RESUMEN
BACKGROUND: Routes of transmission of hepatitis B virus (HBV)/HIV infections are similar and there is a significant rate of co-infection in patients. A study was recently carried out in NHS Fife, Scotland from February 2007 - February 2008 to estimate the prevalence of HBV/HIV co-infection, occult HBV infection and immunisation status against HBV in a cohort of patients with HIV attending the departments of infectious diseases and genitourinary medicine. METHODS: Case notes were reviewed retrospectively (n = 70). Details on patient demographics, risk category, nadir/current CD4 count, HIV viral load and vaccination history were analysed. HBV markers (HBsAg/anti-HBs/anti-HBc/HBV DNA) and alanine transaminase (ALT) levels were tested prospectively if these tests had not been carried out in the previous 12 months. RESULTS AND CONCLUSION: Prevalence of HBV/HIV co-infection was 5.6% of which 2.8% of patients had occult infection and 22.9% had evidence of previous exposure. Although HBV is preventable by vaccination, only 24.2% of patients had been vaccinated against it. Improvements could therefore be made in the field of prevention with vaccination and monitoring the immune response in this cohort. KEYWORDS: Prevalence; Immunization status; Hepatitis B Virus; HIV.
RESUMEN
BACKGROUND: HCV infection is of growing public health importance in Scotland. We aim to establish: patient demographics; risk category; year/country of probable infection; referral/follow-up status; and genotypic variance of HCV in Fife. METHODS: Details of all HCV antibody positive patients, referred and assessed at specialist clinics in NHS Fife, until 1st of May 2007 were obtained retrospectively from the Fife hepatitis C database. RESULTS: In these patients, the ratio of males: female was 2:1, mean age was 36 years, representing a relatively young population, 27.4% of the patients consumed alcohol and 52.4% were smokers. Twelve patients were HIV/HCV co-infected (3.3%). Among the patients, 6.8% had serological evidence of past HBV exposure, 0.5% of patients were HCV/HBV co-infected and 18.8% were vaccinated. Eighty-six percent acquired HCV through injecting drug use and most cases were relatively newly acquired. Referral numbers were on the increase. Thirty-three of patients were under follow-up. Sixty-five percent of patients were genotype 2/3 and 35% were Genotype 1. CONCLUSIONS: Clear patterns were observed in terms of age group, gender, geographical distribution and risk category to facilitate the effective targeting of resources. HCV population in Fife are relatively young, have acquired HCV recently and are mostly of genotype 2/3. This may have a favourable influence on disease progression and cost implications of treating HCV in Fife.