Hooja Saroj, Singhal Anita, Bachhiwal Rekha, Yadav Rajiv, Vyas Nitya
Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India.
Department of Preventive and Social Medicine, SMS Medical College, Jaipur, Rajasthan, India.
Int J Appl Basic Med Res. 2015 Jan-Apr;5(1):36-40. doi: 10.4103/2229-516X.149235.
Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are global health concerns. Due to shared routes of transmission, co-infection is common. Their co-existence can cause severe liver complications and immunological impairment in infected individuals.
To find the prevalence of HBV co-infection in HIV patients and to assess the pattern of liver enzymes and CD4 T-cell counts in HIV monoinfected and HIV/HBV co-infected patients.
A total of 342 consecutive confirmed HIV positive treatment naïve patients were tested for hepatitis B surface antigen (HBsAg). Clinical staging was done according to Centers for Disease Control and Prevention classification guidelines. Liver function tests were performed by an autoanalyser. CD4 T-cells were estimated by FACS Calibur.
Hepatitis B virus co-infection was detected in 8.7% of HIV positive patients as compared to 1.42% in the HIV negative control group (P < 0.05). Majority of the HIV monoinfected and co-infected patients were below 38 years. HBsAg positivity was higher in males (9.4%) and the route of transmission was heterosexual. Categorical data revealed significantly higher proportion of alanine aminotransferase and aspartate aminotransferase (AST) in the co-infected patients compared to the monoinfected patients (P < 0.05). The HIV/HBV co-infected patients had significantly lower CD4 T-cell counts (P = 0.03) and significantly higher AST, alkaline phosphatase and serum bilirubin values (P = 0.023, P = 0.029, P = 0.009 respectively) than the monoinfected group. Males had 1.33 times higher risk than females for co-infection (odds ratio = 1.33; 95% confidence interval 0.57-3.10).
The prevalence of co-infection was high. Raised levels of liver enzymes and lowered CD4 counts were seen in co-infected patients. These findings underscore the importance of HBV screening of all HIV positive individuals before initiating antiretroviral treatment.
人类免疫缺陷病毒（HIV）和乙型肝炎病毒（HBV）是全球关注的健康问题。由于传播途径相同，合并感染很常见。它们的共同存在可导致感染个体出现严重的肝脏并发症和免疫功能损害。
了解HIV患者中HBV合并感染的患病率，并评估HIV单感染和HIV/HBV合并感染患者的肝酶和CD4 T细胞计数模式。
对342例连续确诊的初治HIV阳性患者进行乙型肝炎表面抗原（HBsAg）检测。根据疾病控制与预防中心的分类指南进行临床分期。肝功能检查由自动分析仪完成。CD4 T细胞通过FACS Calibur进行检测。
HIV阳性患者中HBV合并感染的检出率为8.7%，而HIV阴性对照组为1.42%（P<0.05）。大多数HIV单感染和合并感染患者年龄在38岁以下。男性的HBsAg阳性率较高（9.4%），传播途径为异性传播。分类数据显示，合并感染患者的丙氨酸氨基转移酶和天冬氨酸氨基转移酶（AST）比例显著高于单感染患者（P<0.05）。与单感染组相比，HIV/HBV合并感染患者的CD4 T细胞计数显著降低（P = 0.03），AST、碱性磷酸酶和血清胆红素值显著升高（分别为P = 0.023、P = 0.029、P = 0.009）。男性合并感染的风险是女性的1.33倍（比值比 = 1.33；95%置信区间为0.57 - 3.10）。
合并感染的患病率较高。合并感染患者的肝酶水平升高，CD4计数降低。这些发现强调了在开始抗逆转录病毒治疗前对所有HIV阳性个体进行HBV筛查的重要性。
