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
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
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