A poster was presented today at AIDS 2012 in Washington DC. A glaring finding is that people who inject drugs have a lot of hepatitis C. So they must avoid nevirapine in their antiretroviral regimens and other drugs that involve the liver and need monitoring of their liver function. The Global Fund has little funding for treatment of the killing coinfection/opportunistic infection of hepatitis C. Though they fund treatment for all other OIs and many other coinfections.
The full poster is attached. Thanks to one of the authors for providing it.
[him] moderator
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TUPE151 - Poster Exhibition
Prevalence of Hepatitis B and C infections in more than 10000 HIV infected patients in Myanmar
Z. Sai Ko Ko1, A. Thet Ko1, Y. Moh Moh2, N. Thiha2, W. Maung3, S. Khin Ohmar4, A. Mar Mar5, S. Htay6, P. Clevenbergh2
1International Union Against Tuberculosis and Lung Disease, Integrated HIV Care Program, Mandalay, Myanmar, 2International Union Against Tuberculosis and Lung Disease, Mandalay, Myanmar, 3Direction of Diseases Control, Nay Pyi Daw, Myanmar, 4Ministry of Health, National AIDS Program, Nay Pyi Daw, Myanmar, 5University Of Medicine, Medical Unit 1, Mandalay, Myanmar, 6University of Mandalay, Medical Unit 3, Mandalay, Myanmar
Background: In Myanmar, 12% and 2.5% of the general population are reported to be infected by Hepatitis B and C viruses, respectively. However, there is paucity of data on the prevalence of Hepatitis B and C infections in the context of HIV infection. Methods: In this observational cohort study, records of 10138 HIV infected patients, enrolled in the Integrated HIV Care program between May 2005 and December 2011, were reviewed. HBs antigen and HCV antibody status, risk factors for HIV acquisition and gender were extracted.
Results: The overall co-infection rates are 9% (n=866/10138) and 5% (n=500/10138) for Hepatitis B and C respectively. In general, risk factors for HIV acquisition were heterosexual (n=7913/10138, 78%), MSM (n=156/10138, 1.5%), IDU (n=363/10138, 4%), blood transfusion (n=323/10138, 3%) and mother to child transmission (MTC) (n=759/10138, 7.5%). Risk factors in HBV-HIV co-infected patients were heterosexual (n=715/866, risk ratio (RR) =0.7, 95%CI=0.6-0.9, p=0.0006, 83%), MSM (n=23/866, RR=1.7, 95%CI=1.2-2.5, p=0.0057, 3%), IDU (n=34/866, RR=1.1, 95%CI=0.8-1.5, p=0.5919, 4%), blood transfusion (n=26/866, RR=1, 95%CI=0.6-1.3, p=0.7229, 3%) and MTC (n=19/866, RR=0.3, 95%CI=0.2-0.4, p=< 0.0001, 2%). Risk factors in HCV-HIV co-infected patients were heterosexual (n=271/500, RR=3.6, 95%CI=3-4, p< 0.0001, 54%), MSM (n=3/500, RR=0.4, 95%CI=0.1-1.1, p=0.0809, 0.6%), IDU (n=161/500, RR=13, 95%CI=11-15, p=0.0000, 32.2%), blood transfusion (n=26/500, , RR=1.7, 95%CI=1.1-2.4, p=0.0082, 5%) and MTC (n=7/500, RR=0.2, 95%CI=0.1-0.4, p=0.0000, 1.4%).
Conclusions: In male patients, MSM is responsible a higher prevalence of HBV while for HCV it is IDU risk factors. These data will provide programmatic approach to choose of ART for co-infected patients and to conduct effective strategy for monitoring and follow up.
http://pag.aids2012.org/abstracts.aspx?aid=15498
