Data Entry And Analysis
First, the data were cleared by Epi-Info Version 7. Then, the data were extracted to the SPSS version 20 software for the data analysis. Then the data distribution was checked by the ShapiroWilk test. Then, descriptive statistics were summarized and presented in the form of figures and tables. The data were reported with mean and standard deviation for normally distributed data and median and interquartile range for skewed data. The association of the independent variable with the categorical outcome variable was measured by calculating the odds ratio with a 95% confidence interval using bivariate and multivariate logistic regression analysis. Variables having a p-value of less than 0.2 were selected for multivariate logistic regression analysis. To say a value was statistically significant the p-value must be < 0.05. Further, to show the strength of the association, the odds ratio with a 95% confidence interval was used.
Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
The Seroprevalence Of Hbv And Hbv
In this current study, the overall seroprevalence of hepatitis virus infection among HIV-positive patients attending at UoG-SRH was 21% . Furthermore, among hepatitis co-infected patients, the prevalence of HBV was found to be 13.6% . Among HBV co-infected participants, 45.45% were males and 54.55% of them were females. Also, the highest 54.55% HBV co-infection was found in the age groups of < 35 years .
Figure 1 Prevalence of HBV and HCV co-infection among HIV-infected study participants at UoG-SRH 2020.
The seroprevalence of HCV in HIV-positive participants is 8.6% . Among those participants, HCV is more prevalent in males than in females . In addition, the highest HCV seropositivity was seen in participants who come from an urban area . Furthermore, co-infection of HBV plus HCV among HIV-infected study participants amounted to 1.23% .
Table 1 Factor Association on Socio-Demographic and Clinical Characteristics Among Study Participants in UoG-SRH
From a total of 21% hepatitis-infected individuals, 1.23% of the study participants developed all three viral infections .
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How Is It Spread
Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
Treating Hepatitis C Together With Hiv
If youre HIV positive and have hepatitis C infection, then you must receive care from a doctor skilled in the treatment of both HIV and hepatitis.
Due to the new direct-acting antiviral drugs, people living with HIV and hepatitis C co-infection can be treated with most of the same hepatitis C drug regimens as HIV-negative people. Research has shown that cure rates are the same.
Unlike treatment for HIV, hepatitis C treatment is not for life. New drugs to treat hepatitis C only need to be taken for up to 3 months.
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Changing Attitudes About Hiv
When someone is diagnosed with HIV, other people may have negative attitudes and beliefs about that person’s behaviour, lifestyle or circumstances in life. These negative associations form what’s called stigma, an experience that can decrease quality of life because it includes:
Efforts to end stigma will help to:
- prevent new infections
- ensure that people living with HIV receive the care, treatment and support they need
Should People With Hiv Get Tested For Hbv
CDC recommends that all people with HIV get tested for HBV. Testing can detect HBV even when a person has no symptoms of the infection.
There are several HBV blood tests. Results of different tests show different things. For example, a positive hepatitis B surface antigen test result shows that a person has acute or chronic HBV and can spread the virus to others.
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Sex And Dirty Needles
Hepatitis A can also be passed on through sex without a condom or dental dam with someone who has the virus, even if they dont have symptomsIn particular, via anal sex, fingering, rimming, fisting, or exploring the area around the anus with your fingers, mouth or tongue. Touching used condoms, sex toys and douching equipment that have been in someone elses anus can also pass the virus on.
You can protect yourself by:
- Knowing the status of your sexual partners.
- Using a new male or female condom or dental dam every time you have vaginal, anal or oral sex.
- Using a new dental dam or latex gloves for rimming and fingering or using latex gloves for fisting.
- Covering sex toys with a new condom and wash them after use.
- Avoiding sex that involves contact with faeces .
- Washing your hands after touching someones anus or handling used condoms and sex toys.
- Using a new condom for every sexual partner and having regular STI tests.
- Having the hepatitis A vaccine if youre in close contact with someone with hepatitis A or if youre in a high-risk group. This can also be provided as prophylaxis if provided within two weeks of exposure.
Sharing contaminated needles and syringes during recreational drug use can also pass hepatitis A on. Make sure you use new injecting equipment every time you inject drugs.
