Title: A Correlative Study of Biochemical, Virological & Histological Parameters of HBV Infection in HIV/HBV Co-Infection
Authors: S K Singh, Sarvinder Singh, Bhaskar Shahbabu, Vani Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.09
Abstract
Introduction: In the setting of HBV-HIV coinfections, serial monitoring of ALT alone may not predict the severity of HBV disease. This study aims at studying the correlation between ALT, Viral load and the histological progression of HBV related infection in HIV positive individuals.
Methods: The study included 30 ART naïve patients with HIV-HBV co-infection as cases and 30 incidentally detected mono infected (HBsAg positive) as control. All the patients had undergone viral serology, CD4 count and HBV DNA viral load. Selected patients based on HBeAg and HBV-DNA level were subjected to liver biopsy. Liver biopsy was scored by applying Knodell criteria [HAI].
Results-The sero-prevalence rate of HBV in HIV population in our study was 13.3%. HBeAg positivity is 10.7 times (95% CI: 2.1-53.3) more among the cases than the controls and it was statistically significant. The median ALT level in cases was 34.5 IU/L while in control group it was 77.0 IU/L. The median HBV DNA level in cases was 5.7x105copies/ml while in control group, it was 7.3x103 copies/ml. The number of patients qualified for need of liver biopsy based on HBeAg positivity and HBV DNA levels were 13 in cases and 5 among controls. The median HAI score in cases was 7.0, which was significantly more than among controls.
Conclusion: Treatment modality should be devised based on HBV plasma viral load, HBeAg status and liver biopsy and not based solely upon ALT.
Keywords: HBV-HIV Coinfection. Knodell’s Criteria, Liver biopsy score, Histologic Activity Index, HBV plasma viral load, ALT monitoring.
