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Compliance with screening for hepatitis B virus and hepatitis C virus infection prior to initiation of antiretroviral therapy among HIV-1 infected patients in a resource-limited setting

Abstract number: O518

Sungkanuparph S., Wongprasit P., Manosuthi W., Atamasirikul K.

Objective: To assess the compliance of laboratory screening for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection prior to initiation of antiretroviral therapy (ART) among HIV-1 infected patients in a resource-limited setting.

Methods: This observational study was conducted by including HIV-1 infected patients from 3 cohorts of ART initiation in a tertiary-care HIV clinic in Bangkok, Thailand, between January 2004 and October 2007. The medical records were reviewed; demographic data, baseline CD4 and HIV-1 RNA, ART regimen, and date and test results of HBV surface antigen for HBV infection and Anti-HCV antibody for HCV infection were retrieved from the records.

Results: A total of 638 patients were included; mean (SD) age was of 38.4 (8.4) years and 53% were male. Median (IQR) baseline CD4 cell count and HIV-1 RNA were 246 (77–459) cells/mm3 and 143,000 (45,825–445,000) copies/mL, respectively. Prior to initiation of ART, HBV infection and HCV infection were screened in 371 (58%) patients and 273 (43%) patients, respectively. All patients who were screened for HCV infection were also screened for HBV infection. There were no differences of demographics or baseline characteristics between patients who were screened for HBV or HCV infection and those who had never been screened for HBV or HCV infection (p > 0.05). Among 371 patients who were screened for HBV infection, 36 (9.7%) had HBV infection. HCV infection was found in 24 from 273 (8.8%) patients who were screened for HCV infection. Infection of both HBV and HCV was observed only one (0.4%) patient. NNRTI-based ART regimens were initiated in 573 (90%) patients; the rest received PI-based regimens. Of 638 patients, 625 (98%) received 3TC in the regimens. There was no difference of ART regimen or 3TC use between patients who had and did not have HBV infection (p > 0.05). After availability of tenofovir in Thailand in December 2006, patients who were found to have HBV infection from screening received tenofovir with lamivudine in ART regimen.

Conclusion: In resource-limited setting, only approximately half of HIV-1 infected patients get screening for HBV infection and HCV infection prior to initiation of ART. Lack of screening is observed in generalised population of HIV-1 infected patients and is not associated with any factor. Since the prevalence of HBV infection is relatively high, screening of HBV infection prior to initiation of ART should not be omitted in resource-limited settings.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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