Factors associated with HIV and HBV co-infection in Northern Thailand

Objective: To identify factors associated with HIV and hepatitis B virus (HBV) co-infection in\udNorthern Thailand.\udMethods: We tested 355 newly diagnosed HIV-infected subjects for hepatitis B surface antigen,\udhepatitis B surface antibody, and hepatitis B core antibody by using immunochromatographic\udand ELISA methods. Cases were positive for one or more of the HBV markers and controls\udwere negative for all HBV markers. All study subjects were asked to complete a questionnaire\udto identify the associations between variables. We used logistic regression model to evaluate\udthe associations between demographic and behavioral variables and HIV/HBV co-infection.\udResults: A total of 41 cases and 83 controls were suitable to analyze in the study. Among them,\ud15.0% were males, 40.3% were 30–39 years old, 62.9% were married, 18.6% were illiterate\udand 89.5% were employed. Besides, 26 cases (23.4%) had a history of a blood transfusion,\ud12.9% had a history of jaundice, 29.0% had a CD4 cell count ≤ 200 cells/mm3, 0.8% were\udintravenous drug user, 29.8% tattooed, 64.5% had a body piercing, 12.1% were commercial\udsex workers, 11.3% had first sexual intercourse at age ≤ 15 years old, 6.5% were homosexual,\udand no one had a history of HBV vaccination. After controlling for all possible confounder\udfactors in the multiple logistic regression model, we found two factors associated with HIV/\udHBV co-infection: number of years in school and CD4 cell count. Subjects with no education\udwere more likely to have HIV/HBV co-infection, which was 7.07 times (odds ratio = 7.07, 95%\udconfidence interval = 1.77–28.24) greater than those with 7 years of education group. Subjects\udwith CD4 count ≤ 200 cells/mm3 were less likely to have HIV/HBV co-infection than those\udwith a CD count ≥ 200 cells/mm3 (odds ratio = 0.35, 95% confidence interval = 0.13–0.94).\udConclusions: Our findings suggest that having a good education and having a good immune\udstatus are a protective factor of HIV/HBV co-infection. A practical approach would be a\udprovision of wide access to general and sex education on the risk and prevention of HIV, HBV,\udand a promotion of HBV immunization