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Prevalence of Hepatitis B Virus and Hepatitis C Virus Co-infection with Human Immunodeficiency Virus in Thai Patients: A Tertiary-care-based Study


Somnuek Sungkanuparph MD*,
Asda Vibhagool MD*, Weerawat Manosuthi MD*,
Sasisopin Kiertiburanakul MD*, Kalayanee Atamasirikul MSc**,
Anuchart Aumkhyan MT**, Ammarin Thakkinstian M Med Stats***

* Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
*** Clinical Epidemiology Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University


Background : Hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV share the route of transmission. HBV or HCV co-infection with HIV has been associated with a reduced survival rate, an increased risk of progression to severe liver disease, and an increased risk of hepatotoxicity associated with active antiretroviral therapy. Information regarding prevalence of HBV and HCV co-infection with HIV in Thailand is limited.
Patients and Method : A cross-sectional study of prevalence and risk factors of HBV and HCV co-infection in HIV-infected patients was conducted. All HIV-infected patients who were cared for in March 2003 at Ramathibodi Hospital were included.
Results : There were 529 HIV-infected patients with a mean age of 36.7 years and 56.5% males. Of these, 58.8% lived in Bangkok, whereas, the others were from provincial areas. Heterosexual contact were the acquisition of HIV infection in 98.1% of all patients. The prevalence of HBV infection was 8.7%, and HCV infection was 7.8%. There was no difference between the prevalence of these infections in Bangkok and provincial areas (p = 0.115). History of intravenous drug use was associated with both HBV and HCV co-infection (p < 0.001). HCV co-infection group was also associated with male gender (p = 0.002) and elevated serum alanine transaminase (ALT) level (p = 0.0003).
Conclusions : The prevalence of HBV and HCV co-infection with HIV in Thai patients is significant. In the authorís resources-limited setting, history of intravenous drug use is a major indicator to screen for both HBV and HCV co-infection. Male gender and elevated serum ALT level are also suggestive of HCV co-infection.

Keyword : HBV, HCV, HIV, Co-infections

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