Hepatitis B virus seroprevalence and its correlation with CD4 cells and liver enzymes among human immunodeficiency virus positive individuals at a tertiary care hospital in North-West India

Abstract

Background:Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are global health concerns. Due to shared routes of transmission, co-infection is common. Their co-existence can cause severe liver complications and immunological impairment in infected individuals.Aim:To find the prevalence of HBV co-infection in HIV patients and to assess the pattern of liver enzymes and CD4 T-cell counts in HIV monoinfected and HIV/HBV co-infected patients.Materials and Methods:A total of 342 consecutive confirmed HIV positive treatment naïve patients were tested for hepatitis B surface antigen (HBsAg). Clinical staging was done according to Centers for Disease Control and Prevention classification guidelines. Liver function tests were performed by an autoanalyser. CD4 T-cells were estimated by FACS Calibur.Results:Hepatitis B virus co-infection was detected in 8.7% of HIV positive patients as compared to 1.42% in the HIV negative control group (P < 0.05). Majority of the HIV monoinfected and co-infected patients were below 38 years. HBsAg positivity was higher in males (9.4%) and the route of transmission was heterosexual. Categorical data revealed significantly higher proportion of alanine aminotransferase and aspartate aminotransferase (AST) in the co-infected patients compared to the monoinfected patients (P < 0.05). The HIV/HBV co-infected patients had significantly lower CD4 T-cell counts (P = 0.03) and significantly higher AST, alkaline phosphatase and serum bilirubin values (P = 0.023, P = 0.029, P = 0.009 respectively) than the monoinfected group. Males had 1.33 times higher risk than females for co-infection (odds ratio = 1.33; 95% confidence interval 0.57–3.10).Conclusion:The prevalence of co-infection was high. Raised levels of liver enzymes and lowered CD4 counts were seen in co-infected patients. These findings underscore the importance of HBV screening of all HIV positive individuals before initiating antiretroviral treatment.

Prevalence of hepatitis B markers in Senegalese HIV‐1‐infected patients

“…For the vaccination, the first dose is often given at 6 weeks of age. This prevalence variation according to the age groups was also documented in other studies in Africa [Diop‐Ndiaye et al, ] and Asia [Hooja et al, ], with, respectively, 25.3 and 36.7%, which showed a high prevalence, respectively, in patients aged from 30 to 40 and 18 to 38 years. The main routes of transmission in different countries might explain the prevalence variation in the different age groups [Saravanan et al, ].…”

“…This information could explain the higher prevalence of HBV/HIV coinfection in African countries compared to developed countries. As demonstrated by others studies [Attia et al, ; Hooja et al, ], the prevalence of HBV/HIV coinfection was higher in males than females but this difference was not statistically significant ( P = 0.245). Although being not statistically significant, the prevalence of HBV/HIV was higher in patients aged over 40 ( P = 0.181) and lower in patient aged under 20 years.…”

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

“…Specifically, the mean serum ALT level of HIV/HBV coinfected patients was significantly higher than that of HIV mono-infected patients (p = 0.002), similar to studies carried out in Ghana [29] and France [30]. Likewise, the mean AST level of HIV/HBV coinfected patients was significantly higher than that of HIV-mono-infected patients in line with a study reported in Northern India [31], but it was contrary to the findings of a study in Nigeria [32]. In HIV-positive patients, the increase in hepatic enzymes could be secondary to multiple factors such as alcoholism, lipid-lowering drugs, antibiotics, coinfection with hepatotropic viruses or opportunistic infections, and direct hepatic damage caused by HIV [33].…”

Sero-prevalence of Human Immunodeficiency Virus and hepatitis viruses and their correlation with CD4 T-cell lymphocyte counts in pregnant women in the Buea Health District of Cameroon

“…These controversial results may be partly due to the differences in the immune status of the study participants or it may be due to the viral hepatitis. A study by Hooja et al (2015) also proved that HIV infection may accelerate the progression of hepatic complications.…”