Pre-exposure prophylaxis does not prevent you from getting hepatitis A, nor does the contraceptive pill or other forms of contraception .
Hepatitis C Prevention Programmes
Both hepatitis C and HIV are readily transmitted through the sharing of equipment used to inject heroin, crack cocaine and other drugs. Therefore, services use the same approach to prevent transmission of both viruses in people who inject drugs.
should make sufficient quantities of sterile injecting equipment available. Opioid substitution therapy for people with drug dependency reduces the transmission of viral infections because it helps people inject drugs less often. It also helps engage people with healthcare.15
Australia, New Zealand and Western Europe offer integrated hepatitis C, HIV and harm reduction services with promising results, leading to increased access to healthcare among people who use drugs, particularly when programmes involve peer outreach workers.18
Despite the scientific evidence in favour of harm reduction strategies, punitive instead of public health approaches for people who inject drugs are still frequent in many countries. Criminalisation and stigmatisation of people who inject drugs hinders prevention.1920A scale-up of hepatitis C treatment in people who inject drugs would reduce viral loads and make transmission less likely.21
Harm reduction expansion
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How Hiv And Hepatitis B And C Are Spread
HIV damages the immune system and can cause acquired immune deficiency syndrome if untreated. Hepatitis B and C are viruses that can cause serious damage to the liver. To become infected with HIV or hepatitis B or C while playing sports, body fluids such as blood from an infected person would need to enter your bloodstream through:
- a significant abrasion on your skin
- a bleeding wound
- your mucous membranes .
HIV and hepatitis B are spread in similar ways. Because both HIV and hepatitis B are found in blood, semen and vaginal fluids, these infections are transmitted:
- from mother to baby during childbirth or breastfeeding.
HIV cannot be transmitted by a person who is on treatment and who has low levels of virus in their body . In other words, there is no risk of HIV transmission through exposure to blood during sport from a person has an undetectable viral load.
Hepatitis C is spread through blood-to-blood transmission only, but is not thought to be sexually transmitted unless blood is present.
Symptoms Of Hepatitis C
Many people with hepatitis C have no symptoms at all. When symptoms do occur they often involve the following:
- stomach problems
- jaundice a yellowing of the skin and eyes.
Some people will clear the virus without treatment, but this is less likely in the case of people living with HIV.
For most people, hepatitis C continues to reproduce in the body long after infection, turning into a chronic infection. This means that they continue to be infectious, although they may not experience any symptoms at all, or not for many years.
Even with a lack of symptoms, the virus may still be damaging the liver, causing fibrosis a hardening of the liver. This can lead to cirrhosis, which is a permanent scarring of the liver. Cirrhosis increases the risk of liver cancer.
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What Is The Treatment For Individuals With Hiv And Hepatitis
Doctors primarily treat HIV with antiretroviral therapy. This effective treatment helps stop HIV from progressing to a later stage disease called AIDS.
With the exception of HAV, most hepatitis infections are treated with medications called antivirals. Treating HBV and HCV early is important in preventing liver diseases and cancers, some of which may be fatal.
While HBV is also treatable, medications work to suppress the virus. They cant get rid of it entirely. Similar to HIV, treatment for HBV may be lifelong.
HAV is an acute infection. It can resolve on its own, or it can last up to 6 months, according to the . Rest and fluids are standard treatments, but more severe cases may require hospitalization.
HIV-hepatitis coinfections are treatable when detected early, according to the HHS.
Some people may take separate medications for HIV and hepatitis, like in the case of HCV. However, you can sometimes treat both viruses at the same time with the same medications. It may be helpful to find a doctor whos also experienced with treating both viruses.
Risk factors for contracting HIV or hepatitis may include:
- sharing needles, razors, or syringes
- having sex without a condom or other type of barrier method
- transmission during childbirth
What Is The Risk Of Coinfection
A coinfection is when someone has two or more infections at the same time. People living with HIV are at risk of developing coinfections such as hepatitis C because HIV weakens the immune system, which leaves the body more vulnerable to other infections and illnesses.
