Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African HIV Type�1–Infected Ch

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Clinical Infectious Diseases 2008;46:361–366

1058-4838/2008/4603-0002$15.00

DOI: 10.1086/525531

MAJOR ARTICLE

Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African

HIV Typeâ€1–Infected Children

François Rouet,1

Marieâ€Laure Chaix,4

André Inwoley,1

Marieâ€France Anaky,2

Fassinou,3

Alphonse Kpozehouen,6

Rouzioux,4

Stéphane Blanche,5 and

Philippe Msellati,2 for the

Programme Enfant Yopougon (Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278)

1Centre de Diagnostic et de Recherches sur le SIDA, Centre Hospitalier

Universitaire (CHU) de Treichville, 2Programme Agence Nationale de Recherches

sur le SIDA et les Hépatites Virales B et C 1244/1278 Enfant Yopougon,

PACâ€CI, and 3Service de Pédiatrie, CHU de Yopougon, Abidjan, Ivory Coast;

4Laboratoire de Virologie 5Service d’Immunologie et d’Hématologie

Pédiatrique, Université Paris 5, CHU Neckerâ€Enfants Malades, Paris, France;

and 6Centre de Calcul, Centre Muraz, Boboâ€Dioulasso, Burkina Faso

Received 23 May 2007; accepted 17 September 2007; electronically published 2

January 2008.

Presented in part: 16th International AIDS Conference, Toronto, Canada, August

2006 (abstract WEPE0057).

(See the editorial commentary by Puoti et al. on pages 367–9)

Reprints or correspondence: Dr. François Rouet, Laboratoire de Virologie,

Centre Muraz, BP390, BoboDioulasso 01, Burkina Faso (franrouet@...).

Background. The aim of this study, conducted in Ivory Coast, was to evaluate

the prevalence and evolution of viral hepatitis in children coinfected with

human immunodeficiency virus type 1 (HIVâ€1).

Methods. Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were

retrospectively and longitudinally assessed among 280 HIVâ€1–infected

children enrolled in the Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received

highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122

children. Detection of the hepatitis B s antigen (HBsAg) was performed on

specimens collected at inclusion and 6 months later. If results of both tests

were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and

HBV DNA levels were measured at inclusion and during followâ€up. A

fourthâ€generation HCV enzyme immunoassay was used for HCV screening at

inclusion.

Results. In our pediatric cohort, no patients were infected with HCV, but the

prevalence of HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval

[CI], 8.6–16.6). Among the HBV–HIVâ€1–coinfected children, a high rate of

positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of

34]; 95% CI, 65.5%–93.2%) and after a median followâ€up of 18 months (78.3%;

95% CI, 45.5%–92.7%), with no significant difference between children treated

with HAART (with or without 3TC) and untreated ones. These children showed high

HBV DNA levels (usually>8.0 log10 copies/mL) and viral population consisting of

nearly exclusively wildâ€type HBeAgâ€positive HBV strains, strongly suggesting

that most of them were in the initial immunotolerant phase of chronic hepatitis

B.

Conclusion. In subâ€Saharan Africa, children with chronic hepatitis B and who

are treated with 3TCâ€based HAART are at risk of developing 3TC resistance.

Further studies are required to guide the management of

HBV–HIVâ€1–coinfected children.

http://www.journals.uchicago.edu/doi/abs/10.1086/525531

_________________________________________________________________

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[Guest guest]

Clinical Infectious Diseases 2008;46:361–366

1058-4838/2008/4603-0002$15.00

DOI: 10.1086/525531

MAJOR ARTICLE

Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African

HIV Typeâ€1–Infected Children

François Rouet,1

Marieâ€Laure Chaix,4

André Inwoley,1

Marieâ€France Anaky,2

Fassinou,3

Alphonse Kpozehouen,6

Rouzioux,4

Stéphane Blanche,5 and

Philippe Msellati,2 for the

Programme Enfant Yopougon (Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278)

1Centre de Diagnostic et de Recherches sur le SIDA, Centre Hospitalier

Universitaire (CHU) de Treichville, 2Programme Agence Nationale de Recherches

sur le SIDA et les Hépatites Virales B et C 1244/1278 Enfant Yopougon,

PACâ€CI, and 3Service de Pédiatrie, CHU de Yopougon, Abidjan, Ivory Coast;

4Laboratoire de Virologie 5Service d’Immunologie et d’Hématologie

Pédiatrique, Université Paris 5, CHU Neckerâ€Enfants Malades, Paris, France;

and 6Centre de Calcul, Centre Muraz, Boboâ€Dioulasso, Burkina Faso

Received 23 May 2007; accepted 17 September 2007; electronically published 2

January 2008.

Presented in part: 16th International AIDS Conference, Toronto, Canada, August

2006 (abstract WEPE0057).

