HIV/AIDS Coinfection with the Hepatitis B and C Viruses in Brazil

Oliveira, Silvano

INTRODUCTION: Hepatitis B and C viruses and the HIV share the most important forms of transmission, in particular sexual, by blood, and mother-to-child transmission. Infections by these viruses present a dynamic interaction. The HIV accelerates the evolution of liver diseases caused by hepatitis B and C, especially in patients with greater immune deficiencies. The purpose of this study is to estimate the prevalence of HIV/HBV and HIV/HCV coinfections among AIDS cases reported in Brazil and to describe the epidemiological profile.

METHODS: Coinfection was identified through probabilistic record linkage of the data of all patients carrying the HIV recorded as AIDS patients and of those patients reported as carriers of Hepatitis B or C virus in various databases from the Brazilian Health Ministry from 1999 to 2010. The procedure was done using Reclink III software. A logistic regression model is used to estimate the odds of patients being coinfected depending on certain socio-demographic variables.

RESULTS: A total of 370,672 AIDS cases were reported, of which 3,724 (1.0%) and 5,932 (1.6%) were identified as HIV/HBV and HIV/HCV coinfections, respectively. Women are less likely to become coinfected than men (HBV/HIV: OR 0.39, 95% CI=0.35–0.42; HCV/HIV: OR 0.78, 95% CI=0.73–0.83). The odds of coinfection increases with age: HBV coinfection is 3 times higher in older individuals than among those aged 24 and younger; while the odds of HCV coinfection is 12 times higher. The odds of coinfection among injection drug users increases 2- to 6-fold for HBV and HCV, respectively, when compared to sexual exposure.

CONCLUSIONS: This study permitted an important evaluation of HBV/HIV and HCV/HIV coinfections in Brazil utilizing information obtained via merging secondary databases from the Ministry of Health, without the need to conduct seroprevalence research. The procedures considered in this study also permitted fast execution of data analysis, besides being financially viable.