among HIV Infected Persons Receiving Care in a HIV Clinic in Kisumu Kenya

Abstract

Background: Hepatitis B infection among HIV infected persons is of clinical importance because it’s a leading cause of morbidity and mortality. Hepatitis B leads to liver cirrhosis and liver cancer. In Kenya Hepatitis B testing is not presently part of routine care for HIV infected patients despite that HIV increases the progression of HBV related liver disease due to immunosuppression.

Objective: To determine the seroprevalence of Hepatitis B virus infection and Alanine aminotransferase; ALT levels among HIV infected persons in a HIV care clinic.

Methodology: Cross-sectional descriptive study conducted at Family Aids Care and Education Services (FACES) Kisumu, Kenya. A sample size of 136 HIV infected persons above the age of 18 years were recruited.

A questionnaire collecting information on the socio demographic characteristic and exposure factors to Hepatitis B infection was administered, 4mls of blood was collected for the detection of HBsAg (Hepatitis B surface Antigens) by Enzyme Immunoassay with the Murex HBsAg kit. The ALT test was done using COBAS INTEGRAL^® 400 plus, Roche. Statistical analysis was done using SPSS v.16.

Results: The seroprevalence of Hepatitis B infection among HIV infected persons was 13%. Patients with elevated liver enzyme ALT among HIV/HBV co infected persons was 11.76%. A possible association between elevated ALT and Hepatitis B was found (Fishers exact test p=0.044). Exposure factors such as lack of vaccination and having more than one sexual partner were considered to be significantly associated with the Infection ( P<0.005)

Conclusion: There is need for increased screening and awareness of HBV infection for individuals who are HIV positive as the prevalence of the Hepatitis B infection is comparatively high as compared to the prevalence of HBsAg in the general population. The government through the ministry of medical services should look into the policy of making vaccination against Hepatitis B accessible.