High prevalence and genotype distribution of hepatitis C virus among HIV-positive individuals in the Kathmandu Valley, Nepal: Results of the community-based Positive Living with HIV (POLH) Study

Background:

Approximately 30% of 35 million HIV-positive individuals globally are co-infected with hepatitis C virus (HCV). HIV and HCV co-infection is associated with accelerated progression of liver disease as well as increased mortality. Although the estimated rates of HIV/HCV co-infection are particularly high in resource-limited countries, the true burden of co-infection and the distribution of HCV genotypes are not well known in many of such countries. Thus, we investigated the prevalence and genotype distribution of HCV among HIV-positive individuals in the Kathmandu Valley, Nepal.

Methods: 

We conducted this cross-sectional study among 322 HIV-positive individuals recruited through the networks of five non-governmental organizations working with HIV-positive individuals. We collected the blood sample from each participant. All the anti-HCV positive samples were tested for HCV-RNA and genotypes. Correlates of HIV/HCV co-infection were examined using multivariable logistic regression analysis.

Results:

The prevalence of HIV/HCV co-infection was 29.6%. Secondary or higher level of education (adjusted odds ratio [AOR]=2.86; 95% confidence internal [CI]=1.02-8.06), employment (AOR=3.13; 95% CI=1.09-8.93), and history of lifetime injecting drug use (AOR=49.5; 95%CI=15.80-155.52) were associated with higher likelihood of HIV/HCV co-infection. Serum samples of 79 participants were available for genotype assessment. Of them, 36.7% were tested positive for genotype 1, 55.7% for genotype 3, and genotype of the remaining samples was undetermined (7.6%).

Conclusion:

High prevalence of HIV/HCV co-infection and the distribution of prevalent HCV genotype 1 and 3 have important implications for the Nepalese public health system in designing prevention and treatment programs.