Abstract:
Introduction of highly active antiretroviral therapy (HAART) has improved the life of
people living with Human Immunodeficiency Virus (HIV). But the persistence of
opportunistic infections during HAART still presents a huge burden of disease, which
often reverses the direct benefits of anti-retroviral treatment. Hepatitis C virus (HCV) is
one of the many known opportunistic infection agents that together or individually,
continues to escalate the risk of deaths among HIV/AIDS individuals. This study aimed
at determining the prevalence of intravenous drug use and hepatitis C infections among
patients attending the comprehensive care clinic (CCC) at the Malindi district hospital.
A total of 452 subjects were enrolled into the study from the Malindi sub county
Hospital comprehensive care clinic. Socio-demographic information was collected using
individual questionnaires. Blood samples were collected in EDTA tubes and processed
for downstream application. Approximately 41.2% (186/452) subjects were intravenous
drug users (IDUs), of which 152 were aged 40 years or younger while 34 were above 40
years. HCV was solely found among IDUs at a prevalence of 16.4% and not among noninjectors. Due to limited resources, only 25 of the HIV positive samples were sequenced
to determine HIV subtype and drug resistance. By HIV subtype, 60% of the infections
were due to subtype A (majority of them being A1 at 88.66% while A2 and AE
respectively were 6.67%); 12% were subtype C and; 16% were subtype D sixteen
percent (4/25) of the virus isolates had mutations that confer resistance to nucleoside
reverse transcriptase inhibitor (NRTI) class of antiretroviral drugs, while 24% (6/25) had
mutations that confer resistance to non-NRTIs (NNRTIs). For the HCV infections by
genotype, 75% were subtype 1a and 25% were subtype 4a. There were no drug resistant
mutations among the HCV positive samples. This study has revealed a high prevalence
of HCV infections among the IDUs. Public health programs should consider HCV
testing alongside HIV testing.
