Immunovirological and Biochemical Changes in Nigerian Patients with Hepatitis B Coinfection on Antiretroviral Therapy

Jesse Abiodun Otegbayo,Titilola Stella Akingbola,Yetunde Adebisi Aken Óva,Phylis Kanki,Joshua Odunayo Akinyemi,Kayode Solomon Adedapo,David Olufemi Olaleye,Isaac Folorunsho Adewole,Robert Murphy,Georgina Njideka Odaibo

doi:10.4236/wja.2011.12006

Jesse Abiodun Otegbayo, Titilola Stella Akingbola + Show 8 more

Open Access

https://doi.org/10.4236/wja.2011.12006

Copy DOI

Abstract

Hepatitis B virus (HBV) co-infection with HIV is high among Nigerians. Some studies have suggested impaired CD4 recovery among coinfected patients compared to the HIV mono infected. This retrospective study of treatment-naive HIV infected patients was aimed at determining the trend of changes in CD4+ counts, HIV-RNA and renal and liver function tests in response to combined antiretroviral therapy (CART). A questionnaire was utilised to extract clinical and laboratory data of HBV co infected HIV/AIDS patients before treatment and at six, twelve and eighteen months of therapy with CART. Findings were compared to those of HIV mono infected. Relevant statistical instruments were used to analyse for comparisons of means of Log10 HIV viral load and CD4 count using SPSS package 15.0. All levels of sig-nificance were at 5 %. Two thousand five hundred and sixty two patients were analysed. Of these, 354(13.8%) were HBsAg positive. Majority (63.1%) were females. Most of the recruited patients were on combivir and nevirapine. The median CD4 count for the HBsAg negative was 104 cells/mm3 (IQR 34 – 171) and it was significantly higher than those of the positive (91 cells/mm3) (p < 0.05). ALT and AST were higher among HBsAg positives, while urea and creatinine levels were similar. The median change in CD4 count from baseline and during the course of therapy were similar in the two groups. Similarly, virological responses were not different in the two groups at the various time points. In con-clusion no significant difference in the rate of CD4 recovery and HIV-RNA decline in among coinfected and monoin-fected HIV patients at different stages of therapy.

Highlights

Hepatitis B virus (HBV) is a common major endemic infection in Nigeria [1,2] and its association with common major liver diseases is well established in our environment [3,4] as in other parts of the world
The significantly higher coinfection among men compared with women in spite of a predominant female gender affected with HIV is likely a reflection of HBV prevalence among the general population which has been noted to be higher amongst men [15]
The lower prevalence of coinfection among the better educated individuals generally could be due to the level of awareness that may be associated with education and behaviours and practices that may reduce HBV transmission [16]

Summary

Introduction

Hepatitis B virus (HBV) is a common major endemic infection in Nigeria [1,2] and its association with common major liver diseases is well established in our environment [3,4] as in other parts of the world. Previous studies in Nigeria have shown a significant hepatitis B and C virus co-infection with HIV infection [5,6]. These studies showed that hepatitis C, either as mono-infection or as coinfection with HIV infection is relatively low compared with HBV. Hepatotoxicity of antiretroviral drugs especially co-infected patients with hepatitis viruses is a major concern, with increasing incidence of liver lidease [7]. Micheloud et al in their study among HCV-coinfected paediatric patients

Objectives

Methods

Results

Conclusion