Human immunodeficiency virus and HBV co-infection: independent entities, together by coincidence?


  • Ajay Mathur Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Laxmi Kant Goyal Department of Geriatric Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Arvind Kumar Gupta Department of Medicine, Pandit Deen Dayal Upadhyaya Hospital, Jaipur, Rajasthan, India
  • Nupur Hooja Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur, Rajasthan, India
  • R. N. Yadav Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India



HIV infection, HIV-HBV co-infection, Pregnant female, Prevalence, Screening


Background: To ascertain the prevalence of HBV among HIV-infected, treatment- naïve patients visiting a tertiary care centre in Jaipur, Rajasthan, India.

Methods: An observation analytic study was done at a tertiary care centre affiliated to medical college with retrospective analysis of the hospital data of 30 calendar months. During this period routine diagnostic screening of HIV infection and HBV infection was offered to every suspected patient admitted in hospital and every pregnant woman visiting antenatal care clinic. Patients with documentary evidence of HIV infection and history of Hepatitis B vaccination in last 30 days are not screened for these infections at our centre. The HIV screening was done as per NACO guidelines. The HBV screening was done using commercially available enzyme linked immunosorbent assay kits (ELISA) for detection of surface antigen (HBsAg).

Results: The study prevalence of HIV infection was 0.11% (40/35289). The prevalence was more in male (0.45%) than females (0.06%). HBV was not detected in any of the HIV positive patient in this study. The study prevalence of HIV among pregnant females was 0.05% (10/22026).

Conclusions: In this study, prevalence of HIV infection was 0.11%. The study prevalence of HIV among pregnant females was 0.05%. Other than pregnant women, maximum positive cases (13/30, 43.33% positive cases) were in the age group of 25-34 years (sexually active group). No patient had HIV and HBV co-infection.



Saravanan S, Velu V, Kumarasamy N, Nandakumar S, Murugavel KG, Balakrishnan P, Suniti S, et al. Coinfection of hepatitis B and hepatitis C virus in HIV-infected patients in south India. World J Gastroenterol. 2007;13(37):5015.

Mohammadi M, Talei G, Sheikhian A, Ebrahimzade F, Pournia Y, Ghasemi E, et al. Survey of both hepatitis B virus (HBsAg) and hepatitis C virus (HCV-Ab) coinfection among HIV positive patients. Virol J. 2009;6(1):202.

WHO. Hepatitis B: How can I protect myself?. Available at:

Bulletin of the world health organization. Breast is always best, even for HIV-positive mothers. Available at:

Hoffmann CJ, Thio CL. Clinical implications of HIV and hepatitis B co-infection in Asia and Africa. Lancet Infect Dis. 2007;7(6):402-9.

Núñez M, Ríos P, Pérez-Olmeda M, Soriano V. Lack of ‘occult’hepatitis B virus infection in HIV-infected patients. Aids. 2002;16(15):2099-101.

Hofer M, Joller-Jemelka H, Grob PJ, Lüthy R, Opravil M. Swiss HIV cohort study. Frequent chronic hepatitis B virus infection in HIV-infected patients positive for antibody to hepatitis B core antigen only. Eur J Clin Microbiol Infect Dis. 1998,17:6-13.

Michèle LP, Marielle G, Michel B, Henri D, Chavanet PP. Hepatitis B virus seroconversion in HIV-HBV coinfected patients treated with highly active antiretroviral therapy. JAIDS. 2000;23(4):356-7.

Shire NJ, Rouster SD, Stanford SD, Blackard JT, Martin CM, Fichtenbaum CJ, et al. The prevalence and significance of occult hepatitis B virus in a prospective cohort of HIV-infected patients. JAIDS. 2007;44(3):309-14.

National AIDS control organisation. Ministry of Health and Family Welfare, Government of India. National guidelines for HIV testing, 2016. Available at:

Rockstroh JK, Spengler U. HIV and hepatitis C virus co-infection. Lancet Infect Dis. 2004;4(7):437.

