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Introduction:
Risk factors that are associated with HIV infection are also
associated with HBV and HCV infections in sub-Saharan
Africa.(1) These include sexual behaviour, presence of other
sexually transmitted diseases, female and male circumcision
status, percutaneous and perinatal exposures, and poverty.
Hepatitis B and C virus co-infections have been reported to
be common among HIV infected persons in various
countries. In Slovenia, the overall prevalence of HCV
infection in HIV-positive persons was reported to be 16.9%.
In recent studies carried out in Northern Nigeria, the
prevalence of HIV and HCV co-infection was reported as
6.2% in Kano, Abuja 12.5% (2) and Keffi, a neighbouring city
to Abuja, 11.1%.(3) On the other hand, a higher prevalence
of 20.6% was reported among persons with HIV/HBV co-
infection in Keffi, North-Central Nigeria.(3)
Pregnant women infected with hepatitis are very likely to
transmit the infection on to her newborn infant due to
exposure to maternal blood, fluids and faeces. About 10-
20% of infants born to hepatitis B infected mothers have
been reported to be at risk of developing hepatitis.(4)
The HIV-infected pregnant cohort represents a unique
population. In the US, 6.3% was reported as overall
prevalence of HIV and hepatitis B or C virus co-infection
among pregnant women with 1.5% and 4.9% specifically co-
infected with hepatitis B and C respectively.(5) In Rwanda
and Uganda, about 6% of HIV-positive pregnant women
were co-infected with either HBV or HCV.(6) In this study,
we evaluate the prevalence of human immunodeficiency
virus (HIV), hepatitis B virus and hepatitis C virus among
pregnant women attending antenatal clinics in Federal
Capital Territory, Abuja, Nigeria.
Material and Methods:
Study population
This study was conducted at the Wuse General Hospital,
Abuja among pregnant women aged between 15 and 50
years during the period of June, 2005 to March 2006
A total of 500 ante-natal attendees were recruited for the
study from three district hospitals in Abuja, comprising of
Wuse (250), Nyanya (200) and Gwarinpa (50). These
hospitals are secondary health facilities that serve the
inhabitants of the Federal Capital Territory, Abuja - Nigeria.
Sample collection
Five (5) ml of blood each was collected from subjects into
plain sterile bottle following informed consent. Blood
samples were centrifuged and sera separated and stored at
-20 C until used. Samples were analyzed in batches for
antibodies to HIV-1 and 2 by ELISA (Abbot, USA) and
confirmed by Western Blot (Cambridge Biotech, UK),
antibodies to Hepatitis C by ELISA (Abbot, USA;) and HBsAg
(monoclonal, ELISA; Abbot USA), in accordance with the
respective manufacturer’s instructions.
Serum samples that were repeatedly reactive for anti- HCV
and HBsAg by ELISA were indicated as positive in the study.
Statistical Analysis
Relative risk at 95% Confidence Interval and test of
significance at P = 0.05 using Fisher Exact 2-tailed values
were measured using Epi Info Version 6.04 statistical
package
Ethical Issues
Informed consent and ethical approval were obtained from
the subjects and authorities of the affected district hospitals
respectively.
Results:
Out of a total of five hundred (500) samples analyzed for
HIV antibodies, HBsAg and anti-HCV antibodies, 42 (8.4%)
were positive for HIV, HBsAg, 19 (3.8%) and anti-HCV, 8
(1.6%). A break down by district hospital shows that of the
250 samples from Wuse District Hospital, 22 (8.8%), 8 (3.2%)
and 4 (1.6%) were positive for HIV-1 antibodies, HBsAg and
anti-HCV antibodies respectively. Of the 200 samples collec-
ted from Nyanya District Hospital, 17 (8.5%), 8 (4%) and 3
(1.5%) were positive for HIV-1, HBsAg and anti-HCV respect-
ively; while out of the fifty (50) samples from Gwarinpa Dis-
trict Hospital, 3 (6.0%) had HIV-1 antibodies, 3 (6.0%) and 1
(2%) were HBsAg and anti-HCV positive respectively (Table
1).
Table 2 shows the association and Relative Risk (95%CI) of
HIV/HBV and HIV/HCV co-infections in pregnant women at-
tending the three District Hospitals in the FCT, Abuja. Three
(7.1%) HIV positive pregnant women were co-infected with
HBV, having relative risk of 1.95 (CI 95% 0.66-5.74) and Fish-
er Exact 2-tailed P=0.208 whereas only one (2.4%) pregnant
woman had both HIV and HCV co-infection (RR, 1.95 [CI
95% 0.66 - 5.74]) and Fisher Exact 2-tailed P=0.507.
Table 3 indicates age distribution of ante-natal attendees in
relation to HIV, HBsAg and anti-HCV positivity. The highest
prevalence of HIV (13.4%), HBV (5.1%) and HCV (1.9%) infec-
tions occurred in the age bracket of 21-25 years while
among the age group 15-20 years only 1.8% prevalence each
was recorded for HIV, HBV and HCV respectively. None of
the pregnant women in the age bracket 36 years and above
that had HCV infection. Generally, the overall prevalence of
HBV and HCV prevalence among pregnant women in the
FCT, Abuja were 3.8% and 1.6% respectively.
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