Limits...
Viral hepatitis and rapid diagnostic test based screening for HBsAg in HIV-infected patients in rural Tanzania.

Franzeck FC, Ngwale R, Msongole B, Hamisi M, Abdul O, Henning L, Letang E, Mwaigomole G, Battegay M, Hatz C, Tanner M - PLoS ONE (2013)

Bottom Line: Antibodies to HCV (anti-HCV) were found in 10/272 (3.7%, 95% CI 2.0-6.4%) of patients.This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting.The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.

View Article: PubMed Central - PubMed

Affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. fcfranzeck@gmail.com

ABSTRACT

Background: Co-infection with hepatitis B virus (HBV) is highly prevalent in people living with HIV in Sub-Saharan Africa. Screening for HBV surface antigen (HBsAg) before initiation of combination antiretroviral therapy (cART) is recommended. However, it is not part of diagnostic routines in HIV programs in many resource-limited countries although patients could benefit from optimized antiretroviral therapy covering both infections. Screening could be facilitated by rapid diagnostic tests for HBsAg. Operating experience with these point of care devices in HIV-positive patients in Sub-Saharan Africa is largely lacking. We determined the prevalence of HBV and Hepatitis C virus (HCV) infection as well as the diagnostic accuracy of the rapid test device Determine HBsAg in an HIV cohort in rural Tanzania.

Methods: Prospectively collected blood samples from adult, HIV-1 positive and antiretroviral treatment-naïve patients in the Kilombero and Ulanga antiretroviral cohort (KIULARCO) in rural Tanzania were analyzed at the point of care with Determine HBsAg, a reference HBsAg EIA and an anti-HCV EIA.

Results: Samples of 272 patients were included. Median age was 38 years (interquartile range [IQR] 32-47), 169/272 (63%) subjects were females and median CD4+ count was 250 cells/µL (IQR 97-439). HBsAg was detected in 25/272 (9.2%, 95% confidence interval [CI] 6.2-13.0%) subjects. Of these, 7/25 (28%) were positive for HBeAg. Sensitivity of Determine HBsAg was rated at 96% (95% CI 82.8-99.6%) and specificity at 100% (95% CI, 98.9-100%). Antibodies to HCV (anti-HCV) were found in 10/272 (3.7%, 95% CI 2.0-6.4%) of patients.

Conclusion: This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting. The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.

Show MeSH

Related in: MedlinePlus

Enrollment and outcome.Study profile of the evaluation of Determine HBsAg against a reference HBsAg enzyme immuno assay.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3585939&req=5

pone-0058468-g001: Enrollment and outcome.Study profile of the evaluation of Determine HBsAg against a reference HBsAg enzyme immuno assay.

Mentions: During 8 months of enrollment, 279 adult eligible patients were offered to participate in the study as shown in the study profile in Figure 1. Characteristics of 272/279 (97.5%) consenting patients are presented in Table 1. The median age at enrollment was 38 years (interquartile range, IQR 32–47) and 169/272 (63%) of subjects were females. Patients with detectable HBsAg were significantly more likely to be male and had an elevated distribution of ALT levels (median 42 U/l, IQR 30–75 vs. 32 U/l, IQR 23–45; p = 0.006) than patients without HBsAg.


Viral hepatitis and rapid diagnostic test based screening for HBsAg in HIV-infected patients in rural Tanzania.

Franzeck FC, Ngwale R, Msongole B, Hamisi M, Abdul O, Henning L, Letang E, Mwaigomole G, Battegay M, Hatz C, Tanner M - PLoS ONE (2013)

Enrollment and outcome.Study profile of the evaluation of Determine HBsAg against a reference HBsAg enzyme immuno assay.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585939&req=5

pone-0058468-g001: Enrollment and outcome.Study profile of the evaluation of Determine HBsAg against a reference HBsAg enzyme immuno assay.
Mentions: During 8 months of enrollment, 279 adult eligible patients were offered to participate in the study as shown in the study profile in Figure 1. Characteristics of 272/279 (97.5%) consenting patients are presented in Table 1. The median age at enrollment was 38 years (interquartile range, IQR 32–47) and 169/272 (63%) of subjects were females. Patients with detectable HBsAg were significantly more likely to be male and had an elevated distribution of ALT levels (median 42 U/l, IQR 30–75 vs. 32 U/l, IQR 23–45; p = 0.006) than patients without HBsAg.

Bottom Line: Antibodies to HCV (anti-HCV) were found in 10/272 (3.7%, 95% CI 2.0-6.4%) of patients.This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting.The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.

View Article: PubMed Central - PubMed

Affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. fcfranzeck@gmail.com

ABSTRACT

Background: Co-infection with hepatitis B virus (HBV) is highly prevalent in people living with HIV in Sub-Saharan Africa. Screening for HBV surface antigen (HBsAg) before initiation of combination antiretroviral therapy (cART) is recommended. However, it is not part of diagnostic routines in HIV programs in many resource-limited countries although patients could benefit from optimized antiretroviral therapy covering both infections. Screening could be facilitated by rapid diagnostic tests for HBsAg. Operating experience with these point of care devices in HIV-positive patients in Sub-Saharan Africa is largely lacking. We determined the prevalence of HBV and Hepatitis C virus (HCV) infection as well as the diagnostic accuracy of the rapid test device Determine HBsAg in an HIV cohort in rural Tanzania.

Methods: Prospectively collected blood samples from adult, HIV-1 positive and antiretroviral treatment-naïve patients in the Kilombero and Ulanga antiretroviral cohort (KIULARCO) in rural Tanzania were analyzed at the point of care with Determine HBsAg, a reference HBsAg EIA and an anti-HCV EIA.

Results: Samples of 272 patients were included. Median age was 38 years (interquartile range [IQR] 32-47), 169/272 (63%) subjects were females and median CD4+ count was 250 cells/µL (IQR 97-439). HBsAg was detected in 25/272 (9.2%, 95% confidence interval [CI] 6.2-13.0%) subjects. Of these, 7/25 (28%) were positive for HBeAg. Sensitivity of Determine HBsAg was rated at 96% (95% CI 82.8-99.6%) and specificity at 100% (95% CI, 98.9-100%). Antibodies to HCV (anti-HCV) were found in 10/272 (3.7%, 95% CI 2.0-6.4%) of patients.

Conclusion: This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting. The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.

Show MeSH
Related in: MedlinePlus