title: Prevalence and impact of hepatitis B and C virus co-infections in antiretroviral treatment naïve patients with HIV infection at a major treatment center in Ghana.
abstract: Data on the effects of the presence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients co-infected with these viruses and HIV in West Africa are conflicting and little information is available in Ghana. A cohort of 138 treatment naïve individuals infected with HIV was screened for HBV and HCV serologic markers; HBsAg positive patients were tested for HBeAg, anti-HBe, and anti-HBc IgM. The viral load of HIV-1 in the plasma was determined in 81 patients. Eighteen of the 138 patients (13%) and 5 (3.6%) had HBsAg and anti-HCV, respectively. None of the patients had anti-HBc IgM, but 10 (55.6%) and 8 (44.4%) of the 18 patients who were HBsAg positive had HBeAg and anti-HBe, respectively. In patients with measurement of CD4(+) undertaken within 1 month (n = 83), CD4(+) count was significantly lower in patients with HBeAg (median [IQR], 81 [22-144]) as compared to those with anti-HBe (median [IQR], 210 [197-222]) (P = 0.002, CI: -96.46 to 51.21). However, those with HIV mono-infection had similar CD4(+) counts (median [IQR], 57 [14-159]) compared to those with HBeAg (P = 1.0, CI: -71.75 to 73.66). Similar results were obtained if CD4(+) count was measured within 2 months prior to initiation of HAART (n = 119). Generally, HBV and anti-HCV did not affect CD4(+) and viral loads of HIV-1 in plasma but patients with HIV and HBV co-infection who had HBeAg had more severe immune suppression as compared to those with anti-HBe. This may have implication for initiating HAART in HBV endemic areas.
authors.affiliation: Clinical Virology Laboratory, Department of Microbiology, University of Ghana Medical School, Accra, Ghana. kwcsagoe@chs.edu.gh
authors.forename: Kwamena William Coleman
authors.initials: KW
authors.lastname: Sagoe
authors.forename: Afrakoma Adjoa
authors.initials: AA
authors.lastname: Agyei
authors.forename: Francesca
authors.initials: F
authors.lastname: Ziga
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.forename: Theophilus K
authors.initials: TK
authors.lastname: Adiku
authors.forename: Makafui
authors.initials: M
authors.lastname: Seshi
authors.forename: Max Q
authors.initials: MQ
authors.lastname: Arens
authors.forename: Julius Abraham Addo
authors.initials: JA
authors.lastname: Mingle
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D007075:Immunoglobulin M