amfAR, The Foundation for AIDS Research

Screening For Hepatitis Can Improve HIV Care

hepatitis-asian.jpgPhoto: Kevin Tachman An estimated 6–10 million of the 34 million people living with HIV (PLHIV) are co-infected with the hepatitis B (HBV) and/or hepatitis C (HCV) viruses.1 With access to antiretroviral therapy (ART), PLHIV are able to successfully control their HIV infection. However, a recently published study in Nigeria demonstrated how viral hepatitis can complicate HIV treatment. These findings are particularly relevant in the Asian context, where hepatitis rates are high and co-infection rates are increasing as the HIV epidemic grows across the region.

In the study, screening tests for hepatitis were conducted on 19,408 PLHIV in Nigeria between 2004 and 2010: 17.8 percent were co-infected with HBV, 11.3 percent with HCV, and 2.5 percent with both. More individuals with HBV (55.4 percent) or HBV+HCV co-infection (56.7 percent) had weakened immune systems at the beginning of the study, defined as having a CD4 cell count below 200 cells/mm3, compared to those who had HCV co-infection (52.5 percent) or HIV alone (48.6 percent).

A sub-group of 3,205 PLHIV began ART during the study and then remained on it for a median duration of 4.4 years. HBV co-infected individuals had an increase of 144 cells/mm3 in their CD4 levels during treatment and HBV+HCV co-infected individuals had an increase of 105 cells/mm3. These increases were significantly lower than individuals with HCV co-infection and HIV infection alone (both >150 cell/mm3).