INTERPRETING LIVER FUNCTION TEST IN HIV-HBV COINFECTION

Abstract

Background: Liver diseases in HIV infected persons can occur due to hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections, chronic alcoholisms, and hepatic tuberculosis or due to hepatitis caused by antiretroviral drugs. Co infection of HIV and HBV is frequently encountered with HIV having negative impact on HBV progression.

Objectives: The objectives of this study was to detect the prevalence of hepatitis B virus in HIV positive individuals and impact of HBV- HIV on liver function tests.

Materials & Methods: - Serum of 200 patients positive for HIV were screened for HBsAg by ELISA test and LFTs were performed in first, second and third week in serum of patients co infected with HIV- HBV and HBV alone. 

Results: - Prevalence of HBV was found in 15 out of 200 HIV positives with maximum in age group 21-40yrs 60% of the cases. In HIV-HBV co-infected patients the amount of total Bilirubin, ALP and ALT was found to be considerably lower as compared to HBV infected persons only and the difference was statistically significant.

Conclusions: - From the present study it is fairly clear that the co-infection of HIV and HBV is an emerging problem that should be addressed immediately. Hepatic damage in case of co-infected patients should not be assessed only on the basis of serum liver enzyme estimation as their rise is not significant enough in these cases. Liver biopsy accompanied by liver function test provides a clearer picture of nacroinflammation. Such co-infected individuals also face increased risk of hepatotoxicity from anti-retroviral therapy. Individuals with HIV-HBV co-infection should have both the infections completely assessed in order to decide on the best therapeutic option for both viruses.