Hepatitis B (HBV) and C (HCV) are two other forms of infections for which co-infection in HIV has been associated with alteration of the immune response, increased risk of progression to liver diseases, and increased risk of hepatotoxicity associated with antiretroviral therapy. This study aimed to establish the prevalence of hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV patients, evaluate response to treatment between the different categories and identify the possible risk factors associated with this burden of hepatitis B/C among HIV patients and the resulting responses to HAART in Kumba Health, in the South West Region of Cameroon. Method: We performed a systematic screening using Rapid Diagnostic Test, for HBsAg and HCVAb among 299 HIV patients enrolled at the treatment centers in Kumba Health District (District hospital Kumba, Kumba Town Sub-Divisional hospital, and the Apostolic hospital Banga Bakundu), with all positives for HBV or HCV confirmed by the ELISA and results analyzed using SPSS version 20. Out of the 299 participants, 52 HIV patients, 36 HIV/HBV, and 12 HIV/HCV patients were involved in the prospective cohort study for 24 months which permitted monitored the immune response (CD4 counts and viral load test), as well as variation of biochemical parameters (ALAT/ASAT, albumin, bilirubine, creatinine) and weights of the studied participants. Result: Out of the 100 HIV patients involved in the prospective cohort, 36 and 12 were hepatitis B and C virus-positive respectively. Following the analysis of the viral load and CD4 cell counts, there were differences in response to HAART after 24 months between the mono-infected and co-infected patients, taking into consideration the, CD4 cell counts (HIV: 930.846 cells/mm3, HIV/HBV: 595.139 cells/mm3 and HIV/HCV: 678.500cells/mm3), and viral load (HIV: 1777.85copies/ml, HIV/HBV: 2232.61copies/ml and HIV/HCV: 750.83copies/ml). There were variations in biomarkers of the liver (ALAT/ASAT, bilirubin, and albumine) and renal function (creatinine) for both patients. There were also variations of the different biomarkers linked to the infection status of the different participants. Conclusion: There were positive variations in viral load and CD4 cell counts among the studied participants, with a more rapid response to the mono-infected HIV patients compared to the co-infected patients. Similar strength was observed in the variation of the different biomarkers and such variation indicates that co-infection of HIV patients with either hepatitis B or C virus can affect rapid response to HAART and the variations in the level of Biochemical markers among the different categories are linked to the alteration of the functions of the respective organs and so this result could be used for health decisions regarding co-infections.

Background: Malaria parasitemia and HIV infections are globally important public health concerns. People residing in regions where these two infections are endemic are prone to develop co-infection. Sub-Saharan Africa has the greatest burden of both diseases and Cameroon particularly the South West Region has been reported as one of the regions with the highest malaria and HIV prevalence. Hence, there is a need for continuous monitoring and epidemiologic inquiry to generate updated data on the burden of malaria parasitemia on HIV/AIDS. The aim of this study was to determine the prevalence of malaria parasitemia and the association between viral load and malaria parasite density in people living with HIV/AIDS in Kumba, Cameroon. Methods: A cross-sectional study was conducted involving 250 people living with HIV/AIDS selected from five main Community Based Organizations in Kumba during a period of 5 months from April to August 2021. Participants’ consent was obtained followed by socio-demographic and other useful data via a standardized questionnaire. Capillary blood samples were collected and Giemsa-stained blood films were examined to detect malaria parasitemia. The recent viral loads were collected from the participants’ medical files. Pearson’s chi-square was used for the comparison of proportions and correlation analysis to determine the association between parasite density and viral load. Statistical significance was set at p < 0.05. Results: An overall prevalence of malaria parasitemia in people living with HIV/AIDS in Kumba was 27.2%; [95% CI: 21.8% – 33.2%]. Among 215 participants who were HAART-experienced, 49(22.79%); [95% CI: 17.6% – 27.9%] were found to be positive for malaria parasitemia while 19(54.29%); [95% CI: 48.1% – 60.5%] out of the 35 HAART naïve individuals were positive for malaria parasitemia. This difference in prevalence was statistically significant (X2 = 15.078, df = 1, N = 250, p < 0.000). Also, malaria parasite density was significantly dependent on viral load (X2 = 61.065, df = 6, N = 49, p < 0.000). HAART-experienced participants with high viral load(>1000copies/ml) had significantly higher malaria parasite density(>400trophozoites/µL) than HAART-experienced participants with ‘not detectable’ viral load. Conclusion: The prevalence of malaria parasitemia in the study population was 27.2%. HAART naïve individuals had significantly higher malaria parasitemia prevalence and malaria parasite density than HAART-experienced individuals. Malaria parasite density was significantly dependent on viral load in HAART-experienced individuals.

Comorbidity of diabetes mellitus and hypertension is common, with both diseases and their treatment being able to cause liver function abnormalities, which can lead to liver failure. This study aims to access the effect of drugs used in the management of these diseases on liver function. A crosssectional study will be conducted, followed by a case-control design. Ethical clearance will be obtained from the Faculty of Health Sciences Institutional Review Board and administrative authorization from the various hospital directorates. The sampling procedure adopted will be consecutive and shall include all consenting patients aged 21 years and above, treated for hypertension, diabetes mellitus, or both. Pregnant women, patients with liver disease, viral hepatitis, as well as those on known hepatotoxic drugs will be excluded. Clinical, lifestyle, anthropometric data as well as venous blood samples will be collected and analyzed for liver enzymes (aspartate transaminase, alanine transaminase, and gamma glutamyl transferase) total or conjugated bilirubin, hepatitis B surface antigen and hepatitis C virus antibodies. Student T-test will be used to compare means and chi-square to test for proportion. Associated factors will also be determined using odds ratios. A p-value of <0.05 will be considered significant. The prevalence of liver function abnormalities shall be determined. Determinants of liver function abnormalities shall also be identified.

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