Prevalence of hepatitis B and C viruses among human immunodeficiency virus infected children in Northern Nigeria. Pennap GRI, Yahuza, AJ and Abdulkarim, ML Microbiology Unit Nasarawa State University Keffi, Nige ria

Introduction HBV, HCV and HIV are considered endemic in Africa. Despite their biological differences they share common routes of transmission and similar risk factors. Liver disease due to chronic hepatitis (HBV and HCV infection) has become a public health problem especially in those infected with HIV. HIV is also known to increase the pathological effect of hepatitis viruses and potentiates reactivation of latent infection as a result of reduced immunity. The preponderance of coinfection with hepatitis B and C viruses in Sub Saharan Africa is threatening the gains of ART. Careful studies of these interactions are important for informed approach to providing clinical care, public health initiatives and guiding future research.

Aim Due to the importance of hepatitis chronicity and its effect in HIV infection, this study was mooted to: Determine the prevalence of HBV and HCV in HIV infected children Determine probable risk factors of infection,

Materials and Methods Cross-sectional study Study population Ethical clearance Health talk and informed consent Sociodemographic information – questionnaire Sample collection Venipuncture – Serum ◦ storage (-4 0 C)  thawing (room temperature)  Screening procedure--- HBsAg and anti-HCV Rapid Test strips ( according to the Manufacturer’s instructions).

Results and Discussion 200 participants General prevalence – 14.0% HBV prevalence – 3.0% HCV prevalence– 11.0% Vertical transmission???? Relatively low HBV NPI vaccine uptake Occult HBV(HBsAg –ve but HBV DNA +ve)  HCV relatively high  Ability to induce seroconversion of the other – chronology of infection determines dominant virus( Dawurung et al. 2012)

Results and Discussion contd. Examples of similar studies in Nigeria: HBV – 7.7%, 6.6% HCV - 5.2% HBV + HBV – 0%

Figure 1:Seroprevalence of Hepatitis B surface and anti HCV among HIV infected children in relation to sex

Figure 2: Seroprevalence of HBV and HCV in relation to Age

Figure 3: Seroprevalence of Hepatitis B and C virus among the infected children in relation to history of blood transfusion

Figure 4: Seroprevalence of Hepatitis B and C viruses among the infected children in relation to scarification

Figure 5: Seroprevalence of HBV among HIV infected children in relation to history of HBV vaccine

Conclusion Study has shown the burden of coinfection with HBV and HCV as 3.0% and 11.0% respectively. No identifiable risk factor for HBV (statistically). Not identifying risk factors has drawn attention to the probability of obscured risk factors or locality specific risk factors.

Recommendation Routine Screening for HBV and HCV in HIV infected children Establish treatment protocol for coinfected patients (to reduce hepatotoxicity) Strengthen Hepatitis B immunization program

Future Work Larger studies Longitudinal studies Inclusion of more probable risk factors ( viz-a-viz sociocultural practices of the study area) Molecular epidemiology( to capture Occult HBV)

Acknowledgement We wish to acknowledge with thanks the following: Parents/guardians of participants Management of Dalhatu Araf Specialist Hospital, Lafia Dr DS Nyabam-- Statistician

References Anigilage et al.(2013). Prevalence, clinical and immunovirological profile of HIV, HBV among children in Benue State. ISRN Pediatric 10:1155/2013/ Ikpeme et al.(2013).Seroprevalence of HBV in HIV coinfected children and outcomes following HAART in Uyo, Nigeria. African Hlth Science. 13(4): Nwolisa et al.(2013). Prevalence of Hepatitis B coinfection among HIV infected children attending a care and treatment center Owerri, Nigeria. Pan Afr Med J. 14:89 Sadoh et al.(2011). HIV coinfection with Hepatitis B and C viruses among Nigerian children in a ART treatmen program. SAJCH. 5(1)

It is pertinent to investigate hepatitis chronicity especially in regions endemic for HIV, HBV and HCV. T H A N K Y O U