Abstract:
Background: The efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however,
mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV.
Objective: The study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver
disease (CLD) patients in Ethiopia.
Methods: Three hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC)
(n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic
hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV
testing algorithm was employed to screen HIV infection.
Results: Regardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/
345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were coinfected with HBV (HBsAg+HBcAb+) and HCV (anti-HCV+ HCV-RNA+), respectively, and 86.7% (13/15) exhibited a marker of
HBV exposure (total HBcAb+). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than
non-HCC patients [8.6% (11/128) vs 1.8 (4/217), p=0.005 and 3.9% (5/128) vs 0.9% (2/217), p=0.1]. The rate of HIV mono-infection
was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients.
Conclusion: The frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver
disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking
necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in
people living with HIV.
Keywords: HIV, HBV, HCV, HCC, non-AIDS liver diseases
