Evaluation of Biochemical indices among HIV Positive Patients with Hepatitis B and C Co-infection

Abstract

Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are blood borne pathogens that have become global threats.  Co-infection with hepatitis B or C among HIV positive patients has further exposed the patients to liver infections and osmotic imbalance which if not properly handled can lead to death. This study was aimed at investigating the effect of HBV and HCV on the biochemical indices (AST, ALT and electrolytes) among HIV positive patients from the three geopolitical zones in Rivers State.  A total of three hundred and fifteen (375) persons comprising of two hundred and fifty (250) HIV positive patients from the antiretroviral (ART) clinic and one hundred and twenty-five (125) HIV negative controls from medical out-patient department (MOPD) participated in this study. Patients of both sexes and within the age bracket of (10-69) years were included, socio-demographic information was collected by the use of consent forms and questionnaires. Five millilitres (5mls) of blood sample was aseptically drawn from each participant following vein puncture and dispensed aseptically into plain and lithium heparin bottles respectively for the HBV/HCV screening, AST, ALT and electrolytes estimations. The study population comprised of 151 (40.3%) males and 224 (59.7%) females.  Comparing the biochemical indices of the participants, the liver enzymes were found to be higher (p <0.05) in the HBV, HCV, HBV/HCV co-infected and HIV mono-infected when compared with the HIV-negative controls for AST (IU/L) (16.15±2.30, 15.88±2.64, 18.33±0.58, 16.81±6.41, 3.57±1.07), ALT (IU/L) 14.57±2.73, 14.75±3.19, 19.33±4.04, 15.10±3.38, 3.88±3.17). This work showed significant increase for some electrolytes when the HBV, HCV, and HBV/HCV co-infected patients were compared with the HIV-mono-infected and the control individuals ((p <0.05)), potassium (mmol/l) (3.63±0.65, 3.91±3.67, 3.44±0.66), biocarbonate (mmol/l) (13.19±6.71. 16.52±8.17, 23.57±4.68) and chloride (mmol/l) (92.92±8.93, 96.67±17.36, 98.47±8.28). A constant increase in the levels of these enzymes or electrolytes can adversely affect the liver and kidney of these HIV patients with either HBV or HCV infections respectively.

Keywords: Antiretroviral, Co-infection, Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus