Abstract
HIV Co-infection complicates the natural history, clinical course, therapy and management for HIV. The individuals affected represent a treatment challenge fraught with controversies associated with drug resistance, cross-resistance, hepatotoxicity and suboptimal response. This is a descriptive review of co-infection in HIV positive individuals. Studies have shown that HIV co-infection accelerates the natural course of hepatotropic viruses and increased risk of liver cirrhosis, hepatocellular carcinoma, and decompensated liver disease in co-infected individuals. Studies have equally shown increased risk of progression to acquired immunodeficiency syndrome AIDS and AIDS-related death among HIV/HCV co-infected persons and HCV may affect the management of HIV infection, increasing the incidence of liver toxicity associated with antiretroviral regimens. Dual HBV/ HCV co-infection tend to have more severe liver cirrhosis and hepatitis decompensation, and a higher incidence of hepatocellular carcinoma. HIV is a strong risk factor for TB. High prevalence rates are significantly correlated with high TB incidence rates. Tuberculosis equally accelerates the progression of disease in HIV. Co-infection with HIV is a growing public health problem worldwide. There is need for enlightenment and further researches to highlight the importance of public health follow-up and reduction measures for HIV co-infected individuals in order to prevent subsequent infections.
Highlights
Co-infection is the simultaneous infection with two or more different disease causing organisms
Co-infections in Human Immunodeficiency Virus (HIV) positive individuals are seen with Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), dual HBV and HCV, and Mycobacterium tuberculosis [5]
The prevalence is high worldwide, high prevalence of hepatotropic viruses in HIV positive individuals may be as a result of shared modes of transmission between HIV and hepatotropic virus infections, secondly, it may be due to the phenomenon of reactivation of hepatotropic viruses in the setting of HIV immunodeficiency, and lastly, sociodemographic factors: the unawareness of the population at large of the mode/route of transmission [7]
Summary
Co-infection is the simultaneous infection with two or more different disease causing organisms. The viruses are blood borne pathogens and share similar routes of transmission [1,2] It is a growing problem and is associated with increased risk of antiretroviral related hepatotoxicity and increased risk of progression to liver diseases which is a major cause of morbidity and mortality in HIV infected patients [3,4]. Co-infection affects disease progression related to HIV and hepatitis viruses [10] and complicates treatment [11]. Co-infection of HIV with viruses have been recognized worldwide in individuals exposed to blood borne diseases, but limited data are available on the extent of co-infection, effect of these viruses on the immune system and liver in developing countries [7]. Treating HIV first is clearly indicated when CD4 lymphocyte count is very low (
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