Welcome to Open Science
Contact Us
Home Books Journals Submission Open Science Join Us News
Hepatitis B and C Profile, and Choice of ART Among HIV-Infected Patients: A Review of Patients of an Urban Tertiary Hospital Who Received Home Care
Current Issue
Volume 5, 2017
Issue 2 (April)
Pages: 9-16   |   Vol. 5, No. 2, April 2017   |   Follow on         
Paper in PDF Downloads: 22   Since Jul. 24, 2017 Views: 1319   Since Jul. 24, 2017
Halima Mwuese Sule, Department of Family Medicine, Faculty of Medical Sciences, University of Jos/Jos university Teaching Hospital, Jos, Nigeria.
Patricia Aladi Agaba, Department of Family Medicine, Faculty of Medical Sciences, University of Jos/Jos university Teaching Hospital, Jos, Nigeria.
Lisa Lyop Patrick, APIN Centre, Jos University Teaching Hospital, Jos, Nigeria.
Asabe Andrew Mshelia, APIN Centre, Jos University Teaching Hospital, Jos, Nigeria.
Due to similar routes of transmission, human immunodeficiency virus infection is often associated with the risk of co-infection with hepatitis B and/or C virus infection, the consequence of which is an accelerated progression to chronic liver disease. Screening for hepatitis and early commencement of antiretroviral therapy with tenofovir-based dual Nucleoside Reverse Transcriptase Inhibitor (NRTI) backbone has been recommended for co-infected persons as this could reduce the disease burden in them. Unfortunately, in developing countries, due to financial constraints, very few HIV care programs can provide these benefits for their patients. This study was undertaken at a center where hepatitis screening and tenofovir-based regimen were available, and aimed to assess the presence of co-infection with Hepatitis B and/or Hepatitis C in a population of HIV patients, and its impact on the choice of NRTI backbone in the patients’ antiretroviral regimen. Methods: After excluding 12 records due to missing hepatitis screening results, data of 140 HIV-infected patients enrolled at the Jos University Teaching Hospital antiretroviral therapy (ART) clinic, who also received home based care from September 2008 to December 2013, were reviewed. Relevant information was extracted and analyzed using Epi info version 7. Results: Of 140 patients, 22.8% and 8.6% tested positive to HBV and HCV respectively, while 4.3% tested positive to both HBV and HCV. The age group 30-39 years had the highest frequency of those co-infected. More females tested positive to HBV (71.9%) and HCV (66.7%), but equal proportions of both genders had both HBV and HCV (50%). Of those who tested positive to hepatitis (81.6%) were on ART as follows: 22 (84.6%) of HBV co-infected, 3 (50%) of HCV co-infected and 6 (100%) of HBV/HCV co-infected were on the recommended ART regimen that contained dual NRTI backbone while 3 (11.5%) of HBV co-infected and 1(16.7%) of HCV co- infected were on ART regimen with the less ideal mono NRTI backbone. Three (eight percent) patients with hepatitis (1 HBV and 2 HCV) were not on ART. Conclusion: The rate of co-infection with HBV and HCV was high among these patients, and consequently, a majority of them were on the recommended dual NRTI backbone regimen. This reflects a reasonable extent of conformity with recommendations for HIV-hepatitis care. There is however a need to evolve improved strategies to ensure that, all patients are screened and placed on the appropriate regimen.
Hepatitis, Human Immunodeficiency Virus, Antiretroviral Therapy, NRTI Backbone
UNAIDS 2014 The GAP Report 2014. Available from http://www.unaids.org/unaidspublication/2014/UNAIDS_Gap_report_en.pdf (Accessed February 17 2017).
NACA (2015). Nigeria Global Aids Response Country Progress Report 2015. Available from http://www.unaids.org/sites/default/files/country/documents/NGA_narrative_report_2014.pdf (Accessed February 17 2017).
