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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Prevalence of hepatitis B co-infection and response to antiretroviral therapy among HIV-infected patients in Tanzania
AIDS, Volume 27, No. 6, Year 2013
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Description
Objectives: To evaluate the prevalence of HIV/hepatitis B virus (HBV) co-infection and relationship between HIV/HBV and health outcomes in a cohort of HIV-infected adults receiving antiretroviral treatment (ART) in urban Tanzania. Design/methods: Clinical and immunologic responses to ART were compared longitudinally between HIV mono (HIV) and HIV/HBV co-infected (HIV/HBV) adults enrolled between November 2004 and September 2011 at the Management and Development for Health (MDH)-PEPFAR HIV Care and Treatment program in Dar es Salaam, Tanzania. Results: The prevalence of HIV/HBV co-infection was 6.2% (1079/17 539). Compared to HIV patients, HIV/HBV patients were more likely to be male, younger, and more immunosuppressed at ART initiation. Median ART duration was 18.6 [interquartile range (IQR) 4.9-29.5] and 18.2 (IQR 4.2-27.2) months in HIV and HIV/HBV patients, respectively. In multivariate analyses, a trend towards a higher risk of mortality was observed in HIV/HBV patients {hazard ratio 1.18 [95% confidence interval (CI) 0.98- 1.42], P1/40.07} as well as lower CD4 cell counts throughout recovery (P<0.01) and higher risk of moderate-to-severe hepatotoxicity (P values <0.01 for alanine transaminase>120 and >200 IU/l). There was a higher risk of mortality in HIV/HBV patients vs. HIV patients on non-tenofovir (TDF)-containing ART [hazard ratio 1.28 (95% CI 1.02-1.61), P<0.03], whereas there was no difference in the risk of mortality observed in HIV/HBV patients vs. HIV patients on TDF-containing ART [hazard ratio 0.70 (95% CI 0.34-1.44), P<0.33]; interaction P1/40.30. Conclusions: HBV co-infection significantly impacted ART outcomes in this Tanzanian HIV-infected population. Further research is needed to confirm the potential beneficial effects of TDF on mortality in HIV/HBV co-infected individuals in these settings. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Hawkins, Claudia A.
United States, Chicago
Northwestern University Feinberg School of Medicine
Tanzania, Dar es Salaam
Management and Development for Health
Christian, Beatrice
Tanzania, Dar es Salaam
Management and Development for Health
Ye, Jitao
United States, Boston
Harvard T.h. Chan School of Public Health
Nagu, Tumaini Joseph
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Aris, Eric A.
Tanzania, Dar es Salaam
Management and Development for Health
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Chalamilla, Guerino E.
Tanzania, Dar es Salaam
Management and Development for Health
United States, Boston
Harvard T.h. Chan School of Public Health
Spiegelman, Donna L.
United States, Boston
Harvard T.h. Chan School of Public Health
Mugusi, Ferdinand M.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mehta, Saurabh
United States, Ithaca
Cornell University
Fawzi, Wafaie W.
Tanzania, Dar es Salaam
Management and Development for Health
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 64
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e32835cb9c8
e-ISSN:
14735571
Research Areas
Environmental
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania
Participants Gender
Male