INCIDENCE OF HEPATITIS B AND HIV COINFECTION AMONG PATIENTS ATTENDING MALAM AMINU KANO TEACHING HOSPITAL

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Product Code: 00005988

No of Pages: 31

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ABSTRACT

Infections from HIV, Hepatitis B virus constitute a major public health challenge in sub-Saharan Africa, and there are evidences to suggest that there is faster progression of HIV in those co-infected with either HBV. this study was to determine the incidence of HBV infections among HIV-infected patients, and describe the socio-demographic features and correlates of HIV and HBV co-infected patients at Malam aminu kano teaching hospital. One hundred and fifty eight (158) HIV individuals who consented to the study were tested for HBV using Diaspot HBsAg kit (Screening test) and Biorex Diagnostic ELISA kit (Confirmatory test) between November 2019 and April, 2021. CD4 counts were also analysed with Aldrich Sigma kit and flow cytometery respectively. Incidence  rates of Hepatitis B infections among HIV obtained were 5.7%. Individuals who were 51 years or younger were the most affected HBV co-infection was more common among females than males (3.8%: 1.8%, res, P = 0.0004). Out of 9 patients, 8 patients (88.9%) fell within the age range 30-49 years which implies the high incidence  of HIV among labour force while 1 patient (11.1%) fell within the range of 50-60 years .Mean serum ALT and AST among participants with HIV alone were (42.0, 38.3) International Units (IU), but were significantly higher (57.6, 43.7) International Units (IU) for those with HIV/HBV co-infection, P = (0.048, 0.032).Mean CD 4 count for HIV/HBV co-infected participants (389 cell/mm 3) was significantly higher than that for participants with HIV alone (230 cell/mm 3), P = 0.024 Conclusion: Co-infection with hepatitis B virus is common among HIV-infected patients in our setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy. Furthermore, those found to be negative should be immunized with HBV vaccine to improve the prognosis of their HIV status.

 

 



TABLE OF CONTENT

DECLARATION………………………………………………………………………..……II

CERTIFICATION………………………………………….…………………………..…….III

APPROVAL PAGE………………………………………………………………….………..IV

DEDICATION……………………………………………………………..…………….……V

ACKNOWLEDGEMENT……………………………………………….……………..……..VI

TABLE OF CONTENT……………………………………………………………….……...VII

ABSTRACT………………………………………………………………………..…….......VIII

                                                           


CHAPTER ONE

1.0 INTRODUCTION                                                                             1

1.1 BACKGROUND                                                       2

1.2 STATEMENT OF PROBLEM                          3

1.3 AIM AND OBJECTIVES                                 3


CHAPTER TWO

2.0 LITERATURE REVIEW                                              4

2.1 HIV AND AIDS                                                              4

2.1.1 THE STRUCTURE OF HIV                                       4

2.1.2.1 ENTRY OF VIRAL PARTICLE                                         5

2.2 CLASSIFICATION OF HEPATITIS B VIRUS                                  5

2.2.1 HEPATITIS B ANTIGENS                                             6

2.2.2 LIFE CYCLE OF HEPATITIS B VIRUS                     7

2.3 SYMPTOMS OF HBV                                                                   9

2.4 TRANSMISSION OF HBV                                              9

2.5 RISKS GROUPS OF HIV AND HBV COINFECTION                10

2.6  DIAGNOSIS OF HEPATITIS  B                          11

2.7 TREATMENT OF HBV IN SETTING OF HIV                          11

 

CHAPTER THREE

3.0 METHODOLOGY                                                               12

3.1 STUDY AREA                                                               12

3.2 STUDY POPULATION                                                       12

3.3 STUDY DESIGN                                                         12

3.4 SAMPLE SIZE                                                      12

3.7 DATA COLLECTION                                                    13

3.8 DATA ANALYSIS                                                       13


CHAPTER FOUR

4.0 RESULTS                                                                        14

4.1 DEMOGRAPHIC DATA                                                      14


CHAPTER FIVE

5.0 SUMMARY, CONCLUSION AND RECOMMENDATIONS             17

5.1 SUMMARY                                                         17

5.2  CONCLUSION                                                                          19

5.3 RECOMMENDATIONS                                                          19

REFERENCES

 

