Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana.
Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana.
PLoS One. 2022 Nov 23;17(11):e0278037. doi: 10.1371/journal.pone.0278037. eCollection 2022.
Chronic hepatitis negatively affects persons living with HIV. While varying in their transmission efficiency, HIV, HBV, and HCV have shared routes of transmission. Available data suggest widely variable rates of HBV and HCV infections in HIV-infected populations across sub-Saharan Africa. With prolonged survival rates due to increased accessibility to antiretroviral drugs, HBV and HCV have the potential to complicate the prognosis of HIV co-infected patients by contributing significantly to continued morbidity and mortality. The study sought to determine the seroprevalence of HIV/HBV and HIV/HCV co-infections among HIV patients on antiretroviral therapy and to evaluate the effect of HIV/HBV and HIV/HCV co-infections on the immunologic and virologic responses of patients. A cross-sectional study in which samples were taken from 500 people living with HIV and attending ART clinic at the Fevers unit of the Korle Bu Teaching Hospital and tested for Hepatitis B Surface Antigen (HBsAg) and Hepatitis C virus antibody (HCV). CD4 cell counts and HIV-1 RNA levels were estimated as well. Data generated were analysed using IBM SPSS version 22. The seroprevalence of HIV/HBV and HIV/HCV co-infections among people living with HIV was 8.4% and 0.2% respectively. HIV/HBV coinfection included 15/42 (35.7%) males and 27/42 (64.3%) females out of which the majority (97.6%) were in the 21-60 years old bracket. HIV/HBV and HIV/HCV co-infections have varied effects on the immunological and virological response of HIV patients on ART. The mean CD cell count was 361.0 ± 284.0 in HIV/HBV co-infected patients and 473.8 ± 326.7 in HIV mono-infected patients. The mean HIV-1 RNA level was not significantly different (X2 [df] = .057 [1]; P = .811) among HIV/HBV co-infected patients (Log102.9±2.0 copies/mL), compared to that of HIV mono-infected patients (Log102.8±2.1 copies/mL) although HIV mono-infected patients had lower viral load levels. One-third (14/42) of HIV/HBV co-infected patients had virologic failure and the only HIV/HCV co-infected patient showed viral suppression. 336/500 (67.2%) patients had HIV-1 viral suppression (females [66.1%]; males [33.9%]) while 164/500 (32.8%) had virologic failure (females [67.7%]; males [32.3%]). The mean CD4 count of patients with viral suppression and patients with virologic failure was 541.2 cells/μL (95% CI 508.5-573.8) and 309.9 cell/μL (95% CI 261.9-357.9) respectively.The study concludes that, HIV/HBV and HIV/HCV coinfections do not significantly affect the immunologic and virologic responses of patients who have initiated highly active antiretroviral therapy, and treatment outcomes were better in females than in males. There was no HBV/HCV co-infection among patients.
慢性肝炎对 HIV 感染者有负面影响。虽然 HIV、HBV 和 HCV 的传播效率不同，但它们有共同的传播途径。在撒哈拉以南非洲，来自 HIV 感染者的 HBV 和 HCV 感染率存在广泛差异。由于抗逆转录病毒药物的可及性提高，HIV 感染者的生存率延长，HBV 和 HCV 有可能通过显著增加发病率和死亡率，使 HIV 合并感染患者的预后复杂化。本研究旨在确定接受抗逆转录病毒治疗的 HIV 患者中 HIV/HBV 和 HIV/HCV 合并感染的血清流行率，并评估 HIV/HBV 和 HIV/HCV 合并感染对患者免疫和病毒学反应的影响。这是一项横断面研究，从 Korle Bu 教学医院 Fever 科接受抗逆转录病毒治疗的 500 名 HIV 患者中采集样本，并检测乙型肝炎表面抗原（HBsAg）和丙型肝炎病毒抗体（HCV）。还估计了 CD4 细胞计数和 HIV-1 RNA 水平。使用 IBM SPSS 版本 22 分析生成的数据。HIV 感染者中 HIV/HBV 和 HIV/HCV 合并感染的血清流行率分别为 8.4%和 0.2%。HIV/HBV 合并感染包括 42 名男性中的 15 名（35.7%）和 42 名女性中的 27 名（64.3%），其中大多数（97.6%）在 21-60 岁年龄段。HIV/HBV 和 HIV/HCV 合并感染对接受 ART 的 HIV 患者的免疫和病毒学反应有不同的影响。HIV/HBV 合并感染患者的平均 CD 细胞计数为 361.0±284.0，HIV 单感染患者为 473.8±326.7。HIV/HBV 合并感染患者的 HIV-1 RNA 水平（X2[df]=.057[1]；P=.811）与 HIV 单感染患者的 HIV-1 RNA 水平（Log102.8±2.1 拷贝/mL）无显著差异，尽管 HIV 单感染患者的病毒载量水平较低。三分之一（14/42）的 HIV/HBV 合并感染患者出现病毒学失败，唯一的 HIV/HCV 合并感染患者表现出病毒抑制。336/500（67.2%）名患者的 HIV-1 病毒载量得到抑制（女性[66.1%]；男性[33.9%]），而 164/500（32.8%）名患者出现病毒学失败（女性[67.7%]；男性[32.3%]）。病毒抑制和病毒学失败患者的平均 CD4 计数分别为 541.2 个细胞/μL（95%CI 508.5-573.8）和 309.9 个细胞/μL（95%CI 261.9-357.9）。该研究得出结论，HIV/HBV 和 HIV/HCV 合并感染不会显著影响开始接受高效抗逆转录病毒治疗的患者的免疫和病毒学反应，并且女性的治疗结果优于男性。患者中没有 HBV/HCV 合并感染。
