Author(s): Iwalokun BA, Hodonu SO, Olaleye BM, Olabisi OA, Iwalokun BA, Hodonu SO, Olaleye BM, Olabisi OA
Abstract Share this page
Abstract Studies have confirmed HBsAg antigenemia as an important correlate of HIV-1 infections in Nigeria. However, the hepatic pathophysiology and therapeutic implications in antiretroviral regimens are poorly understood. In this study, fifty-four HIV-1 seropositive patients aged 16-47 years (mean age 31.8 years) with CD4 T lymphocyte counts of 148-420 cells/mm3 attending clinics in General Hospital, Ikeja and private medical centres in Lagos Island, Nigeria and forty sex and age-matched apparently healthy controls were serologically examined as carriers of hepatitis B surface antigen (HBsAg) using a particle agglutination assay procedure (Sensitivity 94.5 - 100\%, Serodia-HBs.PA, Fujirebio, Inc.). HBsAg was detected in 28 (51.9\%) and 5 (12.5\%) of the patients and controls respectively ( 2 Mantel-Haenszel = 13.8; P = 0.02). HBV co-infection was found to result in significant (P < 0.05) reduction in total lymphocyte count (1368.6 +/- 53.2 vs. 1590.5 +/- 80.4 cells/ mm3) with 7 of 10 (70\%), 18 of 33 (54.5\%) and 3 of 6 (50\%) HIV-1 patients having < 200, 200 - 350 and > 350 CD4 lymphocyte cells/microl and eliciting HBsAg antigenemia. These patients exhibited 2.9 - 8.6\% reduction in CD4 T lymphocyte counts compared to their seronegative counterparts. Although the liver function parameters measured in HIV-1 patients tested were higher than control values, significantly (P < 0.05) elevated liver enzymes: sGOT (44.1 +/- 2.2 vs. 26.2 +/- 2.1 IU/L), sGPT (46.2 +/- 2.4 vs. 23.5 +/- 1.8 IU/ L), and serum bilirubin levels (2.04 +/- 0.18 vs. 1.0 +/- 0.07 mg/ dL) were observed in HBsAg positive HIV-1 patients. sGOT or sGPT activity that was five times greater than the control was observed in 7(25\%) and 2 (7.7\%) of HbsAg positive and negative HIV-1 patients in whom significant association between decreased total lymphocyte count and measured liver parameters was found. We conclude that hepatitis infection deteriorates liver functions and its investigation in HIV-1 infected patients may be of clino-therapeutic importance prior to antiretroviral therapy administration.
This article was published in Afr J Med Med Sci
and referenced in Journal of AIDS & Clinical Research