Effect of Hepatitis-B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients

Abstract

Background: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function.
Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy- naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver  enzymes were determined using standard techniques.
Results: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co- infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/μl were significantly higher than those with count ≥ 200 cells/μl. (pvalue of <0.01). The mean ALT and  AST of the co - infected patients and all patients with CD4 count <200 cells/μl were higher than the normal reference range.
Conclusion: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count <200 cells/μl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/μl should be given non-hepatotoxic antiretroviral drug.

Keywords: HIV, Hepatitis B, CD4 count, liver function, co-infection