Impact of Hepatitis B and C Virus Infections on the Prognosis of Human Immunodeficiency Virus–Positive Patients Taking Antiretroviral Drugs: A Prospective Cohort Study at the Dormaa Presbyterian Hospital in the Bono Region of Ghana

Abstract

Liver complications in human immunodeficiency virus (HIV) patients coinfected with hepatitis B and C viruses (HBV and HCV) have increased. Also, HBV and/or HCV coinfection influences the outcome of antiretroviral therapy (ART). This study determined the impact of HBV and HCV infection on the prognosis of HIV patients on ART. In this prospective cohort study, 100 ART‐naive HIV patients were recruited. Questionnaires were administered to collect sociodemographic data. Venous blood was collected to screen for HBsAg and anti‐HCV IgM antibodies. Also, haematological and liver function parameters, as well as the HIV load, were assessed before ART initiation. The patients were monitored for 6 months after ART initiation. The overall prevalence of viral hepatitis was 22%, with 11%, 9% and 2% coinfected with HBV, HCV and HBV‐HCV. No significant changes in haematological parameters were observed among patients over the 6 months, except in the HIV‐HCV coinfected patients, whose platelet count significantly declined, and the HIV‐HBV and HIV‐HBV‐HCV coinfected patients, whose WBC count significantly increased. The AST and ALT levels of the HIV‐HBV and HIV‐HCV coinfected patients, and ALT levels for the HIV‐HBV‐HCV coinfected patients, significantly increased after 6 months. The HIV load among patients decreased significantly after 6 months post‐ART initiation. However, the HIV load in coinfected patients was higher than in HIV mono‐infected patients at baseline through the 6 months. In conclusion, ART efficacy was influenced by HBV and/or HCV coinfection. Moreover, liver transaminases significantly increased in the HIV patients with coinfection. The findings bolster the implications of HBV and/or HCV coinfection on ART and liver function. It is recommended that HIV patients be screened for HBV and HCV infection before initiating therapy to ensure better disease management. Furthermore, studies involving larger cohorts are advised to inform policy on viral hepatitis screening among HIV patients in Ghana.