Biochemical and haematological responses of HIV patients co-infected with hepatitis b virus and hepatitis c virus to antiretroviral therapy
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Date
2015-11-05
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Abstract
Background: The introduction of antiretroviral therapy has considerably helped improve
the life expectancy of Human Immunodeficiency Virus (HIV)-infected patients. This
notwithstanding, the antiretroviral therapy (ART) has also been found to induce some
biochemical and haematological abnormality in some HIV-infected patients. The ART-induced biochemical and haematological abnormality is noted to be sometime s
complicated by co-infection with other pathogens such as, Hepatitis B Virus and Hepatitis
C Virus.
Aim: The aim, therefore, was to determine the biochemical and haematological
responses in HIV-infected patients on antiretroviral therapy and those also co-infected
with hepatitis B Virus or hepatitis C Virus in the Tarkwa-Nsuaem Municipality.
Methods: A hospital-based prospective cohort study was conducted on 125 HIV patients
from February, 2014 to May, 2015 at the Tarkwa Government Hospital. Data on socio-demography and exposure to risk factors associated with HBV and HCV co-infection
were collected using structured questionnaire. Venous blood samples were collected
from the participants for Hepatitis B surface antigen (HBsAg) and anti-HCV tests.
Biochemical and haematological indices were obtained by estimation with Vitalab
Selectra Junior Automatic chemistry analyzer and KX-21N Sysmex Automatic
Haematology Analyzer. The biochemical and haematological parameters compared were
haemoglobin (Hb) concentration, total white blood cell (WBC) count and lymphocyte
counts and aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine
and urea, respectively. Comparison was made between the mean at pre-ART and at 6-month and 12-month post ART using two sample t-test at 5% level of significance.
Results: Of the 125 HIV-infected patients included in the study, 39(31.20%) were males
and 86(68.80%) were females with mean age (SD±) 38 (±9.7) years. The prevalence of
HBV, HCV and HBV/HCV co-infection among the HIV patients were 22(17.60%),
9(7.20%) and 2(1.60%) respectively. Logistics regression analysis of history of exposure
to multiple sexual partners, exposure to sharp objects, such as razor blades shared with
others, exposure to tattoo, exposure to blood transfusion and exposure to intravenous drug
revealed no significant association with HBV or HCV co-infection among the HIV
patients. Serum urea increased significantly (p < 0.01) among patients infected with HIV
alone at post ART. There was no significant difference in the Hb concentration, total
WBC, Lymphocyte counts, AST, ALT, Urea and Creatinine concentrations between HIV
patients co-infected with HBV or HCV and those without the co-infection.
Conclusion: Biochemical and haematological responses of HIV patients on ART are not
affected by co-infection with Hepatitis B Virus or Hepatitis C Virus.
Limitation: Hepatitis B envelope antigen (HBeAg) and Deoxyribonucleic acid (DNA)
were not tested to assess the stage of liver disease.
Description
A thesis submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in fulfillment for the requirements of the degree of Master of Philosophy, 2015