Beld M, Penning M, Lukashov V, McMorrow M, Roos M, Pakker N, et al. Evidence that both HIV and HIV induced immunodeficiency enhance HCV replication among HCV seroconverters. Virol. 1998;244:504-12.

Bonacini M, Govindarajan S, Blatt LM, Schmid P, Conrad A, Lindsay KL. Patients co-infected with human immunodeficiency virus and hepatitis C virus demonstrate higher levels of hepatic HCV RNA. J Viral Hepat. 1999;6:203-8.

Soto B, Sánchez-Quijano A, Rodrigo L, del Olmo JA, García-Bengoechea M, Hernández-Quero JE, et al. Human immunodeficiency virus infection modifies the nature history of chronic parenterally acquired hepatitis C with an unusually rapid progression to cirrhosis. J Hepatol. 1997;26:1-5

Ockenga J, Tillmann HL, Trautwein C, Stoll M, Manns MP, Schmidt RE. Hepatitis B and C in HIV infected patients-Prevalence and prognostic value. J Hepatol. 1997;27:8-24.

Gilson RJ, Hawkins AE, Beecham MR, Ross E, Waite J, Briggs M, et al. Interactions between HIV and hepatitis B virus in homosexual men: effects on the natural history of infection. AIDS. 1997;11(5):597-606.

Shahapur PR, Bidri RC. Recent trends in the spectrum of opportunistic infections in human immunodeficiency virus infected individuals on antiretroviral therapy in South India. J Nat Sci Biol Med. 2014;5:392-6.

Chavan VR, Chaudhary V, Ahir P, Mehta R, Mavani PS, Kerkar C, et al. Current scenario of opportunistic and co-infections in HIV-infected individuals at a tertiary care hospital in Mumbai, India. Indian J Med Microbio. 2015;33:78-3.

National AIDS control organisation, ministry of health and family welfare, government of India. NACO annual report, 2012-13. Available at:

Gautam H, Bhalla P, Saini S, Uppal B, Kaur R, Baveja CP, et al. Epidemiology of opportunistic infections and its correlation with CD4 T-lymphocyte counts and plasma viral load among HIV-positive patients at a tertiary care hospital in India. J Int Assoc Physic AIDS Care (Chic). 2009;8:333-7.

Sharma A, Halim J, Jaggi T, Mishra B, Thakur A, Dogra V, et al. Time trends of sero epidemiology of hepatitis C virus and hepatitis B virus coinfection in human immunodeficiency virus-infected patients in a super specialty hospital in New Delhi, India: 2012-2014. Indian J Sex Transm Dis. 2016;37:33-7.

Sharma V, Ramachandran VG, Mogha NS, Bharadwaj M. Hepatitis B and C virus infection in HIV seropositive individuals and their association with risk factors: A hospital-based study. Indian J Med Res. 2018;147:588-93.

Tripathi AK, Khanna M, Gupta N, Chandra M. Low prevalence of hepatitis B virus and hepatitis C virus co-infection in patients with human immunodeficiency virus in Northern India. JAPI. 2007;55:429-31.

Baveja UK, Chattopadhya D, Khera R, Joshi PM. A cross sectional serological study of the co-infection of hepatitis B virus, hepatitis C virus and human immunodeficiency virus amongst a cohort of IDUs at Delhi. Indian J Med Microbio. 2003;21:280-3.

McKee G, Butt ZA, Wong S, Salway T, Gilbert M, Wong J, et al. Syndemic characterization of HCV, HBV, and HIV co-infections in a large population based cohort study. E Clinic Med. 2018;4:99-108.

Parveen M, Smiti N, Vani M, Meenakshi C, Naveen M. Prevalence of HIV, Hepatitis B, Hepatitis C in pregnancy at tertiary care center of Northern India. Adv Res Gastroentero Hepatol. 2016;1(4):1-3.

World Health Organization. Combating hepatitis B and C to reach elimination by 2030: advocacy brief, 2016. Available at:






Original Research Articles