HIV, HBV, HCV, and syphilis co-infections among patients attending the STD clinics of district hospitals in Northern India

Objective: The objective of the study was to assess the risk of co-infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among patients attending sexually transmitted disease (STD) clinics, antenatal clinics (ANC) and Ob-Gyn outpatients department (OPD) clinics which were part of the sentinel surveillance program. Methods: A serological screening was carried out during the period August-November 2002 to assess the risk of infection with HIV-1/2, and co-infection with HBV, HCV, and syphilis among the outpatients attending STD clinics, Ob-Gyn OPD clinics, and ANC of three district hospitals (Agra, Etawah, and Farrukhabad) of Uttar Pradesh state in Northern India. Unlinked and coded serum samples received from 863 patients (635 females and 228 males) were screened by laboratory tests commonly used for laboratory diagnosis of HIV, HBV, HCV, and syphilis. Results Among the 863 samples serological reactivity was detected for HIV-1/2 in 21 (2.4%), HBV in 25 (2.9%), HCV in nine (1.0%), and syphilis in 47 (5.4%). The incidence of HBV was higher among males than females, i.e. 10/228 (4.4%) versus 15/635 (2.4%). Co-infection was observed for HIV-HBV in two (0.2%), HBV-HCV in one (0.1%), and HIV-syphilis in one (0.1%). None were found to have co-infection with HIV-HCV, HBV-syphilis, and HCV-syphilis. Age, sex, literacy level, occupation, locality, migration, and presence of different sexually transmitted infections did not significantly influence the rate of HIV positives. Conclusion: A substantial percentage of the outpatients seen in the clinics of the district hospital in Uttar Pradesh harbor HIV and viral hepatitis infections, which otherwise would remain undiagnosed without serological screening