Epidemiological and Evolutionary Profile of HIV-HBV Co-Infected Patients Followed at Ambulatory Treatment Center in Fann Hospital Dakar-Senegal

CONTEXT: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) infections are major global public health problems because of their frequency, complications and probable socio-demographic consequences.

Viral hepatitis B is identified as more frequent cause of morbidity and mortality in people living with HIV.

The objective of this study was to describe the epidemiological and evolutionary profile of HIV-HBV co-infected patients, treated at CTA/CHNU Fann, in Dakar, Senegal.

METHODOLOGY: This is a retrospective, descriptive and analytical study of patients aged at least 18 years, co-infected with HIV-HBV and followed-up at CTA under ART for at least one year from January 2010 to December 2014.

RESULTS: The study included 457 patients. 58 of these patients were diagnosed positive, (12.7%) of HIV-HBV prevalence. The average age of patients was 39.62 ± 10.12 years with extremes ranging from 21 to 61 years. The sex ratio was 1.23. (96%) of patients were infected with HIV-1 and those at WHO stages III and IV were (67%). The average CD4 count at baseline was 235 cells/mm3 [3-936]. Plasma HIV viral load average at baseline was 4.1 log copies/ml [3.89-5.12] copies/ml. The average body mass index (BMI) was 21.42 ± 3.82 Kg/m². Fever and degraded general status were respectively (65%) and (60%) followed by hepatomegaly and jaundice. The lethality was 3.45%. Of the 58 patients co-infected with HIV-HBV, 51/58 (87.93%) were under a therapeutic regimen containing Tenofovir/lamivudine or Tenofovir/Emtricitabine and 7 patients under a regimen containing lamivudine. At 48 weeks of treatment a good evolution of the biological parameters was noted: (90%) had a controlled viral load, (91%) a normal transaminase, (79%) a normal serum creatinine. Only 29% had a CD4 cell count <350 cells/mm3.

CONCLUSION: The Seroprevalence of viral hepatitis B remains relatively high (12.70%) among PLHIV in Dakar. While active search for hepatitis B has been effective in all PLHIV since 2010, overall management remains a challenge as hepatitis B markers and viral DNA assay are not at the reach of patients.