HIV care intervention - limited resources, limitless opportunities

This case is intended to inspire HIV caregivers and patients that, even in the most trying circumstances of limited resources, AIDS can be managed effectively with highly active antiretroviral therapy (HAART) and perseverance. Southern African Journal of HIV Medicine Vol. 7 (1) 2006: pp. 44-4

The Prevalence of Hepatitis B Co infection in a South African (SA) Urban government HIV Clinic

Objective: There are 350 million hepatitis B carriers world-wide. Mono-infection with Hepatitis B in urban South Africa has been estimated at approximately 1%. The exact prevalence rate of hepatitis B in the HIV population has not been well established. Hepatitis B screening is not standard of care in the HIV government clinics. Coinfection with hepatitis B and HIV can influence ARV treatment and prognosis of both of these diseases. Evaluating the Hepatitis B/HIV coinfection prevalence was the goal of this study. Design: This is the first prospective observational report of the prevalence of hepatitis B/HIV co infection in South Africa. Patients were recruited from a HIV clinic in regional hospital in Johannesburg. Previous hepatitis B serology could not have been previously done. Standard hepatitis B serology was performed. Results: 502 participants were screened. The cohort\'s average age was 37 +/- 9 years and an average CD4 count of 128 cells/mm3 Twenty- four (4.8%) were hepatitis B surface antigen positive. 47% of the participants showed some evidence of hepatitis B exposure. The risk of hepatitis B coinfecition was not significantly different by sex, race, CD4 count or age. Liver function tests were not a good predictor of hepatitis B infection. Conclusion: The coinfection rate of hepatitis B/HIV as defined by hepatitis B surface antigen positivity is 5X the prevalence of non HIV infected individuals in urban SA. With a 5% hepatitis B/HIV coinfection rate, consideration to increase accessibility of Truvada for first line treatment for this population is imperative. South African Medical Journal Vol. 98 (7) 2008: pp. 541-54