Original articles

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

Cynthia Firhaber, Anne Reyneke, Doreen Schulz, Babatyi Malope, Patrick Macphail, Ian Sanne, Adrian Di Biseglie


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.

Authors' affiliations

Cynthia Firhaber, Clinical HIV Research Unit

Anne Reyneke, CHRU

Doreen Schulz, CHRU

Babatyi Malope, Right to Care

Patrick Macphail, Right to Care

Ian Sanne, CHRU

Adrian Di Biseglie, Saint Louis University

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Cite this article

South African Medical Journal 2008;98(7):541.

Article History

Date submitted: 2007-10-26
Date published: 2008-07-09

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