Also, we relied on diagnosis of liver diseases (hepatotoxicity, cirrhosis and primary liver cancer) on clinical notes of the patients, where available

On By msisig

Also, we relied on diagnosis of liver diseases (hepatotoxicity, cirrhosis and primary liver cancer) on clinical notes of the patients, where available. overall hepatitis screening rate of over 90% for each virus; HBV, HCV and HBV/HCV were detected in 3162 (17.8%), 1983 (11.3%) and 453 (2.5%) HIV infected adults respectively. The rate of liver disease was low, but highest among HIV mono-infected patients (29, 0.11%), followed by HBV co-infected patients (15, 0.08%). Patients with HBV co-infection and triple infection had higher log10 HIV RNA loads (HBV: 4.6 copies/mL HIV only: 4.5 copies/mL, 0.0001) and more severe immune suppression (HBV: 645, 55.4%; HBV/HCV: 97, 56.7%) prior to initiation of HAART compared to HIV mono-infected patients (1852, 48.6%) ( 0.0001). Of 3025 patients who were 4.4 years on HAART and whose CD4 cell counts results at baseline and end of follow up were available for analyses, CD4 increase was significantly lower in those with HBV co-infection (HBV: 144 cells/mm3; HBV/HCV: 105 cells/mm3) than in those with HCV co-infection (165 cells/mm3) and HIV mono-infection (150 cells/mm3) (= 0.0008). CONCLUSION: High rates of HBV and HCV infections were found in this Lepr HIV cohort. CD4 recovery was significantly diminished in patients with HBV co-infection. values of 0.05 were considered statistically significant. RESULTS Between June 2004 and December 2010, 19?408 HIV individuals were enrolled and followed for a median of 53 mo (interquartile range: 31-72 mo). Table ?Table11 presents a summary of the main characteristics of the cohort at baseline. Subjects diagnosed with HBV were more likely to LBH589 (Panobinostat) be young (median age: 32 years; 0.001), male and to have had high HIV RNA loads and CD4+ cell count below 200/mm3. HCV co-infected individuals were more likely to be males, older (median age: 36 years), have had low level of education and high HIV RNA in their plasma. Table 1 Baseline characteristics by hepatitis status of patients at Jos University Teaching Hospital, 2004-2010 (%) 0.01 human immunodeficiency virus (HIV) only; Undetect: Undetectable; Interm: Intermediate; HBV: Hepatitis B virus; HCV: Hepatitis C virus. Hepatitis screening LBH589 (Panobinostat) and prevalence of co-infections At the beginning of the study period, 99.3% and 99.5% of recruited HIV infected individuals underwent HBV and HCV screening respectively. There has been a significant decline in the rates of screening for HBV and HCV during approximately 7 year study period to 73.0% and 87.6% respectively in 2010 2010 ( 0001, Figure ?Figure2).2). Overall, the prevalence of HBsAg was 20.7%. A significant increase in the rate of HBV from 14.4% in 2004 to 21.0% in 2010 2010 was observed ( 0.001) and although, fluctuating rates of HCV Ab was recorded among those that LBH589 (Panobinostat) were screened, an increasing pattern was noted. The prevalence of HCV Ab was 10.6% in 2004, increasing to 11.7% in 2010 2010. Higher rates of HBV infection was found in men than women rising from 17% in 2004 to 25% in 2010 2010. Open in a separate window Figure 2 Rates of hepatitis co-infection of human immunodeficiency virus infected individuals in both genders (A) and men (B) among acquired immunodeficiency syndrome prevention initiative in Nigeria cohort, Jos University Teaching Hospital; 2004-2010. HBV: Hepatitis B virus; HCV: Hepatitis C virus. Overlapping diagnosis Cumulatively, 3185 (17.8%) patients were positive to HBsAg and 2014 (11.3%) patients had HCV Ab. 453 (2.5%) patients had evidence of combined HBV and HCV infections (Figure ?(Figure3).3). Liver disease was diagnosed in 50 (0.3%) patients. Of these, 15 had HBV, 6 had HCV and 29 had no evidence of hepatitis co-infection. None of those with triple infection had a diagnosis of liver disease. Diagnoses of liver disease were achieved via conventional means, including: assessment of sequential liver enzymes, liver ultrasound, and alpha fetoprotein. Open in a separate window Figure 3 Prevalence of hepatitis B, hepatitis C, hepatitis B and C and liver disease diagnoses among human immunodeficiency virus infected individuals at Jos University Teaching Hospital, 2004-2010. Impact of hepatitis co-infection on outcome of ARTs Higher proportion of HBV (645, 55.4%) and HBV/HCV (97, 56.7%) co-infected patients had CD4+ cell counts below 200 cells/mm3 at baseline compared with HCV (343, 52.5%) and HIV (1852, 48.6%) patients ( 0.0001) (Table ?(Table2).2). The median HIV RNA at baseline was Log10 4.6 copies/mL each for HBV and HCV patients; and 4.5 copies/mL for HIV mono-infected patients ( 0.0001) (Figure ?(Figure4).4). At the end of follow up.