Importance of biochemical analysis of the liver function in the management of disease progression in people living with HIV/AIDS and co-infected by HIV and hepatitis B virus in Cameroon

Abstract

Liver diseases in HIV infected persons can occur due to hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections, chronic alcoholism, and hepatic tuberculosis as well as antiretroviral drugs. Coinfection by HIV and HBV is frequently encountered with negative impact on HIV progression. The aim of this study was to evaluate the importance of biochemical analysis of the liver function in the management of disease progression in people living with HIV/AIDS and co-infected by hepatitis B virus in Cameroon. Serum of 75 patients positive for HIV was screened for HBsAg by immunochromatographic test in Yaoundé central hospital, from November 2015 to February 2016. Liver enzymes (AST, ALT, CB, TB and γ-GT), as well as CD4 T cell level determination were assessed following the standard procedures. A second blood sample was taken from HIV mono-infected and HIV/HBV co-infected after three months. The socio-demographic data was also collected. The data was entered and analyzed using SPSS version 22.1 statistical software and p<0.05 was considered as statistically significant. Hepatitis B virus surface antigen (HBsAg) was identified in 12 patients out of 75 HIV-positive patients for a HIV/HBV co-infection prevalence of 16%. Study participants with HIV/HBV co-infection have a high ALT mean level (p<0.05), than HIV mono-infected participants and the difference was statistically significant. Analysis using the second blood sample carried out 3 months later, showed significant elevation of AST, ALT, ALP, conjugated bilirubin and total bilirubin, (46.66±33.42 IU; 148.48±40.65 IU; 153.68±65.82 IU; 0.149±0.028 mg/dl; 0.75±0.089 mg/dl), while the γ-GT remained stable over time. No statistically significant CD4 count mean difference was observed between HIV mono-infected and HIV/HBV co-infected participants. The first blood sample showed significant elevation of ALT in HIV/HBV co-infected patients in the Yaoundé Central hospital. High levels of liver enzymes were seen in co-infection during the second blood sampling, hence there is a necessity of careful monitoring of these patients for better care.

Keywords: co-infection, HBV, HIV, CD4 T cells, liver enzymes