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Title: HEPATITIS C VIRUS AND HUMAN IMMUNODEFICIENCY VIRUS COINFECTION AMONG ATTENDANTS OF VOLUNTARY COUNSELING AND TESTING CENTER, AND HIV FOLLOW UP CLINICS AT TIKUR ANBESSA HOSPITAL, ADDIS ABABA, ETHIOPIA
Authors: GEBRE, KIBRU
Advisors: D. P. Monga (Proffesor),Daniel Fekade (MD, M. Sc.)
Copyright: 2005
Date Added: 23-May-2008
Publisher: Addis Ababa university
Abstract: ABSTRACT HCV was previously known as non-A non-B hepatitis or post transfusion hepatitis. It causes an acute and necroinflamatory disease of liver. Due to shared risk factors of transmission, coinfection with HIV and HCV is common and of increasing clinical relevance. A number of studies have suggested that the presence of HIV infection accelerates the courses of HCV related liver diseases which becomes an important cause of morbidity and mortality in HIV infected persons receiving antiretroviral drugs/HAART. Because of the threat of worsened liver diseases, HCV–infection limits the use of many medications effective in the treatment of HIV/AIDS. Thus, a hospital based cross sectional survey was conducted on serum samples collected for HIV screening and HIV positive samples collected for other clinical investigations from consecutive follow up patients at Tikur Anbessa Specialized Hospital from January to April 2005. The objective of the study was to determine magnitude of HCV/HIV coinfection on these individuals. An interviewer-administered questionnaire was used to collect data on demographic characteristics, and risk factors for HCV infection. During the study period, 783 serum samples, 462 from VCT center attendants and 321 from HIV follow up cases, were collected. Regarding the gender profile of the study subjects, 338 were males and 445 were females. All serum samples collected were tested for anti HCV antibodies using third generation ELISA kit and only HIV positive samples that tested as negative for HCV-antibodies were further investigated for HCV-core antigens. Fifty-nine of 783 sera were positive for HCV-antibodies with over all prevalence rates of 7.5%. The sex specific prevalence rate was 10.5% (34/338) for males and 5.6% (25/445) for females. Relatively, HCV infection was higher in males than in females (P < 0.025, OR =1.88, 95% CI =1.10-3.22). Similarly, the HCV infection was significantly higher in HIV infected individuals when it was compared to HIV-non-infected ones i.e. 11.6% vs. 2.6% (P < 0.000, OR=4.97, 95%CI=2.41 to 10.27). Additionally, 2.9% of HIV positive samples that were negative for HCV antibodies were tested as positive for HCV core antigen. The HCV antibody distribution with respect to occupation was more or less uniform in each professional category. Similarly, risk exposure analysis has shown that no apparent risk factor that caused HCV infection was inferred from this data. Even though, history of catheterization (P < 0.05, OR=2.59, 95% CI=1.03-6.53) and STI (P < 0.01, OR= 2.19, 95% CI=1.23-3.89) has shown statistically significant association with HCV infection, the results were however, confounded by HIV infection. In general, the study has shown a significant proportion of HCV infection among HIV infected individuals. Hence, centers caring for HIV infected patients should develop strategies for ensuring all HIV infected individuals undergoing testing for HCV before initiation of antiretroviral therapy for the better managements of HIV patients. Further community-based studies are required to determine the mode/s of HCV transmission and its interaction with HIV.
Description: A THESIS PRESENTED TO GRADUATE STUDIES PROGRAMME, ADDIS ABABA UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTERS OF SCIENCE IN MEDICAL MICROBIOLOGY
URI: http://hdl.handle.net/123456789/1200
Appears in:Thesis - Medical Microbiology

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