Barth RE, Huijgen Q, Taljaard J, Hoepelman AIM. Hepatitis B/C and HIV in sub-Saharan Africa: an association between highly prevalent infectious diseases. A systematic review and meta-analysis. Int J Infect Dis. 2010; 14(12): e1024-e1031.
Alter JM.Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006; 44S6-S9.
Musa BM, Bussell S, Borodo MM, Samaila AA, Femi OL. Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: A systematic review and meta-analysis. Nig J Clin Prac. 2015;18(2):163-172.
Huy BV, Vernavong K, Kinh NV. HBV and HCV coinfection among HIV/AIDS patients in the National hospital of tropical diseases, Vietnam. AIDS Res and Treatment. 2014;2014: 581021. Doi: 10.1155/2014/581021.
Konstantinou D, Deutsch M. The spectrum of HBV/HCV coinfection: epidemiology, clinical characteristics, viral interactions and management. Ann Gastroenterol. 2015;28: 221-228.
WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. 2016. Available from http://www.who.who.int/hiv/pub/arv/arv-2016/en/ (Acessessed February 17 2017).
Van Griensven J, Phirum L, Choun K, Thai S, De Weggheleire A, Lynen L.Hepatitis B and C co-infection among HIV-infected adults while on antiretroviral treatment: Long term survival, CD4 cell count recovery and antiretroviral toxicity in Cambodia. PLoS ONE 2014;9(2): e88552.doi:10.1371/journal.pone.0088552.
World Health Organisation 2009; Rapid advice: antiretroviral therapy for HIV infection in adults and adolescents. Available from http://www.who.int/hiv/pub/arv/rapid_advice_art.pdf. Accessed February 17 2017.
Qurishi N, Kreuzberg C, Luchters G, Effenberger W, Kupfer B, Sauerbruch T, Rockstroh J et al. Effect of antiretroviral therapy on liver-related mortality in patients with HIV and hepatitis C virus coinfection. The Lancet.2003;362: 1708-1713.
Mendes-Correa MC, Nunez M. Management of HIV and hepatitis virus coinfection. Exp Opinion Pharm. 2010;11: 2497–2516.
Thio CL, Smeaton L, Hollabaugh K, Saulynas M, Kulkami S, Hakim J, Nyirenda M et al. Comparism of HBV-active HAART regimens in an HIV-HBV multinational cohort. AIDS 2015;29:1173-1182.
Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Considerations for antiretroviral use in patients with coinfections Hepatitis B(HBV)/HIV coinfection. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/25/hbv-hiv (Accessed February 18 2017).
Diwe CK, Okwara EC, Enwere OO, Azike JE, Nwaimo NC. Sero-prevalence of hepatitis B virus and hepatitis C virus among HIV patients in a suburban University Teaching Hospital in south-east Nigeria. Pan Afr Med J. 2013;16:7.
Noubiap JJN, Aka PV, Nanfack AJ, Agyingi LA, Ngai JN, Nyambi PN. Hepatitis B and C co-infections in e HIV-positive populations in Cameroon, West Central Africa: Analysis of samples collected over more than a decade. PLoS ONE. 2015. 10(9): e0137375.doi: 10.1371 /journal.pone.0137375.
Easterbrook P, Sans A, Harmanci H. Challenges and priorities in the management of HIV/HBV and HIV/HCV coinfection in resource limited settings. Semin Liver Dis 2012;32: 147-157.
AASLD/IDSA HCV Guidance Panel. Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing and treating adults infected with hepatitis C virus. Hepatol. 2015; 62: 932- 954.
Ford N, Singh K, Cooke GS, Mills EJ, von Schoen-Angerer T, Kamarulzaman A, du Cross P. Expanding access to treatment for hepatitis C in resource-limited settings: lessons from HIV/AIDS. Clin infect Dis. 2012:1465 - 1472.
