Prevalence and Laboratory Profile of Hepatitis B Virus Co-infected Nigerian Children with Human Immunodeficiency Virus
E. U. Ejeliogu *
Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
S. Oguche
Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
A. O. Ebonyi
Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
E. S. Okpe
Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
E. S. Yiltok
Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
M. O. Ochoga
Department of Paediatrics, Benue State University Teaching Hospital, Makurdi, Nigeria.
J. A. Anejo-Okopi
AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria.
O. O. Agbaji
Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
J. A. Idoko
National Agency for the Control of AIDS (NACA), Abuja, Nigeria.
P. Okonkwo
AIDS Prevention Initiative in Nigeria (APIN) LLC, Abuja, Nigeria.
P. Kanki
Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA.
*Author to whom correspondence should be addressed.
Abstract
Abstracts
Aims: To determine the prevalence of HBV co-infection in HIV-infected children and compare the baseline laboratory profile of mono-infected and co-infected patients.
Study Design: This was a retrospective cohort study.
Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic of Jos University Teaching Hospital, Jos, Nigeria between January 2008 and December 2012.
Methodology: We reviewed the clinical records of 452 treatment-naïve children aged 2 months to 15 years confirmed to be HIV positive with Polymerase Chain Reaction (PCR) for children <18 months or Western blot for children ≥18 months. The baseline laboratory tests included: HBsAg, plasma viral load and alanine transaminase (ALT), CD4+T cell count for children ≥5years or CD4+T cell % for children <5years.
Results: Three hundred and ninety-four (87.2%) were mono-infected with HIV while 58 (12.8%) were co-infected with HIV and HBV (HIV/HBV). At baseline, the median viral load was 4.6 log copies/mL for mono-infected compared to 4.7 log copies/mL for HIV/HBV (P=.48). The median CD4+T cell count was 366 cells/µL for mono-infected compared to 332 cells/µL for HIV/HBV (P=.64). The median CD4+T cell % was 19% for mono-infected compared to 17% for HIV/HBV (P =.29). The median ALT level for the whole cohort was 23 IU/L for mono-infected compared to 26 IU/L for HIV/HBV (P=.15). However the median ALT level for mono-infected children aged 11-15 years was 28IU/L compared to 43 IU/L for co-infected children of same age (P =.008).
Conclusion: A high rate of hepatitis B co-infection was observed in HIV-infected children at our centre; however more severe HIV disease was not observed. Older children co-infected with HBV had significantly higher ALT levels compared to their mono-infected counterparts. Early detection is therefore necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HBV.
Keywords: HIV, hepatitis B, co-infection, CD4 T, viral load, alanine transaminase, Nigeria