 

 

 

 

 

 

CHAPTER ONE

1.0 INTRODUCTION

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are 240 million HBV carriers in the world, of who roughly 600,000 die annually from HBV-related liver disease (Zuckerman, 2004). The implementation of effective vaccination programs in many countries has resulted in a significant decrease in the incidence of acute hepatitis B. Nevertheless, hepatitis B remains an important cause of morbidity and mortality (CDC, 2001). The pathogenesis and clinical manifestations of hepatitis B are due to the interaction of the virus and the host immune system, which lead to liver injury and, potentially, cirrhosis and hepatocellular carcinoma (Chisariet al., 2002 write all author name). Patients can have either an acute symptomatic disease or an asymptomatic disease. Icteric hepatitis is associated with a prodromal period, during which a serum sickness–like syndrome can occur (Hollinger et al., 2001). The symptomatology is more constitutional and includes; anorexia, nausea, vomiting, low-grade fever, myalgia, fatigability, disordered gustatory acuity and smell sensations (aversion to food and cigarettes), right upper quadrant and epigastric pain (intermittent, mild to moderate). Patients with fulminant and subfulminant hepatitis may present with; hepatic encephalopathy, somnolence, disturbances in sleep pattern, mental confusion, coma, ascites, gastrointestinal bleeding, coagulopathy (Hollinger et al., 2001). Patients with chronic hepatitis B infection can be immune tolerant or have an inactive chronic infection without any evidence of active disease, and they are also asymptomatic. Patients with chronic active hepatitis, especially during the replicative state, may have symptoms similar to those of acute hepatitis (Janssen et al., 2000).

1.1 BACKGROUND OF THE STUDY

Early Mesopotamian civilizations thought that the liver was the basis of life. They were therefore familiar with liver disease and jaundice, the yellow discolouring of the skin and eyes that is a common symptom of hepatitis B infection. By 1885, it was known that hepatitis could be transmitted by syringes and blood transfusions. By 1947, the terms hepatitis A and hepatitis B had been coined by McCollum to distinguish among a number of outbreaks in the late 1930's. Between the late 1950's and 1970's, Murray had demonstrated that hepatitis disease could be transmitted orally. Research on the family precipitated rapidly in 1963, when Baruch Blumberg, then at the National Institutes of Health and currently at the Fox Chase Cancer Center, was examining thousands of blood samples in search of inherited polymorphisms among different parts of the world. He utilized sera from multiply transfused hemophiliacs, reasoning that such sera would contain genetically polymorphic antibodies. During this investigation, blumberg discovered that a sample from an Australian aborigine contained an antigen, which he later called Australia Antigen and is now called the Hepatitis B surface antigen, which reacted with an antibody in the serum from a hemophiliac subject. By 1968, Prince and Okochi had determined that the Australia antigen was found exclusively in the hepatitis B patients. The characterization of the Hepatitis B surface antigen was a milestone in research because it allowed further study despite inability to isolate the virus. By 1970, Dane et al;. had detected a complete virus particle and in 1981, the first vaccine against hepatitis B called Heptavax was licenced. Hepatitis B is a worldwide healthcare problem, especially in developing areas.


1.2 STATEMENT OF PROBLEM

Immuno suppression brought as a result of Hepatitis B, the infection makes a patient more prone to other infections like higher fiver which can lead to the development of cirrhosis and hepatocellular carcinoma in chronic carrier. Thus diagnosing and treating hepatitis B infections amongst individuals is absolutely important as it will go a long way to reduce the development of cirrhosis and hepatocellular carcinoma.


1.3 AIM AND OBJECTIVES

1.3.1 Aim

1. To determine the incidence of Hepatitis B and HIV coinfection among patients attending the Malam Aminu Kano Teaching Hospital.


1.3.2 The Objective

1. To determine the incidence of Hepatitis B and HIV coinfection among patients attending the Malam Aminu Kano Teaching Hospital based on age group.

2. To determine the the incidence of Hepatitis B and HIV coinfection classified based on sex of the patients

3. To compose the the incidence of Hepatitis B and HIV coinfection amongst patients attending the Malam Aminu Kano Teaching Hospital.



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