Effect of Hepatitis-B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients

Abstract

Background: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver enzymes were determined using standard techniques. Results: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co-infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (pvalue of <0.01). The mean ALT and AST of the coinfected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. Conclusion: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.

Magnitude of Hepatitis B Virus and Hepatitis C Virus among HAART Taking Patients and Association with Liver and Renal Function and CD4+ T Cells Level

“…The observed 4.7% HIV-HBV co-infection rate was lower compared with the study in North West Ethiopia which reported 5.6% [12]. Conversely, HIV-HBV co-infection rate of this study was higher as compared to worldwide HBV prevalence which was 3.1% [21] [22,23], both from Addis Ababa and lower than study in Kenya (6%) and Nigeria (6%) [19,24]. The reason for such variations in co-infection rate among HIV infected patients could possibly be due to difference in the distribution of these viruses in the various geographic locations, recruitment setting, sample size and ethnic variation.…”

“…This supports other studies conducted by Olawumi et al, Abera et al, who reported a high mean level of ALT among HIV patients co-infected either with HBV or HCV The absolute CD4+ count is an important predictive bio-marker that can be employed in establishing decision points for initiating appropriate therapy as well as monitoring in HIV positive patients in resource limited settings. In the present study HBV-HIV co-infected patients had lower mean level of CD4 compared to mono-infected ones which is intensely supported by Wondimeneh et al, Olawumi et al, Chandra et al and Griensven et al [12,18,24,26]. This might be due to HBV's nature to lead severe liver disease including acute hepatitis cirrhosis, and hepatocellular carcinoma.…”

Impact of HIV and HIV with HBV co-infection on hepatic transaminases and CD4+ T cell counts in Sokoto, North Western Nigeria

“…Further studies may give insight into other reasons. Mean ALT and AST levels were significantly higher in patients with severe immunosuppression (CD4 + T cell counts < 200 cells/mm³ {Immunolog-ically defined AIDS}) than in patients without severe immunosuppression (CD4 + T cell counts > 200 cells/mm³), irrespective of HBV co-infection and this is consistent with finding of Olawumi et al, (2014) in their study [9] . Elevated ALT and AST levels were also more common in patients with immunologically defined AIDS compared to patients with CD4 + T lymphocyte counts > 200 cells/mm³, and this represents about 21% and 31% of total patients with elevated ALT and AST levels respectively.…”

“…Idoko et al, (2009) in their studies observed similar finding with regard to CD4 + T cell counts, however observed significant difference in relation to ALT levels [8] . Olawumi et al, (2014) in their studies documented similar results with regard to CD4 + T cell counts and AST levels [9] . Human immunodeficiency virus infection is primarily known to cause CD4 + T cell depletion.…”

Prevalence and Factors Associated with HIV and Hepatitis B and Hepatitis C Co Infection in Children Attended at the Hubert Koutoukou Maga National University Teaching Hospital (CNHU-HKM) of Cotonou

“…Most children involved in the survey had a normal rate of transaminases, but 45% of them had a detectable viral load, and 55% an immunodeficiency, without significant relationship with co-infection. In Nigeria, Olawumi et al had found that HIV/HBV co-infection was associated with a decline in CD4 cell count, and an increase in transaminases [20]. Transaminases increase has also been reported by Pol [13].…”