Prevalence and impact of hepatitis B and C virus co-infections in antiretroviral treatment naïve patients with HIV infection at a major treatment center in Ghana
Journal of Medical Virology
Clinical Virology Laboratory, Department of Microbiology, University of Ghana Medical School, Accra, Ghana; Department of Medicine, University of Ghana Medical School, Accra, Ghana; Pharmacy Department, Korle-Bu Teaching Hospital, Accra, Ghana; Retrovirus Laboratory, Department of Pediatrics, Washington University Medical School, St. Louis, MO, United States
Data on the effects of the presence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients co-infected with these viruses and HIV in West Africa are conflicting and little information is available in Ghana. A cohort of 138 treatment naïve individuals infected with HIV was screened for HBV and HCV serologic markers; HBsAg positive patients were tested for HBeAg, anti-HBe, and anti-HBc IgM. The viral load of HIV-1 in the plasma was determined in 81 patients. Eighteen of the 138 patients (13%) and 5 (3.6%) had HBsAg and anti-HCV, respectively. None of the patients had anti-HBc IgM, but 10 (55.6%) and 8 (44.4%) of the 18 patients who were HBsAg positive had HBeAg and anti-HBe, respectively. In patients with measurement of CD4 + undertaken within 1 month (n=83), CD4 + count was significantly lower in patients with HBeAg (median [IQR], 81 [22-144]) as compared to those with anti-HBe (median [IQR], 210 [197-222]) (P=0.002, CI: -96.46 to 51.21). However, those with HIV mono-infection had similar CD4 + counts (median [IQR], 57 [14-159]) compared to those with HBeAg (P=1.0, CI: -71.75 to 73.66). Similar results were obtained if CD4 + count was measured within 2 months prior to initiation of HAART (n=119). Generally, HBV and anti-HCV did not affect CD4 + and viral loads of HIV-1 in plasma but patients with HIV and HBV co-infection who had HBeAg had more severe immune suppression as compared to those with anti-HBe. This may have implication for initiating HAART in HBV endemic areas. © 2011 Wiley Periodicals, Inc.
antiretrovirus agent; hepatitis B core antibody; hepatitis B surface antigen; hepatitis B(e) antibody; hepatitis B(e) antigen; adult; article; CD4+ T lymphocyte; controlled study; Ghana; Hepatitis B virus; Hepatitis C virus; highly active antiretroviral therapy; human; Human immunodeficiency virus 1; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; immune response; major clinical study; mixed infection; prevalence; screening test; virus load; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Coinfection; Comorbidity; Female; Ghana; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis C; Hepatitis C Antibodies; HIV Infections; HIV-1; Humans; Immunoglobulin M; Male; Middle Aged; Viral Load; Hepatitis B virus; Hepatitis C virus; Human immunodeficiency virus 1