A Prospective Study of Liver Function Tests, CD4 Counts and Seroprevalence of Hepatitis–B virus Coinfection with Human Immunodeficiency Virus in a  Teaching Hospital of Rural setup

DR.N.RAMA KRISHNA; DR.SIRISHA PAVANA NEKKALA; DR.BANDARU NARASINGA RAO

Volume : V, Issue : IV, April - 2016

A Prospective Study of Liver Function Tests, CD4 Counts and Seroprevalence of Hepatitis–B virus Coinfection with Human Immunodeficiency Virus in a Teaching Hospital of Rural setup

Dr. N. Rama Krishna, Dr. Sirisha Pavana Nekkala, Dr. Bandaru Narasinga Rao

Abstract :

Background: Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) are global health concerns. Due to common routes of transmission, co–infection is common. Their co–existence alters the disease nature and can cause severe liver complications like cirrhosis or malignancy and immunological impairment in infected individuals. Aim: To find the prevalence of HBV co–infection in HIV patients and to assess the hepatotoxicity by estimating liver function tests and CD4 T–cell counts in HIV monoinfected and HIV/HBV co–infected patients. Materials and Methods: A total of 540 consecutive confirmed HIV positive for treatment patients were tested for hepatitis B surface antigen (HBsAg). Clinical staging was done according to Center for Disease Control and Prevention(CDC) classification guidelines. Liver function tests were performed by a random access auto analyser (Medica Easyra); CD4 Tcells were estimated by Partec cyflow counter, Germany. Results: Hepatitis B virus co–infection was detected in 11.48% of HIV positive patients as compared to 1.48% in the HIV negative control group (P < 0.05). Majority of the HIV monoinfected and co–infected patients were below 40 years. HBsAg positivity was higher in males (12.46%) 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 < 0.05) and significantly higher AST, ALT, alkaline phosphatase, serum bilirubin (P < 0.05, P < 0.05, P < 0.05 respectively) and significantly lower albumin values than the monoinfected group (P < 0.05). Males had 2.3 times higher risk than females for co–infection. 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. The assessment of liver function was used for guiding them for possible therapy for HBV in order to reduce the disease complications