title: Hepatitis B virus seroprevalence and its correlation with CD4 cells and liver enzymes among human immunodeficiency virus positive individuals at a tertiary care hospital in North-West India.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India.
authors: Saroj
authors: S
authors: Hooja
authors: Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India.
authors: Anita
authors: A
authors: Singhal
authors: Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India.
authors: Rekha
authors: R
authors: Bachhiwal
authors: Department of Preventive and Social Medicine, SMS Medical College, Jaipur, Rajasthan, India.
authors: Rajiv
authors: R
authors: Yadav
authors: Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India.
authors: Nitya
authors: N
authors: Vyas
keywords: CD4 T-cells; Co-infection; hepatitis B virus; human immunodeficiency virus; liver enzymes