title: Baseline characteristics of HIV & hepatitis B virus (HIV/HBV) co-infected patients from Kolkata, India.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) and HIV co-infection has variable prevalence worldwide. In comparison to HBV mono-infection, the course of chronic HBV infection is accelerated in HIV/HBV co-infected patients. the present study was carried out to analyse the baseline characteristics (clinical, biochemical, serological and virological) of treatment naïve HIV/HBV co-infected and HIV mono-infected patients.
  
  
  METHODS
  Between July 2011 and January 2013, a total number of 1331 HIV-seropositive treatment naïve individuals, enrolled in the ART Centre of Calcutta School of Tropical Medicine, Kolkata, India, were screened for hepatitis B surface antigen (HBsAg). A total of 1253 HIV mono-infected and 78 HIV/HBV co-infected patients were characterized. The co-infected patients were evaluated for HBeAg and anti-HBe antibody by ELISA. HIV RNA was quantified for all co-infected patients. HBV DNA was detected and quantified by real time-PCR amplification followed by HBV genotype determination.
  
  
  RESULTS
  HIV/HBV co-infected patients had proportionately more advanced HIV disease (WHO clinical stage 3 and 4) than HIV mono-infected individuals (37.1 vs. 19.9%). The co-infected patients had significantly higher serum bilirubin, alanine aminotransferase (ALT), alkaline phosphatase and ALT/platelet ratio index (APRI). CD4 count was non-significantly lower in co-infected patients. Majority (61.5%) were HBeAg positive with higher HIV RNA (P<0.05), HBV DNA (p<0.001) and APRI (p<0.05) compared to those who were HBeAg negative. HBV/D was the predominant genotype (73.2%) and D2 (43.7%) was the commonest subgenotype.
  
  
  CONCLUSIONS
  HIV/HBV co-infected patients had significantly higher serum bilirubin, ALT, alkaline phosphatase and lower platelet count. HBeAg positive co-infected patients had higher HIV RNA and HBV DNA compared to HBeAg negative co-infected patients. Prior to initiation of antiretroviral treatment (ART) all patients should be screened for HBsAg to initiate appropriate ART regimen.
authors.affiliation: Calcutta School of Tropical Medicine, Kolkata, India.
authors.forename: Jayeeta
authors.initials: J
authors.lastname: Sarkar
authors.affiliation: ICMR Virus Unit, Kolkata, India.
authors.forename: Debraj
authors.initials: D
authors.lastname: Saha
authors.affiliation: Calcutta School of Tropical Medicine, Kolkata, India.
authors.forename: Bhaswati
authors.initials: B
authors.lastname: Bandyopadhyay
authors.affiliation: Calcutta School of Tropical Medicine, Kolkata, India.
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Saha
authors.affiliation: B.P. Poddar Hospital & Research Centre, Bhagirathi Neotia Hospital, Kolkata, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Kedia
authors.affiliation: DNGM Research Foundation, Kolkata, India.
authors.forename: D N
authors.initials: DN
authors.lastname: Guha Mazumder
authors.affiliation: ICMR Virus Unit, Kolkata, India.
authors.forename: Runu
authors.initials: R
authors.lastname: Chakravarty
authors.affiliation: Calcutta School of Tropical Medicine, Kolkata, India.
authors.forename: Subhasish Kamal
authors.initials: SK
authors.lastname: Guha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D060085:Coinfection / Q000503:physiopathology*; D005260:Female; D006678:HIV / Q000472:pathogenicity*; D015658:HIV Infections / Q000097:blood / Q000503:physiopathology* / Q000821:virology; D006509:Hepatitis B / Q000097:blood / Q000503:physiopathology* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D006514:Hepatitis B Surface Antigens