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Friday, 20 September 2013 11:21

Thesis Statement: Featured

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Thesis Statement:

         The rate of Hepatitis B infection among people with diagnosed with HIV in the US is much higher compared to the US-reported rate for the general population.

Literature review

         In the United States, there is a close similarity between human immunodeficiency virus types 1 with viral hepatitis epidemiology. The prevalence of HBV infection among individuals with HIV patients is reported to be about 80% with the prevalence of chronic HBV infection being 10% (Tedaldi, Peters, Neuhaus J, and et al. 2008). This data is, however, limited in the present day yet this data is crucial for understanding the infection of HBV among the HIV-infected individuals. Unlike in the past, number of people becoming infected with HIV and Hepatitis B is rising tremendously in the United States. The Center of Disease Control has estimated that over 1, 178, 350 adolescents and adults are living with HIV infection by 2008.  This is the most recent national data showing the estimated prevalence of individuals living with HIV in the U. S. The statistics indicates an increase of about 7% from the 2006 estimates (Williams, Bell, Kuhnert, Alter, 2011).

Despite the increasing number of individuals becoming infected, national data on HBV infection prevalence show contradicting data. Various health departments, through the CDC, have reported that since 1990s to 2009, the prevalence of HIV infection has reduced (CDC, 2009). This is as a result of the use of infant vaccination and vaccinations   provided to adolescents and children (Williams, Bell, Kuhnert, Alter, 2011). The researchers are optimistic that with the declining trend, a major population of patients with HIV will be protected through the hepatitis B infection. The Institute of Medicine (IOM) in 2010 reported that the surveillance capacity for monitoring chronic and acute viral hepatitis is limited at a local and state level as a result of these reports not being submitted by the state. This leads to variable and incomplete data.

The CDC reports (2010) shows that an estimate of 1.2 million Americans with chronic HBV infection and other 38, 000 people contracted the Hepatitis B infection in 2010 (CDC, 2010).  The current data on the prevalence of Hepatitis B infection in the U. S does not agree with the national data of this problem in the general population. Studies have shown that about thirty percent of those living with HBV are in correctional facilities (Hudson, Nyamathi, Shoptaw, et al. 2009, p 340–346). This suggested that   blood-borne transmission among inmates is the main source of HBV infection to the wider population (Soriano, Puoti, Bonacini, et al. 2008; Hammer, Erin, Reiss, et al 2008).  This view is supported by evidence that there is a high incidence of the spread of sexual transmitted infections, viral hepatitis and HIV infection among those who are incarcerated compared to the non-incarcerated individuals. These diseases spread also during the sharing of needles such as those using illicit drugs, risky behaviors in prisons and jails. Last is that various studies have supported that prison status has an impact on HIV –related risks (Flynn, Solomon and Vertefeuille, 2004). 

Previous  researchers have defined chronic HBV  infection by use of  a positive Hepatitis  B  surface antigen without  considering the  serological markers and have only reported on cross sectional data  (Tovo, Dos Santos, de Mattos, & Almeida 2006; Holland, Yong, Moscicki 2000). The incident HBV infection data for HIV -infected individuals is limited yet this data could have helped in the provision of opportunities on HBV infection prevention among HIV-infected individuals. One of the studies has reported that the acute HBV infection incidences   is as large as 12.2 cases in 1000 persons and the prevalence rate being 7.8% (Kellerman SE, Hanson DL, McNaghten AD, Fleming 2003). This study utilizes a window of observation from 1998 to 2001 and did not provide the proportion of HBV infection of becoming chronic and failure to be reported (Kim, 2009).

This means that the HBV infection prevalence in the United States is underestimated. The available national data indicate and an overall decrease of HB infection incidences in the overall population within the past two decades (CDC, 2008). In reference to this research gap, this study aims to contribute to literature on HBV infection among HIV-infected people. It will describe the HBV infection Epidemiology in an observational, prospective cohort to find out the actual prevalence rate, and to determine factors associated with diagnosis of HBV among HIV infected patients. 


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Solomon L, Flynn C, & Vertefeuille J (2004) Prevalence of HIV hepatitis B and hepatitis C in correctional facilities.Journal of Urban Health.P 25–37.

Kim W (2009) Epidemiology of hepatitis B in the United States. Hepatology. 49:s28-s34.

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 Holland C, Yong M, Moscicki A, Durako S (2000) risk factors of hepatitis B, , and humancytomegalovirus among HIV-infected and high-risk uninfected adolescents. Sex Transm Dis 27:296–303

Kellerman S, Hanson D, McNaghten D, Fleming P (2003) Prevalence of chronic hepatitis. J Infect Dis.p –577.

Tedaldi E, Neuhaus J, & Peters L, et al. (2008) Opportunistic disease and mortality in patient’s co infected with hepatitis. Clin Infect 47:1468–1475.

Hammer M, Eron J, Reiss P, et al (2008) antiretroviral treatment of HIV infection. Panel. JAMA p, 555–570.

Hudson, A, Nyamathi, A, Shoptaw, S et al. (2009) Impact of PRISON Status on HIV-Related risk behaviors. AIDS Behav, p 340–346 

Soriano V, Puoti M, and Bonacini M et al (2008) patients with chronic hepatitis in HIV-Hepatitis B virus. P 1399–1410

Williams I, Bell B, Kuhnert W, Alter M (2011) transmission patterns of acute hepatitis B in the U. S, 1982–2006. Arch Intern Med, p 242–8.


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