Hepatitis B virus and hiv infections among patients in Mulago hospital.

Objective: To compare the frequency of exposure to hepatitis B infection among HIV seropositive and HIV seronegative medical outpatients.
Design: Case control study.
Setting: Mulago hospital medical outpatient clinics.
Patients: One hundred and twenty nine consecutive HIV seropositive patients and one hundred and twenty nine HIV seronegative control patients.
Results: The frequency of anti-HBc among the HIV seropositive patients was 65.1% compared to 41.9% in the HIV seronegative patients (95% confidence interval: 1.51-4.45; p-value: 0.0002). Of the 84 HIV positive patients with anti-HBc, 52 (61.9%) had more than five lifetime sexual partners. In comparison, of the 45 HIV positive patients with no anti-HBc, only 18 (40%) had more than five lifetime sexual partners (95% confidence interval: 1.04-1.80; p-value: 0.028). There was no significant difference in the frequency of HBsAg and HBeAg among the HIV seropositives and HIV seronegatives.
Conclusion: The frequency of previous exposure to hepatitis B infection was higher among HIV seropositive patients compared with HIV seronegative patients and was associated with a greater number of lifetime sexual partners. Safe sexual behaviour and reduction in the number of sexual partners should continue to be promoted in the community including HIV positive patients, because it is likely to have the added advantage of reducing coincident exposure to HBV infection. This is especially important for the immunocompromised HIV positive patients who are more likely to develop a chronic infectious carrier state and among whom HBV control by vaccination is less effective than in the immunocompetent individuals.