Title: Impact of HIV and HIV with HBV co-infection on hepatic transaminases and CD4+ T cell counts in Sokoto, North Western Nigeria
Authors: A Yakubu, B Hali, A I Mamman, B O P Musa
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.55
Abstract
Human immunodeficiency virus (HIV) and Hepatitis B (HBV) virus co-infection is not unexpected because both infections have common routes of transmission. The former increases morbidity and mortality of HBV liver related diseases. Alanine aminotransferase (ALT) and Asphatate aminotransferase (AST) are enzymes that reflect integrity of liver cells and whose elevation in the blood indicate liver cell injury. The CD4+ T cells which are often depleted and malfunctioned in HIV infection play a central role in the immunology of HBV infection.
This study aimed at determining impact of HIV and HIV with HBV co-infection on Hepatic transaminases and CD4+ T cell counts. A cross-sectional design was adopted, in which 180 treatment naïve HIV infected adults attending HIV clinics at Usmanu Danfodiyo University Teaching Hospital, Sokoto (UDUTH) and Specialist Hospital Sokoto (SHS), were recruited in the study from March 2014 to October 2015. Alanine aminotransferase and asphatate aminotransferase levels, CD4+ T cell counts, and HBsAg were evaluated.
The prevalence of HBsAg among HIV infected patients was higher among male participants compared to female participants (P=0.016). Mean ALT and AST levels were higher in males compared to females among the study participants (P<0.077; 0.044 respectively). Mean CD4+ T cell counts were significantly higher among female study participants than in male study participants (P= 0.0001). The mean CD4+ T cell counts, ALT and AST levels were higher among patients with HIV and HBV co-infection compared to HIV mono-infected patients (P< 0.022; 0.854; 0.341 respectively). Prevalence of elevated ALT and AST levels were higher among patients with HIV and HBV co-infection than in patients with HIV mono-infection (P< 0.323: 0.074 respectively). Severely immunosuppressed individuals irrespective of Hepatitis B co-infection were more likely to have either higher mean or elevated ALT and AST levels.
Baseline ALT, AST levels and HBsAg screening should be ensured in HIV patients. Treatment options for patients with severe immunosuppression in either HIV mono-infection or HIV and HBV co-infection should be carefully considered and monitoring of transaminases be ensured.
Keywords; HIV infection, Hepatitis B virus co-infection, Hepatic transaminases, CD4+ T cell counts.
