title: Liver function test abnormalities in Nigerian patients with human immunodeficiency virus and hepatitis B virus co-infection.
abstract: Data on baseline hepatic function of HIV and hepatitis B virus (HBV) co-infected patients are limited in sub-Saharan Africa. We assessed liver function test (LFT) abnormalities in Nigerian patients with HIV/HBV co-infection to highlight the impact of HIV on HBV-related liver disease in sub-Saharan Africa. A cross-sectional study involving 100 HIV/HBV co-infected patients and 100 age- and sex-matched HBV mono-infected controls. Blood testing for HIV antibodies, CD4+ cell count, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), LFTs, platelet count, fasting blood glucose and lipid profile were carried out. Non-invasive hepatic fibrosis scores (aspartate aminotransferase-platelet ratio index [APRI] and FIB-4) were also calculated. Co-infected patients had deranged liver enzymes more than the controls (77% versus 64%, P = 0.04). The predominant patterns of enzyme derangement in co-infected patients were either predominantly ↑ALP (30% versus 4%, P < 0.0001) or mixed (30% versus 15%, P = 0.01) but predominantly ↑AST/ALT in the controls (25% versus 9%, P = 0.003). Co-infected patients had higher fibrosis scores for both APRI (P = 0.002) and FIB-4 (P = 0.0001). On further analysis, LFT abnormalities and fibrosis scores were only significantly higher in co-infected patients in the immune clearance and HBeAg-negative chronic hepatitis phases. LFT abnormalities are common in Nigerians with HBV infection and co-infection with HIV negatively impacts on hepatic function.
authors: Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria. mikezindu@yahoo.com
authors: M O
authors: MO
authors: Iroezindu
authors: O O
authors: OO
authors: Agbaji
authors: C A
authors: CA
authors: Daniyam
authors: G C
authors: GC
authors: Isiguzo
authors: C
authors: C
authors: Isichei
authors: M O
authors: MO
authors: Akanbi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D060085:Coinfection; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000821:virology; D018023:HIV Seronegativity; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006784:Hospitals, Teaching; D006801:Humans; D008099:Liver / Q000276:immunology / Q000821:virology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012959:Socioeconomic Factors; D019562:Viral Load
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens
keywords: AIDS; HIV; co-infection; hepatic fibrosis; hepatitis B virus; human immunodeficiency virus; liver function test