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.