Co-Infection Burden of Hepatitis C Virus and Human Immunodeficiency Virus among Injecting Heroin Users at the Kenyan Coast.

Autor: Mwatelah RS; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Institute of Tropical Medicine and Infectious Diseases, Nairobi, Kenya; Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya., Lwembe RM; Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya., Osman S; Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya., Ogutu BR; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Institute of Healthcare Management, Strathmore University, Nairobi, Kenya., Aman R; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Institute of Healthcare Management, Strathmore University, Nairobi, Kenya; African Center for Clinical Trials, Nairobi, Kenya., Kitawi RC; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Institute of Tropical Medicine and Infectious Diseases, Nairobi, Kenya; Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya., Wangai LN; Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya., Oloo FA; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Technical University of Kenya, Nairobi, Kenya., Kokwaro GO; Institute of Healthcare Management, Strathmore University, Nairobi, Kenya., Ochieng W; Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya; Institute of Healthcare Management, Strathmore University, Nairobi, Kenya.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2015 Jul 24; Vol. 10 (7), pp. e0132287. Date of Electronic Publication: 2015 Jul 24 (Print Publication: 2015).
DOI: 10.1371/journal.pone.0132287
Abstrakt: Background: Injection drug use is steadily rising in Kenya. We assessed the prevalence of both human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infections among injecting heroin users (IHUs) at the Kenyan Coast.
Methods: A total of 186 IHUs (mean age, 33 years) from the Omari rehabilitation center program in Malindi were consented and screened for HIV-1 and HCV by serology and PCR and their CD4 T-cells enumerated by FACS.
Results: Prevalence of HIV-1 was 87.5%, that of HCV was 16.4%, co-infection was 17.9% and 18/152 (11.8%) were uninfected. Only 5.26% of the HIV-1 negative injectors were HCV positive. Co-infection was higher among injectors aged 30 to 40 years (20.7%) and among males (22.1%) than comparable groups. About 35% of the injectors were receiving antiretroviral treatment (ART). Co-infection was highest among injectors receiving D4T (75%) compared to those receiving AZT (21.6%) or TDF (10.5%) or those not on ART (10.5%). Mean CD4 T-cells were 404 (95% CI, 365 - 443) cells/mm3 overall, significantly lower for co-infected (mean, 146; 95% CI 114 - 179 cells/mm3) than HIV mono infected (mean, 437, 95% CI 386 - 487 cells/mm3, p<0.001) or uninfected (mean, 618, 95% CI 549 - 687 cells/mm3, p<0.001) injectors and lower for HIV mono-infected than uninfected injectors (p=0.002). By treatment arm, CD4 T-cells were lower for injectors receiving D4T (mean, 78; 95% CI, 0.4 - 156 cells/mm3) than TDF (mean 607, 95% CI, 196 - 1018 cells/mm3, p=0.005) or AZT (mean 474, 95% CI -377 - 571 cells/mm3, p=0.004).
Conclusion: Mono and dual infections with HIV-1 and HCV is high among IHUs in Malindi, but ART coverage is low. The co-infected IHUs have elevated risk of immunodeficiency due to significantly depressed CD4 T-cell numbers. Coinfection screening, treatment-as-prevention for both HIV and HCV and harm reduction should be scaled up to alleviate infection burden.
Databáze: MEDLINE
Externí odkaz: