Coexposure to HIV and hepatitis viruses. Prevalence in Africa and influence of HIV infection on the markers of active hepatitis viruses replication.

Researchers collected sera from 1773 individuals in 2 African countries (Ivory Coast and Burundi). The study population in Africa included healthy female prostitutes prisoners adult diabetics patients with tuberculosis; psychiatric patients African men on the staff of a tourist hotel pregnant women personnel from the Abidjan hospitals staff members of the Abidjan prison and their relatives and patients from a sexually transmitted disease clinic. The objectives were to determine the prevalence of co-exposure to persistent hepatitis B virus (HBV) infection and human immunodeficiency virus (HIV) infections and to analyze the influence of HIV infection on active hepatitis replication markers. Laboratory personnel tested the sera for HIV antibody using the ELISA test. If sera proved positive for HIV using ELISA they then determined actual positivity with the Western blot. In the Ivory Coast sera researchers used Western blots with HIV-1 or HIV-2 as antigenic probes. 54 (3.7%) of the 1470 participants from the Ivory Coast tested positive for both HB Ag and HIV-1 and/or HIV-2 antibody. 11 (3.6%) of the 303 sera from Burundi were positive for both HB Ag and HIV-1 antibody. In Burundi of the HB Ag carriers positive for antibody to HIV 2 of 11 (18.2%) were positive for the active hepatitis B replication marker (HBe Ag). On the other hand 11 of 26 (42.3%) in the Ivory Coast were positive for both. In Burundi HB Ag individuals negative for the HIV antibody and positive for HBe Ag numbered 4 of 20 (20%) no significant difference. In the Ivory Coast however 4 of 32 (12.5%) HB Ag carriers negative for antibodies to the HIVs were HBe Ag positive (p<.01). The discrepancy between HBe Ag prevalences in Burundi and the Ivory Coast indicates that further studies using an additional marker of active HBV replication such as serum HBV DNA are necessary. Additionally longitudinal studies are warranted in Africa to determine how much HIV superinfection in chronic HBs Ag carriers extends the period of active viral replication or reactivates HBV replication.