Caracterização da coinfecção HIV e hepatite B na população de um hospital de referência em São Luís - MA

Abstract

The virus that causes hepatitis B (HBV) is a DNA virus belonging to the Hepadnaviridae family, genus Orthohepadnavirus. It can be transmitted sexually, vertically and parenterally. Co-infection caused by the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV) occurs in considerable numbers and is related to the common

transmission route of these viruses. The objective of this work is to characterize co- infection with the hepatitis B virus among people living with HIV (PLHIV) in a reference

service. It was carried out from January 2022 to July 2023 in a reference hospital in the state of Maranhão for infectious-parasitic diseases and its population was PLHIV, with a clinical and serological diagnosis recorded in the medical record, aged 18 years or over, who were undergoing regular outpatient follow-up at the unit and presented results of serological markers for Hepatitis B in their medical records. Data were collected from 500 medical records based on the analysis of consultation records, carried out by the service's multidisciplinary team and compiled into an investigative form. A total of 301

records were included. 263 (87.37%) corresponded to PLHIV and 38 (12.62%) to co- infected patients (HIV and HBV). Among the co-infected patients, 21(55.26%) were

between 41 and 60 years old, 35(92.11%) were male, 22(57.89%) were mixed race, 17(44.74%) were single, 11 (28.95%) had completed primary education and 38 (100%) were using antiretroviral therapy with tenofovir. Of the PLHIV, 96 individuals (36.50%) were vaccinated for hepatitis B. Of these, 37 (38.54%) received the four recommended doses of the vaccine, 82 (85.42%) had reactive Anti-HBs marker titers and 3(3 .13%) of these patients presented reactive Anti-HBs due to contact with HBV. In relation to laboratory tests, it can be seen that in the overall sample the TCD4+ cell count was less

than 350mm3, with 114 (43.35%) in the PLHIV group and 19 (50%) in the group co- infected with Hepatitis B, while the HIV viral load was above 40 copies/mL, with 211 in

the PLHIV group (80.23%) and 28 in the co-infected group (73.68%). Furthermore, it

was identified that 38 (12.6%) people tested positive for HBsAg, 102 (38.78%) had non- reactive anti-Hbc, while 143 (54.37%) had reactive results for Anti-Hbc. HBs. As for

HBeAg, 9 (23.68%) of patients co-infected with HIV and HBV had reactive results, while 21 (55.26%) had reactive results for Anti-HBe. Data regarding hepatitis B viral load indicated that the viral load was less than 2000 IU/ml in 10 (26.32%) of the patients, out of a total of 17 patients who underwent the test. Investigating the presence of the hepatitis B virus, by carrying out specific tests, and evaluating the vaccination status for HBV in PLHIV can play a crucial role in improving the prognosis in this population.