WHO. The World Health Report 2008. Primary health care: now more than ever. Available from: http://www.who.int/whr/2008/whr08_en.pdf (Accessed February 19 2017).
Akintola O, Hangulu L. Infection control in home-based care people living with HIV/AIDS/TB in South Africa: an exploratory study. Glob Pub Health.2014; 9: 382-393
FRON. National Population Commission 2006. National Population Census. Available from http://www.nigeriamasterweb.com/Nigeria06CensusFigs.html (Accessed on February 19 2017).
Peter TJ, Olayinka AT, Agbaji OO, Ogunsola FT. Epidemiology of hepatitis B and hepatitis C virus infection among HIV counselling and testing clients in Jos, north central Nigeria. Afr J Clin Exper Microbiol. 2015; 16:92-96.
Balogun TM, Emmanuel S, Ojerinde EF. HIV, Hepatitis B and C viruses’coinfection among patients in a Nigerian tertiary hospital. Pan Afr Med J.2012;12:100.
Ogwu-Richard SO, Ojo DA, Akingbade OA, Okonko IO. Triple positivity of HBsAg, anti-HCV antibody, and HIV and their influence onCD4+ lymphocyte levels in the highly HIV infected population of Abeokuta, Nigeria. Afr Health Sci. 2015;15:719-727.
Forbi JC, Gabadi S, Alabi R, Iperepolu HO, Pam CR, Entonu PE, Agwale SM. The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+lymphocyte levels in the highly HIV infected population of North-Central Nigeria. Mem Inst Oswaldo Cruz. 2007;102:535-537.
Ojide CK, Kalu EI, Ogbaini-Emevon E, Nwadike VU. Co-infections of hepatitis B and C with human immunodeficiency virus among adult patients attending human immunodeficiency virus outpatients clinic in Benin City, Nigeria. Nig J Clin Prac. 2015; 18: 516-521.
Otegbayo JA, Taiwo BO, Akingbola TS, Odaibo GN, Adedapo KS, Penugonda S, Adewole IF et al. Prevalence of hepatitis B and C seropositivity in a Nigerian cohort of HIV-infected patients. Ann Hepatol. 2008;7:152-156.
Egah DZ, Banwat EB, Audu ES, Iya D, Mandong BM, Anele AA, Gomwalk NE et al. Hepatitis B surface antigen, hepatitis C and HIV antibodies in a low-risk blood donor group, Nigeria. East Mediterr Health J. 2007;13:961-966.
Chandra N, Joshi N, Raju YSN, Kumar A, Teja VD. Hepatitis B and/or C coinfection in HIV-infected patients: a study in a tertiary care centre from south India. Ind J Med Res. 2013; 138:950 – 954.
Saravanan S, Velu V, Kumarasamy N, Nandakumar S, Murugavel KG, Balakrishnan P, Suniti S. Coinfection of hepatitis B (HBV) and hepatitis C (HCV) in south India. World J Gastroenterol. 2007;13:5015-5020.
SeyedAlinaghi S, Jam S, Mehrkhani F, Fattahi F, Sabzvari D, Kourorian Z, Jabbari H, Mohraz M. Hepatitis-C and hepatitis-B co-infections in patients with human immunodeficiency virus in Tehran, Iran. Acta Med Iran 2011;49:252-257.
Brandão NAA, Pfrimer IAH, Martelli CMT, Turchi MD. Prevalence of hepatitis B and C infection and associated factors in people living with HIV in Midwestern Brazil. Braz J Infect Dis. 2015;19:426–430.
Open Science Scholarly Journals
Open Science is a peer-reviewed platform, the journals of which cover a wide range of academic disciplines and serve the world's research and scholarly communities. Upon acceptance, Open Science Journals will be immediately and permanently free for everyone to read and download.
Office Address:
228 Park Ave., S#45956, New York, NY 10003
Phone: +(001)(347)535 0661
Copyright © 2013-, Open Science Publishers - All Rights Reserved