Abstract
People with concomitant human immunodeficiency virus (HIV) and tuberculosis (TB) have an increased risk of hepatotoxic reactions due to antiretroviral therapy (ART) and anti-TB therapy (ATT). Concomitant hepatitis B virus (HBV) in these patients may lead to poorer health outcomes. To assess liver enzyme levels and immune response in adults with HIV, HBV, and TB, data from 300 antiretroviral-naïve people living with HIV (PLWHIV) were analyzed. The prevalence of HIV/HBV (cHIV/HBV) and HIV/TB (cHIV/TB) was 28% (95% CI: 23.0–33.4) and 10% (95% CI: 6.8–14.0), respectively. HIV/HBV/TB (cHIV/HBV/TB) prevalence was 5.3% (95% CI: 3.1–8.5). There was a statistically significant difference between the groups of participants in HIV viral load (p = 0.004), hemoglobin levels (p = 0.025), and body mass index (p = 0.011). A larger proportion of cHIV/HBV/TB participants (37.5%) had an aspartate aminotransferase to platelet ratio index (APRI) score ≥0.5 (p = 0.013), a lower cutoff for significant liver fibrosis. Immunological non-responders (CD4+ T-cell count <20% gain and HIV viral load <400 copies/mL at 6 months) were observed in all groups except those with cHIV/TB. Our findings support the need to screen for infections that could cause excessive liver damage prior to ATT or ART initiation, such as HBV.
Highlights
Approximately 251,000 tuberculosis (TB)-associated deaths were recorded among people living with human immune deficiency virus (PLWHIV) in 2018 with a high proportion of people withPathogens 2020, 9, 950; doi:10.3390/pathogens9110950 www.mdpi.com/journal/pathogensPathogens 2020, 9, 950 concomitant human immunodeficiency virus (HIV)/TB occurring in Africa [1]
[95% CI: 6.8–14.0] (30/300) had concomitant HIV/TB (cHIV/TB), and 5.3% [95% CI: 3.1–8.5] (16/300) were participants with cHIV/hepatitis B virus (HBV)/TB
In this study conducted in a cohort of people living with HIV (PLWHIV) initiating antiretroviral therapy (ART) in Botswana, we found a cHIV/HBV/TB prevalence of 5.3% with cHIV/HBV/TB participants having the lowest hemoglobin level and high HIV viral loads
Summary
Pathogens 2020, 9, 950 concomitant HIV/TB (cHIV/TB) occurring in Africa [1]. Botswana is no exception and is listed among the thirty highest TB/HIV burdened countries by the World Health Organization (WHO) [1]. Other HIV co-infections such as viral hepatitis, hepatitis B virus (HBV) is highly prevalent in Africa with approximately 71% of people with concomitant HIV/HBV (cHIV/HBV) reported in sub-Saharan. Botswana has one of the highest reported HBV incidences among PLWHIV in Southern. Treatment of HIV co-infections has been shown to decrease HIV viral load [10], other multiple undiagnosed infections could counteract this effort and possibly lead to delayed immune recovery. There are limited data on the burden of multiple infections with TB and HBV among
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
