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1 February 2008

Volume 46, Number 3
Clinical Infectious Diseases 2008;46:361–366
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4603-0002$15.00
DOI: 10.1086/525531
MAJOR ARTICLE

Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African HIV Type‐1–Infected Children

François Rouet,1

Marie‐Laure Chaix,4

André Inwoley,1

Marie‐France Anaky,2

Patricia Fassinou,3

Alphonse Kpozehouen,6

Christine Rouzioux,4

Stéphane Blanche,5 and

Philippe Msellati,2 for the

Programme Enfant Yopougon (Agence Nationale de Recherches sur le SIDA et les Hépatites Virales B et C 1244/1278)

1Centre de Diagnostic et de Recherches sur le SIDA, Centre Hospitalier Universitaire (CHU) de Treichville, 2Programme Agence Nationale de Recherches sur le SIDA et les Hépatites Virales B et C 1244/1278 Enfant Yopougon, PAC‐CI, and 3Service de Pédiatrie, CHU de Yopougon, Abidjan, Ivory Coast; 4Laboratoire de Virologie 5Service d’Immunologie et d’Hématologie Pédiatrique, Université Paris 5, CHU Necker‐Enfants Malades, Paris, France; and 6Centre de Calcul, Centre Muraz, Bobo‐Dioulasso, Burkina Faso

Background.The aim of this study, conducted in Ivory Coast, was to evaluate the prevalence and evolution of viral hepatitis in children coinfected with human immunodeficiency virus type 1 (HIV‐1).

Methods.Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were retrospectively and longitudinally assessed among 280 HIV‐1–infected children enrolled in the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122 children. Detection of the hepatitis B s antigen (HBsAg) was performed on specimens collected at inclusion and 6 months later. If results of both tests were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and HBV DNA levels were measured at inclusion and during follow‐up. A fourth‐generation HCV enzyme immunoassay was used for HCV screening at inclusion.

Results.In our pediatric cohort, no patients were infected with HCV, but the prevalence of HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval [CI], 8.6–16.6). Among the HBV–HIV‐1–coinfected children, a high rate of positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of 34]; 95% CI, 65.5%–93.2%) and after a median follow‐up of 18 months (78.3%; 95% CI, 45.5%–92.7%), with no significant difference between children treated with HAART (with or without 3TC) and untreated ones. These children showed high HBV DNA levels (usually >8.0 log10 copies/mL) and viral population consisting of nearly exclusively wild‐type HBeAg‐positive HBV strains, strongly suggesting that most of them were in the initial immunotolerant phase of chronic hepatitis B.

Conclusion.In sub‐Saharan Africa, children with chronic hepatitis B and who are treated with 3TC‐based HAART are at risk of developing 3TC resistance. Further studies are required to guide the management of HBV–HIV‐1–coinfected children.

Received 23 May 2007; accepted 17 September 2007; electronically published 2 January 2008.

  • (See the editorial commentary by Puoti et al. on pages 367–9)

Reprints or correspondence: Dr. François Rouet, Laboratoire de Virologie, Centre Muraz, BP390, BoboDioulasso 01, Burkina Faso ().

Cited by

F. Rouet, M.-L. Chaix, A. Kpozehouen, A. Inwoley, M.-F. Anaky, P. Fassinou, C. Rouzioux, S. Blanche, P. Msellati. (2009) Relationship of CD4+ T-cell counts and plasma HIV-1 RNA levels with serological HBeAg/anti-HBe patterns obtained in West-African HBV-HIV-1-co-infected children. Journal of Tropical Pediatrics
Online publication date: 15-Jun-2009.
CrossRef
Massimo Puoti, Daniela Manno, Paola Nasta, and Giampiero Carosi. (2008) Editorial Commentary: Hepatitis B Virus and HIV Coinfection in Low‐Income Countries: Unmet Needs. Clinical Infectious Diseases 46:3, 367-369
Online publication date: 1-Feb-2008.
Citation-Full Text-PDF Version (197 kB)

  • Presented in part: 16th International AIDS Conference, Toronto, Canada, August 2006 (abstract WEPE0057).

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