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Impact of Single and Concomitant HBV and HIV Infections on Alanine aminotransferase and Bilirubin in Benue State

This study was to determine the impact of single and concomitant HBV/HIV infections on alanine aminotransferase and bilirubin as well as the impact of Highly Active Antiretroviral Therapy ( HAART) on the natural history of HBV in HIV infected individuals. Cross sectional study was carried out in three senatorial districts of Benue State, Nigeria, between April and July, 2013. A total of 219 blood samples were collected randomly from volunteered consented participants and analyzed for HBV markers (HBsAg, HBsAb, HBcAb and HBeAg) using Enzyme Linked Immunosorbent Assay (ELISA). Serum alanine aminotransferase (ALT), direct bilirubin and total bilirubin levels were quantified. Categorical variables were compared using chi square test while Univariate analysis of variance (UNIANOVA) was used to compare numerical variables in groups. Thirty (13.7%) had HBV current infection with 10.0% (3/30) carrying antigens of infectivity (HBeAg). HBsAg was lowest among HIV positive individuals on HAART (3.2%) but was highest among HIV negative subjects (16.9%). Univariate multiple comparisons shows that concomitant HBV-HIV infected individuals significantly had higher ALT compared with HIV mono-infection (P=0.00), HBV mono-infection (P=0.01), HIV positive individuals on HAART (P=0.01) and the control subjects (P=0.00). Direct bilirubin significantly had higher elevation among individuals with HBV mono-infection compared with HIV positive individuals on HAART (P=0.03) and non HAART (P=0.01). There was no individual with severe or life threatening serum elevation of ALT but one case of HBV infected male with severe elevation of total bilirubin was recorded. Hence, HBV-HIV concomitant infection significantly impact serum ALT elevation and HAART is of positive predictive impact on the history of HBV among HIV positive individuals.