Immunovirological and Biochemical Changes in Nigerian Patients with Hepatitis B Coinfection on Antiretroviral Therapy

Abstract

Hepatitis B virus (HBV) co-infection with HIV is high among Nigerians. Some studies have suggested impaired CD4 recovery among coinfected patients compared to the HIV mono infected. This retrospective study of treatment-naïve HIV infected patients was aimed at determining the trend of changes in CD4+ counts, HIV-RNA and renal and liver function tests in response to combined antiretroviral therapy (CART). A questionnaire was utilised to extract clinical and laboratory data of HBV co infected HIV/AIDS patients before treatment and at six, twelve and eighteen months of therapy with CART. Findings were compared to those of HIV mono infected. Relevant statistical instruments were used to analyse for comparisons of means of Log10 HIV viral load and CD4 count using SPSS package 15.0. All levels of sig-nificance were at 5 %. Two thousand five hundred and sixty two patients were analysed. Of these, 354(13.8%) were HBsAg positive. Majority (63.1%) were females. Most of the recruited patients were on combivir and nevirapine. The median CD4 count for the HBsAg negative was 104 cells/mm3 (IQR 34 – 171) and it was significantly higher than those of the positive (91 cells/mm3) (p < 0.05). ALT and AST were higher among HBsAg positives, while urea and creatinine levels were similar. The median change in CD4 count from baseline and during the course of therapy were similar in the two groups. Similarly, virological responses were not different in the two groups at the various time points. In con-clusion no significant difference in the rate of CD4 recovery and HIV-RNA decline in among coinfected and monoin-fected HIV patients at different stages of therapy.

Share and Cite:

J. Otegbayo, T. Akingbola, J. Akinyemi, K. Adedapo, G. Odaibo, Y. Aken Óva, D. Olaleye, I. Adewole, R. Murphy and P. Kanki, "Immunovirological and Biochemical Changes in Nigerian Patients with Hepatitis B Coinfection on Antiretroviral Therapy," World Journal of AIDS, Vol. 1 No. 2, 2011, pp. 31-36. doi: 10.4236/wja.2011.12006.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. A. Otegbayo, F. A. Fasola and A. Abja, “Prevalence of Hepatitis B Surface and E Antigens, Risk Factors for Viral Acquisition and Serum Transaminase among Blood Donors in Ibadan, Nigeria,” Trop Gastroenterol, Vol. 24, No. 4, 2003, pp. 196-197.
[2] N. D. Sirisena, M. O. Njoku, J. A. Idoko, et al., “Carriage Rate of Hepatitis B Surface Antigen in an Urban Community in Jos Plateau State, Nigeria,” The Nigerian Postgraduate Medical Journal, Vol. 9, No. 1, 2002, pp. 7-10.
[3] S. O. Ola, J. A. Otegbayo, G. N. Odaibo, O. D. Olaleye and I. O. Olubuyide, “Serum Anti-HCV and Hepatitis B Surface Antigenaemia in Nigerian Patients with Acute Icteric Hepatitis,” West African Journal of Medicine, Vol. 21, Vol. 3, No2, 2002, pp. 215-217.
[4] I. O. Olubuyide, B. Aliyu, O. A. Olalelye, S. O. Ola, F. Olawuyi, U. H. Malabu, S. O. Odemuyiwa, G. N. Odaibo and G. C. Cook, “Hepatitis B and C Virus and Hepatocellular Carcinoma,” Transactions of the Royal Society of Tropical Medicine, Vol. 91, No. 1, 1997, pp. 38-41. doi:10.1016/S0035-9203(97)90387-4
[5] C. J. Uneke, O. Ogbu, P. U. Inyama, G. I. Anyanwu, M. O. Njoku and J. H. Idoko, “Prevalence of Hepatitis-B Surface Antigen among Blood Donors and Human Immunodeficiency Virus-Infected Patients in Jos, Nigeria,” Memórias do Instituto Oswaldo Cruz, Vol. 100, No. 1, 2005, pp. 13-16. doi:10.1590/S0074-02762005000100002
[6] J. A. Otegbayo, B. O. Taiwo, T. S. Akingbola, G. N. Odaibo, K. S. Adedapo, S. Penugonda, I. F. Adewole, D. O. Olaleye, R. Murphy and P. Kanki, “Prevalence of Hepatitis B and C Seropositivity in a Nigerian Cohort of HIV-Infected Patients,” Annals of Hepatol, Vol. 7, No. 2, 2008, pp. 152-156.
[7] D. L. Thomas, “Growing Importance of Liver Disease in HIV-Infected Persons,” Hepatology, Vol. 43, No. 2, 2006, pp. S221-S229. doi:10.1002/hep.21033
[8] D. Micheloud, J. Jensen, J. M. Bellón, R. Gonzalez, M. J. Mellado, M. L. Navarro, M. A. Mu?oz-Fernández and S. Resino, “Spanish Group of Pediatric HIV Infection. Long-Term Response to Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus and Hepatitis C Virus Coinfected Children: 6 Years of Follow-up,” The Pediatric Infectious Disease Journal, Vol. 26, No. 11, 2007, pp. 1061-1064. doi:10.1097/INF.0b013e31812e531c
[9] M. F. Miller, C. Haley, M. J. Koziel and C. F. Rowley, “Impact of Hepatitis C Virus on Immune Restoration in HIV-Infected Patients Who Start Highly Active Antiretroviral Therapy: A Meta-Analysis,” Clinical Infectious Diseases, Vol. 41, No. 5, 2005, pp. 713-720. doi:10.1086/432618
[10] A.de Luca, R. Bugarini, A. C. Lepri, M. Puoti, E. Girardi, A. Antinori, A. Poggio, G. Pagano, G. Tositti, G. Cadeo, A. Macor, M. Toti and A. D’Arminio Monforte, “Italian Cohort Naive Antiretrovirals Study Group. Coinfection with Hepatitis Viruses and Outcome of Initial Antiretroviral Regimens in Previously Naive HIV-Infected Subjects,” Archives of Internal Medicine, Vol. 162, No. 18, 2002, pp. 2125-2132.
[11] J. C. Forbi, S. Gabadi, R. Alabi, H. O. Iperepolu, C. R. Pam, P. E. Entonu and S. M. Agwale, “The Role of Triple Infection with Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus (HIV) Type-1 on CD4+ Lymphocyte Levels in the Highly HIV Infected Population of North-Central Nigeria,” Memórias do Instituto Oswaldo Cruz, Vol. 102, No. 4, 2007, pp. 535-537. doi:10.1590/S0074-02762007005000025
[12] A. M. di Bisceglie, M. Maskew, D. Schulze, A. Reyneke, L. McNamara and C. Firnhaber, “HIV-HBV Coinfection among South African Patients Receiving Antiretroviral Therapy,” Antiviral Therapy, Vol. 15, No. 3, 2010, pp. 499-503. doi:10.3851/IMP1494
[13] P. R. Spradling, J. T. Richardson, K. Buchacz, A. C. Moorman and J. T. Brooks, “The HIV Outpatient Study (HOPS) Investigators*. Prevalence of Chronic Hepatitis B Virus Infection among Patients in the HIV Outpatient Study, 1996-2007,” Journal of Viral Hepatitis, Vol. 17, No. 12, 2010, pp. 879-886. doi:10.1111/j.1365-2893.2009.01249.x
[14] C. L. Thio and B. Hepatitis, “Human Immunodeficiency Virus Coinfection,” Hepatology, Vol. 49, No. 5, 2009, pp. S138-145. doi:10.1002/hep.22883
[15] M. P. Adoga, S. D. Gyar, S. Pechulano, O. D. Bashayi, S. E. Emiasegen, T. Zungwe, O. H. Iperepolu, C. Agupugo and S. M. Agwale, “Hepatitis B Virus Infections in Apparently Healthy Urban Nigerians: Data from Pre- Vaccination Tests,” The Journal of Infection in Developing Countries, Vol. 4, No. 6, 2010, pp. 397-400.
[16] S. O. Ola, M. M. Ladipo, J. A. Otegbayo, G. N. Odaibo, E. A. Bamgboye, O. G. Nwaorgu, S. W. Shokunbi and O. D. Olaleye, “Demographic Factors in HIV Infected Patients Seen at UCH, Ibadan, Nigeria,” African Journal of Medicine & Medical Sciences, Vol. 34, No. 3, 2005, pp. 297-301.
[17] J. Idoko, S. Meloni, M. Muazu, L. Nimzing, B. Badung, C. Hawkins, J. L. Sankalé, E. Ekong, R. Murphy, P. Kanki and C. L. Thio, “Impact of Hepatitis B virus Infection on Human Immunodeficiency Virus Response to Antiretroviral Therapy in Nigeria,” Clinical Infectious Diseases, Vol. 49, No. 8, 2009, pp. 1268-1273. doi:10.1086/605675

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.