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Comparative evaluation of baseline characteristics of HIV mono infected and HIV/HBV co infected cohort in eastern India
BMC Infectious Diseasesvolume 14, Article number: P14 (2014)
India has the third largest estimated number of HIV infected people and 40 million individuals in India are estimated to be Hepatitis B virus infected. In comparison to HBV mono-infection, the course of chronic HBV infection is more accelerated in HIV/HBV co-infected subjects. We analyzed the baseline characteristics of the HIV/HBV co-infected and HIV mono-infected patients.
Between July 2011 and January 2013, a total number of 1331 HIV-seropositive treatment naïve individuals, enrolled in the ART Centre of Calcutta School of Tropical Medicine were screened for HBsAg. A number of 1253 HIV mono-infected and 78 HIV/HBV co-infected patients were characterized. The co-infected patients were evaluated for HBeAg and anti HBe antibody by ELISA. HBV DNA was detected by nested PCR amplification followed by HBV genotype determination.
The median age (35 years) was similar in HIV mono-infected and HIV/HBV co-infected group. The proportion of advanced HIV disease (WHO clinical stage III & IV) was more in HIV/HBV co-infected patients (37.1% vs. 19.9%) than HIV mono-infected subjects. The co-infected subjects had significantly higher serum bilirubin, ALT, alkaline phosphatase, creatinine and ALT/platelet ratio index. CD4 count was non significantly lower in co-infected patients. Majority (61.5%) were HBeAg reactive with higher HBV DNA (p=0.0001) and APRI (p=0.04) as compared to HBeAg negative (38.5%) patients. Genotype HBV/D (71.7%) was the predominant genotype followed by HBV/A (19.4%) and HBV/C (8.9%) among the co-infected patients from eastern India.
HIV/HBV co-infection warrants long term prospective study on immune recovery, HIV and HBV viral replication, and hepatotoxicity.