HIV Education Programs Vital for High Risk Patients

A high prevalence of anti-HIV antibodies has been found in patients with hepatitis B virus (HBV) and hepatitis C virus (HCV).

A cross-sectional study published in the International Journal of Environmental Research and Public Health evaluated serum samples donated from 409 HBV and HCV patients (126 HBV+ and 283 HCV+) referred to the Viral Hepatitis Ambulatory Clinic in Rio de Janeiro, Brazil.

The serum samples were tested for the presence of the hepatitis B surface antigen (HBsAg), as well as antibodies to HBV core (anti-HBc) and to HBsAg (anti-HBs), HCV (anti-HCV), and HIV (anti-HIV-1/2) using commercial enzyme immunoassays.

The anti-HIV, HBsAg, anti-HBc, anti-HBs, anti-HBcIgM, anti-HBe, HBeAg, and anti-HCV antibodies were measured. The anti-HCV positive samples were tested for viral RNA and genotype.

The results of the study showed anti-HIV antibody prevalence was 10.31%, confidence interval (CI 95%:5.1-15.5) (12/126) and 4.59% (CI 95%: 2.1-7.0) (13/283) in HBV and HCV patients, respectively.

The mean ± standard deviation (SD) viral load for HCV-RNA was 5.14 ± 1.64 IU/mL and the genotypes were (HCV-1, n = 163; HCV-2, n = 1, HCV-3, n = 14; and HCV-5, n = 2).

Nearly 40% of HCV patients detected anti0HBs reactive sera, while 26% showed anti-HBc reactive sera.

Within the HBV group, factors associated with the presence of anti-HIV antibodies included male gender, sexual orientation, marital status, history of hepatitis treatment, tattooing, oral sex, STDs, and partners with hepatitis or HIV.

“Consumption of alcohol was more frequent among HBV+ individuals, but a history of illicit narcotic substances was more common among HCV+ individuals,” the authors wrote. “In the latter group, 24 (68.6%) rarely used these substances, while 9 (25.7%) individuals reported frequent intake. In the HBV+ group, 8 individuals reported illicit narcotic substances, and 4 (50%) of them had used cocaine.”

Those in the HCV group with factors associated with the presence of anti-HIV antibodies included female gender, marital status, previous history of STDs, anal intercourse, and numerous sexual partners.

“Some risk factors for HIV acquisition were common in both groups of HBV+ and HCV+ individuals, such as a history of intravenous medicine administration, dental procedures, earrings/piercings, and having manicures and pedicures,” the authors wrote. “Recently, sharing nonsterilised manicure/pedicure instruments was described as a possible route of HIV-1 transmission.”

The study had some limitations because of the cross-sectional design of the casual relationship between the time of exposure and subsequent infection couldn’t be established. Additionally biases within the study population may have occurred because of the convenience sampling.

Also, during in-person interviews, individuals may not have answered honestly in regards to their sexual practices and drug abuse, the study noted.

“A previous study showed that females may be 5 times more likely to become infected with HIV, and this prevalence was associated with sexual behavior such as prostitution, injection drug use and poor living conditions,” the authors wrote. “Furthermore, this result reflects the feminization of the HIV epidemic that has been documented in Brazil and other countries, where women represent approximately 50% of people living with HIV and may even reach the majority in certain age groups.”

The authors concluded these results reinforce the need for educational programs that focus on HIV infection, especially in patients with HBV and HCV.