Anabire Nsoh Godwin, Tetteh William Jackson, Obiri-Yaboah Dorcas, Annan Isaac, Luuse Arnold Togiwe, Aryee Paul Armah, Helegbe Gideon Kofi, Hagan Oheneba Charles Kofi, Eliason Sabastian
Department of Biochemistry & Molecular Medicine, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana.
School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
BMC Res Notes. 2019 Jul 31;12(1):466. doi: 10.1186/s13104-019-4513-8.
HIV positive individuals infected with viral hepatitis B (HBV) or C (HCV) are at an increased risk of progression to kidney and liver failures. Therefore, prior to initiation of antiretroviral therapy, early diagnosis and initiation of appropriate treatment protocols are imperative for co-infected individuals. This study evaluated the prevalence of HBV and HCV, and extent of liver and renal dysfunction among 90 newly diagnosed HIV patients attending the Cape Coast Teaching Hospital HIV clinic.
Levels of alanine aminotransferase, aspartate-platelet ratio index and estimated glomerular filtration rate were used respectively to diagnose hepatotoxicity, liver fibrosis and chronic kidney disease (CKD). Association analyses were evaluated by Pearson's Chi-square test or Fisher's exact test and considered significant at p < 0.05. Using rapid diagnostic tests, 75.6% (n = 68) had HIV1 mono-infection, 24.4% (n = 22) had HIV1/HBV co-infection while 0.0% (n = 0) had HIV1/HCV co-infection. The prevalence of hepatotoxicity, liver fibrosis, and CKD were 7.8% (n = 7), 2.2% (n = 2), and 15.5% (n = 14) respectively. Similar proportions of HIV1/HBV and HIV1 were diagnosed with liver fibrosis (p = 0.431). In relation to hepatotoxicity Grade, a high proportion of HIV1/HBV were diagnosed with Grade 2 (p = 0.042). Also, severely reduced kidney function (CKD stage 4) was observed in only HIV1/HBV (n = 2, 9.1%, p = 0.053).
感染乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）的HIV阳性个体发展为肾衰竭和肝衰竭的风险增加。因此，在开始抗逆转录病毒治疗之前，对合并感染的个体进行早期诊断并启动适当的治疗方案至关重要。本研究评估了90名在海岸角教学医院HIV诊所新诊断的HIV患者中HBV和HCV的流行率以及肝肾功能障碍的程度。
分别使用丙氨酸氨基转移酶水平、天冬氨酸-血小板比率指数和估计肾小球滤过率来诊断肝毒性、肝纤维化和慢性肾脏病（CKD）。采用Pearson卡方检验或Fisher精确检验进行关联分析，p<0.05被认为具有统计学意义。使用快速诊断检测，75.6%（n = 68）为HIV1单一感染，24.4%（n = 22）为HIV1/HBV合并感染，而0.0%（n = 0）为HIV1/HCV合并感染。肝毒性、肝纤维化和CKD的患病率分别为7.8%（n = 7）、2.2%（n = 2）和15.5%（n = 14）。HIV1/HBV和HIV1被诊断为肝纤维化的比例相似（p = 0.431）。关于肝毒性分级，高比例的HIV1/HBV被诊断为2级（p = 0.042）。此外，仅在HIV1/HBV中观察到严重肾功能降低（CKD 4期）（n = 2，9.1%，p = 0.053）。