(See the editorial commentary by Puoti et al. on pages 367–9)

Reprints or correspondence: Dr. François Rouet, Laboratoire de Virologie,

Centre Muraz, BP390, BoboDioulasso 01, Burkina Faso (franrouet@...).

Background. The aim of this study, conducted in Ivory Coast, was to evaluate

the prevalence and evolution of viral hepatitis in children coinfected with

human immunodeficiency virus type 1 (HIVâ€1).

Methods. Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were

retrospectively and longitudinally assessed among 280 HIVâ€1–infected

children enrolled in the Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received

highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122

children. Detection of the hepatitis B s antigen (HBsAg) was performed on

specimens collected at inclusion and 6 months later. If results of both tests

were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and

HBV DNA levels were measured at inclusion and during followâ€up. A

fourthâ€generation HCV enzyme immunoassay was used for HCV screening at

inclusion.

Results. In our pediatric cohort, no patients were infected with HCV, but the

prevalence of HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval

[CI], 8.6–16.6). Among the HBV–HIVâ€1–coinfected children, a high rate of

positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of

34]; 95% CI, 65.5%–93.2%) and after a median followâ€up of 18 months (78.3%;

95% CI, 45.5%–92.7%), with no significant difference between children treated

with HAART (with or without 3TC) and untreated ones. These children showed high

HBV DNA levels (usually>8.0 log10 copies/mL) and viral population consisting of

nearly exclusively wildâ€type HBeAgâ€positive HBV strains, strongly suggesting

that most of them were in the initial immunotolerant phase of chronic hepatitis

B.

Conclusion. In subâ€Saharan Africa, children with chronic hepatitis B and who

are treated with 3TCâ€based HAART are at risk of developing 3TC resistance.

Further studies are required to guide the management of

HBV–HIVâ€1–coinfected children.

http://www.journals.uchicago.edu/doi/abs/10.1086/525531

_________________________________________________________________

Make distant family not so distant with Windows Vista® + Windows Live™.

http://www.microsoft.com/windows/digitallife/keepintouch.mspx?ocid=TXT_TAGLM_CPC\

_VideoChat_distantfamily_012008

[Guest guest]

Clinical Infectious Diseases 2008;46:361–366

1058-4838/2008/4603-0002$15.00

DOI: 10.1086/525531

MAJOR ARTICLE

Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African

HIV Typeâ€1–Infected Children

François Rouet,1

Marieâ€Laure Chaix,4

André Inwoley,1

Marieâ€France Anaky,2

Fassinou,3

Alphonse Kpozehouen,6

Rouzioux,4

Stéphane Blanche,5 and

Philippe Msellati,2 for the

Programme Enfant Yopougon (Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278)

1Centre de Diagnostic et de Recherches sur le SIDA, Centre Hospitalier

Universitaire (CHU) de Treichville, 2Programme Agence Nationale de Recherches

sur le SIDA et les Hépatites Virales B et C 1244/1278 Enfant Yopougon,

PACâ€CI, and 3Service de Pédiatrie, CHU de Yopougon, Abidjan, Ivory Coast;

4Laboratoire de Virologie 5Service d’Immunologie et d’Hématologie

Pédiatrique, Université Paris 5, CHU Neckerâ€Enfants Malades, Paris, France;

and 6Centre de Calcul, Centre Muraz, Boboâ€Dioulasso, Burkina Faso

Received 23 May 2007; accepted 17 September 2007; electronically published 2

January 2008.

Presented in part: 16th International AIDS Conference, Toronto, Canada, August

2006 (abstract WEPE0057).

(See the editorial commentary by Puoti et al. on pages 367–9)

Reprints or correspondence: Dr. François Rouet, Laboratoire de Virologie,

Centre Muraz, BP390, BoboDioulasso 01, Burkina Faso (franrouet@...).

Background. The aim of this study, conducted in Ivory Coast, was to evaluate

the prevalence and evolution of viral hepatitis in children coinfected with

human immunodeficiency virus type 1 (HIVâ€1).

Methods. Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were

retrospectively and longitudinally assessed among 280 HIVâ€1–infected

children enrolled in the Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received

highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122

children. Detection of the hepatitis B s antigen (HBsAg) was performed on

specimens collected at inclusion and 6 months later. If results of both tests

were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and

HBV DNA levels were measured at inclusion and during followâ€up. A

fourthâ€generation HCV enzyme immunoassay was used for HCV screening at

inclusion.

Results. In our pediatric cohort, no patients were infected with HCV, but the

prevalence of HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval

[CI], 8.6–16.6). Among the HBV–HIVâ€1–coinfected children, a high rate of

positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of

34]; 95% CI, 65.5%–93.2%) and after a median followâ€up of 18 months (78.3%;

95% CI, 45.5%–92.7%), with no significant difference between children treated

with HAART (with or without 3TC) and untreated ones. These children showed high

HBV DNA levels (usually>8.0 log10 copies/mL) and viral population consisting of

nearly exclusively wildâ€type HBeAgâ€positive HBV strains, strongly suggesting

that most of them were in the initial immunotolerant phase of chronic hepatitis

B.

