Effects of Hepatitis B Virus Co-Infection and Antiretroviral Therapy on Disease Progression among HIV Patients Treated at the Buea Regional Hospital, Southwest Region, Cameroon: A Case-Control Study

Abstract

In the era of "test and treat", when AIDS-defining events have been drastically reduced, chronic liver disease associated with viral hepatitis and antiretroviral therapy (ART) remains an important cause of non-AIDS morbidity and mortality among HIV-infected patients. Compared to the general population, HIV-infected patients are about 10-times at risk of hepatitis B virus infection. Additionally, several antiretroviral regimens are hepatotoxic. Therefore, effective monitoring and management of ART and HBV co-infection are essential to ending the AIDS epidemic and eliminating viral hepatitis by 2030. This was a hospital-based, matched (age and sex) case-control study. HIV patients (case patients) on ART for at least six months and "healthy" controls aged 18 years and older were enrolled. Blood samples were collected for immuno-hematologic indices and transaminases measurements. Data were presented as counts, percentages, median (IQR) and means (SD), and a p-value < 0.05 was considered significant. The comparisons of means were performed using ANOVA on SPSS version 23. Of the 212 participants, 106 were case patients (60 HIV only and 46 HIV/HBV co-infections). The median age of the study participants was 37 years (IQR: 33 -44.8), and 69.3% were female. The median duration of ART in HIV patients was 43 months (IQR: 16 -77.3 months) with most patients on efavirenz-based ART (75.5%). Overall, transaminase levels were higher in the case patients than in healthy controls, while