HBV co-infection in HIV infected patients and its effect on progress of the disease

Introduction: Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a common event due to similar routes of transmission, with significant clinical implications. Progression to liver disease is more rapid in HIV-HBV co-infected patients. The present study was designed to find the sero-prevalence of HBV in newly diagnosed HIV positive patients. Materials and Methods: 200 newly diagnosed HIV positive cases were enrolled in present study. 3-5 cc blood was collected from these patients and HBsAg ELISA was carried out on serum obtained. HBsAg positive samples were processed further to detect HBeAg and anti-HBeAg by ELISA. Liver Function Tests (LFTs) and CD4 T cell count were noted. Results: Out of 200 HIV positive patients, 4% were co-infected with HBV. Out of the 4% co-infected cases 37.5% were HBeAg positive and 62.5% were anti-HBe positive None of the HIV-HBV co-infected case had a CD4 T-cell count >500 cells/µL whereas 55.2% of HIV mono-infected cases had CD4 T-cell counts > 500 cells/µL. 37.5% HIV-HBV co-infected cases had CD4 T-cell count ≤200 cells/µL whereas only 11.4% HIV mono-infected cases had CD4 T-cell count ≤200 cells/µL.HIV-HBV co-infected cases had more deranged liver enzymes. 50% of HIV-HBV co-infected cases belonged to WHO stage II, whereas majority (91.6%) of HIV mono-infected cases belonged to WHO stage I. Conclusion: This study highlights that, routine screening of HBsAg should done in all HIV infected patients and virological markers of HBV, Liver Function Tests and CD4 T cell count of HIV-HBV co-infected patients should be assessed for appropriate management.