Human Immunodeficiency Virus and Hepatitis C virus Co-Infection in Children in Jos, Nigeria
[1]
Emeka Uba Ejeliogu , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[2]
Stephen Oguche , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[3]
Augustine O. Ebonyi , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[4]
Sylvanus E. Okpe , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[5]
Esther S. Yiltok , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[6]
Collins C. John , Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[7]
Martha O. Ochoga , Department of Paediatrics, Benue State University Teaching Hospital, Makurdi, Nigeria.
[8]
Joseph A. Anejo-Okopi , AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria.
[9]
Oche O. Agbaji , Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
[10]
Prosper Okonkwo , AIDS Prevention Initiative in Nigeria (APIN) LLC, Abuja, Nigeria.
Background: Human Immunodeficiency Virus (HIV) and Hepatitis C virus (HCV) share similar modes of transmission and hence co-exist in the same host at significantly high rates. The effect of HIV infection on progression of HCV infection in adults is well established. HCV infection also increases the toxicity to antiretroviral medications. Co-infection with HCV may lead to rapid progression of HIV disease. This study aimed to determine the rate of co-infection with hepatitis C in HIV-infected children in Jos, Nigeria and compare the baseline laboratory parameters of mono and co-infected patients. Methods: We reviewed the clinical records of three hundred and sixty-two treatment-naïve children aged 18 months to 15 years confirmed HIV positive with Western blot enrolled at AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic at Jos University Teaching Hospital (JUTH), Jos, Nigeria between January 2008 and December 2012. Their HCV antibody test, CD4+T count for children ≥5years, CD4+T % generated by automated method for children <5years, viral load and alanine transaminase (ALT) results were analysed. Results: Three hundred and forty-four (95.0) were mono-infected with HIV while 18 (5.0) were co-infected with HIV and HCV. The median viral load was 4.6 log copies/ml for mono-infected compared to 4.8 log copies/ml for HIV/HCV (P = .09). The median CD4+T count was 366 cells/µl for mono-infected compared to 359 cells/µl for HIV/HCV (P = .82). The median CD4+T % was 19% for mono-infected compared to 20% for HIV/HCV (P = .43). The median ALT level was 23 IU/L for mono-infected compared to 28 IU/L for HIV/HCV (P = .12). Sixty-seven (18.5%) children had elevated ALT (>41IU/L) but there was no difference between the 2 groups: HIV mono-infection 18.3%, HIV and HCV co-infection 22.2% (P = .51). Conclusion: Five percent of HIV-infected children in this cohort were co-infected with hepatitis C; however more severe HIV disease and increased liver enzymes were not observed. Early detection is however necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HCV.
HIV, Hepatitis C, Co-Infection, CD4+T, Viral Load, Alanine Transaminase, Nigeria
[1]
WHO Report: Fighting disease, fostering development. Geneva: World Health Organization; 1996.
[2]
Sadoh AE, Sadoh WE, Iduoriyekemwen N J. HIV co-infection with hepatitis B and C viruses among Nigerian children in an antiretroviral treatment programme. SAJCH. 2011; 5(1):7-10.
[3]
Ogboghodo BC, Aigbirior MR, Bazuaye GN, Ebomoyi MI, Iyave VI. Human immunodeficiency virus-1 coinfection in children in Benin City. African Journal of Biomedical Research. 2009; 12: 1-6.
[4]
R. Chakraborty, G. Rees, D. Bourboulia et al., “Viral coinfections among African children infected with human immunodeficiency virus type 1,” Clinical Infectious Diseases. 2003; 36: 922–924.
[5]
Telatela SP, Matee MI, Munubhi EK. Seroprevalence of hepatitis B and C viral coinfections among children infected with human immunodeficiency virus attending the paediatric HIV care and treatment center at Muhimbili National Hospital in Dar-es- Salaam, Tanzania. BMC Public Health. 2007; 7: 338-343.
[6]
Feld JJ, Ocama P, Ronald A. The liver in HIV in Africa. Antivir Ther. 2005; 10: 953-965.
[7]
Pol S, Soriano V. Management of chronic hepatitis C virus infection in HIV-infected patients. Clin Infect Dis. 2008; 47: 94-101.
[8]
Benhamou Y, Bochet M, Di Martino V, Charlotte F, Azria F, Coutellier A, Vidaud M, Bricaire F, Opolon P, Katlama C, Poynard T. Liver fibrosis progression in human immunodeficiency virus and hepatitis C coinfected patients. Hepatology. 1999; 30: 1054-1058.
[9]
Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001; 345: 41-52.
[10]
Greub G. Clinical progression, survival, and immune recovery during antiretroviral therapy in patients with HIV-1 and hepatitis C virus coinfection: the Swiss HIV Cohort Study. Lancet. 2000; 356: 1800-1805.
[11]
Soriano V, Sulkowski M, Bergin C, Hatzakis A, Cacoub P, Katlama C, Cargnel A, Mauss S, Dieterich D, Moreno S, Ferrari C, Poynard T, Rockstroh J. Care of patients with chronic hepatitis C and HIV coinfection: recommendations from the HIV-HCV international panel. AIDS. 2002; 16: 813-828.
[12]
Ladep NG, Agaba PA, Agbaji O, Muazu A, Ugoagwu P, Imade G et al. Rates and imparct of hepatitis on HIV infection in a large African cohort. World J Gastroenterol. 2013; 19(10): 1602–1610.
[13]
Anigilaje EA, Olutola A. Human immunodeficiency virus and hepatitis C virus co-infection among children in an antiretroviral therapy programme in Benue, Nigeria. The Internet Journal of Infectious Diseases. 2013 Volume 12 Number 1.
[14]
Schuval S, Van Dyke RB, Lindsey JC, Palumbo P, Mofenson LM et al: Hepatitis C Prevalence in Children With Perinatal Human Immunodeficiency Virus Infection Enrolled in a Long-term Follow-up Protocol. Arch Pediatr Adolesc Med. 2004; 158:1007-1013.
[15]
Toussi SS, Abadi J, Rosenberg M, Levanon D: Prevalence of Hepatitis B and C Virus Infections in Children Infected with HIV. Clin Inf Dis. 2007; 45:795-798.
[16]
Rouet F, Chaix M, Inwoley A et al: Frequent occurrence of chronic Hepatitis B virus infection among West African HIV type-1 infected children. Clin Infect Dis. 2008; 46:361-366.
[17]
Zhou S, Zhao Y, He Y et al., “Hepatitis B and hepatitis C seroprevalence in children receiving antiretroviral therapy for human immunodeficiency virus-1 infection in China, 2005-2009,” Journal of Acquired Immune Deficiency Syndromes. 2010; 54: 191–196.
[18]
Sadoh AE, Sadoh WE, Iduoriyekemwen NJ. Some laboratory features of HIV infected Nigerian children co-infected with hepatitis B and C. Annales of Biomedical Sciences. 2012; 11: 29-39.
[19]
Resti M, Jara P, Hierro L et al. Clinical features and progression of perinatally acquired hepatitis C infection. J Med Virol 2003; 70(3): 373–377.
[20]
Kage M, Fujisawa T, Shiraki K et al. Pathology of chronic hepatitis C in children. Hepatology 1997; 26(3): 771–775.
[21]
Casiraghi MA, De Paschale M, Romanao L et al. Long term Outcome (35 years) of hepatitis C after acquisition of infection through mini transfusions of blood given at birth. Hepatology 2004; 39(1): 90–96.
[22]
Mohan P, Colvin C, Glymph C et al. Clinical spectrum and histopathologic features of chronic hepatitis C infection in children. J Pediatr 2007; 150(2): 168–174.
[23]
Sulkowski MS. Management of hepatic complications in HIV infected persons. J Infect Dis. 2008; 3: 279–93.
[24]
Labarga P, Vispo E, Barreiro P, et al: Rate and predictors of success in the retreatment of chronic hepatitis C virus in HIV/hepatitis C Virus coinfected patients with prior non-response or relapse. J Acquir Immune Defic Syndr. 2010; 53: 364–368.
[25]
Turkova A, Thorne C, Galli L et al. HCV treatment in children and young adults with HIV/HCV co-infection in Europe. 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. Kuala Lumpur, June 30-July 3, 2013. Abstract. Abstract WEPE484.