Conclusion. In subâ€Saharan Africa, children with chronic hepatitis B and who

are treated with 3TCâ€based HAART are at risk of developing 3TC resistance.

Further studies are required to guide the management of

HBV–HIVâ€1–coinfected children.

http://www.journals.uchicago.edu/doi/abs/10.1086/525531

_________________________________________________________________

Make distant family not so distant with Windows Vista® + Windows Live™.

http://www.microsoft.com/windows/digitallife/keepintouch.mspx?ocid=TXT_TAGLM_CPC\

_VideoChat_distantfamily_012008

[Guest guest]

Clinical Infectious Diseases 2008;46:361–366

1058-4838/2008/4603-0002$15.00

DOI: 10.1086/525531

MAJOR ARTICLE

Frequent Occurrence of Chronic Hepatitis B Virus Infection among West African

HIV Typeâ€1–Infected Children

François Rouet,1

Marieâ€Laure Chaix,4

André Inwoley,1

Marieâ€France Anaky,2

Fassinou,3

Alphonse Kpozehouen,6

Rouzioux,4

Stéphane Blanche,5 and

Philippe Msellati,2 for the

Programme Enfant Yopougon (Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278)

1Centre de Diagnostic et de Recherches sur le SIDA, Centre Hospitalier

Universitaire (CHU) de Treichville, 2Programme Agence Nationale de Recherches

sur le SIDA et les Hépatites Virales B et C 1244/1278 Enfant Yopougon,

PACâ€CI, and 3Service de Pédiatrie, CHU de Yopougon, Abidjan, Ivory Coast;

4Laboratoire de Virologie 5Service d’Immunologie et d’Hématologie

Pédiatrique, Université Paris 5, CHU Neckerâ€Enfants Malades, Paris, France;

and 6Centre de Calcul, Centre Muraz, Boboâ€Dioulasso, Burkina Faso

Received 23 May 2007; accepted 17 September 2007; electronically published 2

January 2008.

Presented in part: 16th International AIDS Conference, Toronto, Canada, August

2006 (abstract WEPE0057).

(See the editorial commentary by Puoti et al. on pages 367–9)

Reprints or correspondence: Dr. François Rouet, Laboratoire de Virologie,

Centre Muraz, BP390, BoboDioulasso 01, Burkina Faso (franrouet@...).

Background. The aim of this study, conducted in Ivory Coast, was to evaluate

the prevalence and evolution of viral hepatitis in children coinfected with

human immunodeficiency virus type 1 (HIVâ€1).

Methods. Hepatitis B virus (HBV) and hepatitis C virus (HCV) markers were

retrospectively and longitudinally assessed among 280 HIVâ€1–infected

children enrolled in the Agence Nationale de Recherches sur le SIDA et les

Hépatites Virales B et C 1244/1278 cohort. Among these, 173 (61.8%) received

highly active antiretroviral therapy (HAART), including lamivudine (3TC) for 122

children. Detection of the hepatitis B s antigen (HBsAg) was performed on

specimens collected at inclusion and 6 months later. If results of both tests

were positive, hepatitis B e antigen (HBeAg)/hepatitis B e antibody (HBeAb) and

HBV DNA levels were measured at inclusion and during followâ€up. A

fourthâ€generation HCV enzyme immunoassay was used for HCV screening at

inclusion.

Results. In our pediatric cohort, no patients were infected with HCV, but the

prevalence of HBsAg at inclusion was 12.1% (34 of 280; 95% confidence interval

[CI], 8.6–16.6). Among the HBV–HIVâ€1–coinfected children, a high rate of

positive HBeAg chronic hepatitis B (CHB) was noted at inclusion (82.4% [28 of

34]; 95% CI, 65.5%–93.2%) and after a median followâ€up of 18 months (78.3%;

95% CI, 45.5%–92.7%), with no significant difference between children treated

with HAART (with or without 3TC) and untreated ones. These children showed high

HBV DNA levels (usually>8.0 log10 copies/mL) and viral population consisting of

nearly exclusively wildâ€type HBeAgâ€positive HBV strains, strongly suggesting

that most of them were in the initial immunotolerant phase of chronic hepatitis

B.

Conclusion. In subâ€Saharan Africa, children with chronic hepatitis B and who

are treated with 3TCâ€based HAART are at risk of developing 3TC resistance.

Further studies are required to guide the management of

HBV–HIVâ€1–coinfected children.

http://www.journals.uchicago.edu/doi/abs/10.1086/525531

_________________________________________________________________

Make distant family not so distant with Windows Vista® + Windows Live™.

http://www.microsoft.com/windows/digitallife/keepintouch.mspx?ocid=TXT_TAGLM_CPC\

_VideoChat_distantfamily_012008