Human immunodeficiency virus and Hepatitis C virus co-infection in children in Jos, Nigeria

Abstract

Background: Human Immunodeficiency Virus (HIV) and Hepatitis C virus (HCV) share similar modes of transmission and hence co-exist in the same host at significantly high rates. The effect of HIV infection on progression of HCV infection in adults is well established. HCV infection also increases the toxicity to antiretroviral medications. Co-infection with HCV may lead to rapid progression of HIV disease. This study aimed to determine the rate of co-infection with hepatitis C in HIVinfected children in Jos, Nigeria and compare the baseline laboratory parameters of mono and co-infected patients. Methods: We reviewed the clinical records of three hundred and sixty-two treatment-naïve children aged 18 months to 15 years confirmed HIV positive with Western blot enrolled at AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic at Jos University Teaching Hospital (JUTH), Jos, Nigeria between January 2008 and December 2012. Their HCV antibody test, CD4+T count for children ≥5years, CD4+T % generated by automated method for children <5years, viral load and alanine transaminase (ALT) results were analysed. Results: Three hundred and forty-four (95.0) were mono-infected with HIV while 18 (5.0) were co-infected with HIV and HCV. The median viral load was 4.6 log copies/ml for mono-infected compared to 4.8 log copies/ml for HIV/HCV (P = .09). The median CD4+T count was 366 cells/μl for mono-infected compared to 359 cells/μl for HIV/HCV (P = .82). The median CD4+T % was 19% for mono-infected compared to 20% for HIV/HCV (P = .43). The median ALT level was 23 IU/L for mono-infected compared to 28 IU/L for HIV/HCV (P = .12). Sixty-seven (18.5%) children had elevated ALT (>41IU/L) but there was no difference between the 2 groups: HIV mono-infection 18.3%, HIV and HCV co-infection 22.2% (P = .51). Conclusion: Five percent of HIV-infected children in this cohort were co-infected with hepatitis C; however more severe HIV disease and increased liver enzymes were not observed. Early detection is however necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HCV.