Evaluation of glycated haemoglobin and hepatitis B antigenic markers in people living with HIV in Ilorin, north-central Nigeria

Abstract

Background: Metabolic and viral co-morbidities, particularly Hepatitis B Virus (HBV) infection and dysglycemia, are increasingly recognized among People Living with HIV (PLHIV) in sub-Saharan Africa. Antiretroviral Therapy (ART) improves survival but may alter glucose metabolism, while HBV co-infection exacerbates hepatic and metabolic complications. Aim and Objectives: To determine the prevalence of Hepatitis B surface Antigen (HBsAg) positivity and assess glycated haemoglobin (HbA1c) levels among HIV-positive patients on ART in Ilorin, North-Central Nigeria. Material and Methods: A case-control study was conducted among 150 participants (80 HIV-positive on ART, 70 HIV-negative controls). HIV status was confirmed serologically. HBV antigenic markers were identified using commercial immunoassay kits (Rapid Labs, UK). HbA1c was determined by cation-exchange chromatography. Diabetes and prediabetes were defined using ADA criteria: HbA1c ≥ 6.5% and 5.7-6.4%, respectively. Data were collected by trained laboratory scientists under faculty supervision and analyzed with SPSS v25 using t-tests and ANOVA (significance set at p < 0.05). Results: The mean HbA1c was similar between HIV/HBV co-infected, HIV-only, and control groups (p = 0.162). HIV patients on ART for < 1 year had significantly higher HbA1c (5.01 ± 0.84%) than those on ART > 1 year (4.56 ± 0.99%) (p = 0.031). The prevalence of HIV/HBV co-infection was 35%. No HIV patient met the HbA1c threshold for diabetes. Conclusion: HIV/HBV co-infection was common, while HbA1c values suggested that HbA1c may underestimate glycemia in PLHIV. Strengthening HBV screening and using glucose-based tests for glycemic monitoring are essential for improved patient management.