Seroprevalence and biochemical features of hepatitis B surface antigenemia in patients with HIV-1 infection in Lagos, Nigeria

Abstract

Studies have confirmed HBsAg antigenemia as an important correlate ol HIV-1 infections in Nigeria. However, the hepatic pathophysiology and therapeutic implications in antiretroviral regimens are poorly understood. In this study, fifty-four HIV-1 seropositive patients aged 16-4 7 years (mean age 31.8 years) with CD4 T lymphocyte counts of 148 - 420 cells/mm' attending clinics in General Hospital. Ikeja and private medical centres in Lagos Island, Ni geria and forty sex and age-matched apparently healthy controls were serologically examined as carriers of hepati tis B surface antigen (HBsAg) using a particle agglutina tion assay procedure (Sensitivity 94.5 - 100%,Serodia®HBs.PA. Fujirebio. Inc.). HBsAgwas detected in 28 (51.9%) and 5 (12.5%) of the patients and controls respectively (- 2 Mantel-I laenszel = 13.8; P = 0.02). HBV co-infection was found to result in significant (P < 0.05) reduction in total lymphocyte count (1368.6 + 53.2 vs. 1590.5 + 80.4 cells/ mm') with 7 of 10 (70%), 18 of33 (54.5%) and 3 o f 6 (50%) 11IV-1 patients having < 200, 200 - 350 and > 350 CD4 lymphocyte cells/fil and eliciting HBsAg antigenemia. These patients exhibited 2.9 - 8.6% reduction in CD4 T lymphocyte counts compared to their seronegative coun terparts. Although the liver function parameters measured in HIV-1 patients tested were higher than control values, significantly (P < 0.05) elevated liver enzymes: sGOT(44.1 ±2.2 vs. 26.2+ 2.1 !U/L),sGPT (46.2+ 2.4 vs. 23.5 + 1.8 IIJ/ L), and serum bilirubin levels (2.04 + 0.18 vs. 1.0 + 0.07 mg/ dL) were observed in 11 BsAg positive HIV-1 patients. sGOT or sGPT activity that was five times greater than the con trol was observed in 7(25%) and 2 (7.7%) of HbsAg positive and negative HIV-1 patients in whom significant association between decreased total lymphocyte count and measured liver parameters was found. We conclude that hepatitis infection deteriorates liver functions and its investigation in HIV-1 infected patients may be of clino-thera peutic importance prior to antiretroviral therapy administration