Long term highly active antiretroviral therapy outcomes in hiv infected nigerians and those co-infected with hepatitis b and c

Authors:*Okwuraiwe A.P., Audu R.A., Ige F.T., Salu, O.B., Musa, A.Z. and Ezechi, O.C.
Int J Biol Med Res. 2021; 12(2): 7272-7275  |  PDF File

Abstract

Aims: HIV co-infected with hepatitis B and/or C virus is common largely due to shared routes of transmission. A paucity of data exists for long term treatment outcomes of HIV infected patients, and those co-infected with hepatitis B and C (HBV, HCV) despite the high burden in Nigeria. The aim of the study was to describe treatment outcomes of long-term HIV, and assess the effect of hepatitis B and C co-infection on a long-term response to antiretroviral therapy (ART) in HIV infected Nigerians. Methods: A cohort study of HIV infected adults consecutively initiating ART between July 2004 and December 2007, followed up for 7 years (2011-2014). HBV and HCV infection was diagnosed by hepatitis B surface antigen (HBsAg), and antibody detection (HCVAb). HIV viral load and CD4 were monitored 3-monthly, after initiating ART. Treatment outcome comparisons were made between HIV mono-infected and HIV co-infected with hepatitis B, hepatitis C and both. Results: A total of 2,801 adults were included (median age: 35.5 years; 64.2% female), of whom 197 (7.03%) were co-infected with HBV and 53 (1.89%) with HCV. During the 7-year follow up, 369 (13.17%) individuals were lost-to-follow-up. Immune reconstitution measured by CD4 recovery was lower in both HBV and HCV co-infection but was not statistically significant (p ≤ 0.05). The median baseline HIV viral load was 4.63 log copies/ml for all groups which decreased to undetected at a median time of 6 months and remained so for the study duration. Conclusion: Significant clinical, but no immunological and virological difference was found in ART treatment outcomes between HIV patients and those co-infected with HBV and HCV, after 7 years of follow-up. In other words, hepatitis B and C co-infection do not affect treatment if eligible patients are placed on ART regimes that are potent against HIV.