Burden and Determinants of Hepatitis B Virus Co-infection in a Cohort of HIV Positive Pregnant Women in Jos, Nigeria

Abstract

Background: Human immunodeficiency virus (HIV) infected pregnant women represent a unique population and co-infection with hepatitis B Virus (HBV) is considered a major health problem worldwide. Aims: This study was undertaken to determine the prevalence and determinants of hepatitis B infection among a group of HIV positive pregnant women in Jos, Nigeria. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, between December 2011 and May, 2012. Methodology: A cross sectional study among consecutive HIV positive pregnant women at the antenatal clinic of the Jos University Teaching Hospital (JUTH), Jos, over a 5-month period. Hepatitis B surface antigen (HBsAg) detection was done using in vitro diagnostic kit. Reactive samples were confirmed by Enzyme Linked Immunosorbent assay (ELISA) kit. Information on socio-demographic characteristics and other risk factors associated with the prevalence of HBsAg among HIV positive pregnant women were obtained from participants using pre-tested questionnaires. Data was analyzed using Epi info statistical software version 3.5.1 (CDC, Atlanta Georgia, USA). Results: Among the 124 HIV positive pregnant women studied, 15 (12.1%) were positive for HBsAg. HIV/ HBV co-infection rates were highest among the age group 31–40 years, unmarried, uneducated, multigravidae, those at third trimester of pregnancies, with multiple sex partners, and those with history of STI, low CD4 count and high viral load. Statistical analysis showed significant association between multiple sex partners (P = 0.017), history of jaundice (P = 0.001), low CD4 count (P = 0.006), high HIV viral load (P = 0.001) and hepatitis B infection among the study population. Conclusion: Prevalence of hepatitis B virus infection among HIV positive pregnant women among this group of Nigerian women is high. Intensive free hepatitis B screening among HIV positive pregnant women attending ante-natal clinics as a policy especially those with history of multiple sexual partners, jaundice, low CD4 count and high viral load is recommended so as to immunize those without HBV infection.