HIV and HCV are also transmitted in similar ways, which means that people who have HIV may be at higher risk of exposure to HCV. In the United States, over a third of people living with HIV also have hepatitis C.
Coinfection of HCV and HIV is higher among those who use injected drugs. According to the Centers for Disease Control and Prevention , HCV coinfection occurs in between 62 and 80 percent of people with HIV who use injected drugs.
A systematic review of 783 studies concluded that people living with HIV were six times more likely to have hepatitis C than people without HIV.
Hepatitis C infections are more serious in people with HIV and can lead to more severe damage of the liver. HIV and HCV coinfections can increase the risk of:
- liver fibrosis and cirrhosis, which is a buildup of scar tissue in the liver
- end-stage liver disease
A person can contract HCV through direct contact with blood or other body fluids that contain the virus. Possible modes of transmission include:
Ways to prevent hepatitis C include:
- not sharing needles
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How To Prevent Hepatitis B
Hepatitis B is a liver infection caused by a virus . It can be serious and theres no cure, but the good news is its easy to prevent. You can protect yourself by getting the hepatitis B vaccine and having safer sex. If you have oral, anal, and vaginal sex, use condoms and dental dams to help stop the spread of hepatitis B and other STDs.
Who Should Be Vaccinated
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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The Epidemiology Of Hiv/hepatitis C Co
It is estimated that 6.2% of people living with HIV also show signs of past or present hepatitis C infection. This equates to 2.3 million people living with HIV, over half of whom are .7 Injection drug use accounts for 23% of new hepatitis C infections while 8% of people living with chronic hepatitis C currently inject drugs.8
Among people living with HIV, the prevalence of hepatitis C is highest in people who inject drugs , followed by and pregnant women .9 Studies also show very high rates among living with HIV, although less data has been collected.
As a result, developing models of care that meet the needs of people from these key populations is a vital first step to providing an effective co-infection treatment programme. However, the proportion of people living with HIV and hepatitis C co-infection varies considerably, according to risk group and world region.
In 2016, low- and middle-income countries accounted for about 75% of people living with hepatitis C. China has the largest hepatitis C epidemic , followed by Pakistan , India and Egypt . These four countries account for almost 40% of all people living with hepatitis C.10
Eastern Europe is home to the greatest number of people living with HIV-hepatitis C co-infection, estimated to be around 600,000 people.11 Around 400,000 people in sub-Saharan Africa are also living with HIV/hepatitis C co-infection.12
How Are Hepatitis B And Hepatitis C Spread From Person To Person
Like HIV, the hepatitis B and hepatitis C viruses spread:
- From mother to child: Pregnant women can pass these infections to their infants. HIV-HCV coinfection increases the risk of passing on hepatitis C to the baby.
- Sexually: Both viruses can also be transmitted sexually, but HBV is much more likely than HCV to be transmitted sexually. Sexual transmission of HCV is most likely to happen among gay and bisexual men who are living with HIV.
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Can Hiv Treatment Lower The Risk Of Hepatitis B
“What this means to us is that effective HIV therapy appears to restore an impairment in the immune response that protects someone with HIV from acquiring hepatitis B infection,” study senior author Dr. Chloe Thio, a professor of medicine at Johns Hopkins University School of Medicine, said in a university news release.
The study, published in the October issue of Annals of Internal Medicine, involved 2,400 gay and bisexual men who were enrolled in the Multicentre AIDS Cohort Study. Researchers found that the men successfully treated with HIV therapy had the same risk for hepatitis B infection as the men who did not have HIV. Hepatitis B is a virus that can damage the liver.
The study showed HIV-positive men on HIV therapy who had no detectable virus in their blood were 80 percent less likely to be infected with hepatitis B over about 9.5 years, compared to men with HIV who weren’t on HIV therapy or had detectable levels of the virus in their blood.
Researchers said their findings also confirm the long-standing belief that vaccination against the hepatitis B virus protects people regardless of their HIV status.
Study lead author Dr. Oluwaseun Falade-Nwulia, an assistant professor of medicine at Hopkins, said, “We found a 70 percent reduction in new infections in the men who reported receiving at least one dose of vaccine.”