Sero-Prevalence of HBV and HIV Co-Infection in the Senatorial Districts of Ekiti State, Southwest, Nigeria

Abstract

Hepatitis is an inflammatory disease of the liver which can be acute or chronic. It can be caused by viruses (viral hepatitis), certain chemicals, drugs, prolonged or excessive consumption of alcohol (alcoholic hepatitis), some genetic abnormalities or a dysfunctional immune system (autoimmune hepatitis). And of the five types of viral hepatitis, HBV infection is the most virulent and infectious. According to a CDC (Centres for Disease Control and Prevention) estimate, nearly 300 million people are infected with hepatitis B virus (HBV), globally. It is a major public health challenge in most countries of the world, particularly in endemic areas. If HBV infection is bad for the general (healthy) populace, it is worse for the people living with HIV (PLWH). While HIV in PLWH helps to weaken or wreck the immune system, HBV attacks the liver- the most important organs in the body as far metabolism of drugs and related substances are concerned. This thus makes an already bad situation for the PLWH complicated and difficult to manage. It is critical and vital to screen all PLWH for HBV infection or assess their risks of contracting HBV infection. In the light of this, this study was designed to determine the sero-prevalence of HIV- HBV co-infection among PLWH/suspected PLWH in the three senatorial districts in Ekiti State (southwest, Nigeria).To do this, 209 PLWH/suspected PLWH were consecutively enrolled in the study population. The PLWH/suspected PLWH attending anti-retroviral (ARV) various clinics in the districts were re-screened with enzyme linked immunosorbent assay (ELISA) to establish that they were truly HIV positive. They were also screened for HBV using a rapid test kit and ELISA. Self-administered questionnaires were served on the subjects in order to collect their demographic data and investigate likely predisposing factors. Both descriptive and inferential statistical analyses were carried out using different statistical techniques with the aid of SPSS. The results of the study indicated that 29 of the subjects had HIV- HBV co-infection, thus representing an overall co-infection prevalence of 13.9%. One hundred and sixty-two of the subjects were HIV positive, representing 78% of the study population.  Twelve (5.4%) were negative to both HIV and HBV, while 6 (2.9%) were positive to HBV but negative to HIV. The study investigated the association between certain demographic variables and HBV, viz; age, gender, marital status, religion, tribe and occupation and some risk factors like smoking, use of sharp objects in initiation procedures. Subjects within the 26-35years age bracket had the highest HBV rate (6.3%), while 56-65 had the least (0.5%), female subjects had higher rate (11.7%) than the male subjects No significant association was established between HBV and any of the demographic variable or suspected risk factors. The findings of this study have shown that the prevalence of HIV-HBV co-infection among people living with HIV/AIDS in Ekiti State is relatively on the high side. It is therefore suggested that Ekiti State should vaccinate all children in the state against hepatitis, especially HBV, free of charge.  And preferably, the government should heavily subsidise shepatitis vaccination for adults in the state.