Hepatitis B, Hepatitis C and Tuberculosis coinfection among people living with HIV: A retrospective study from a tertiary care centre in South India
Abstract
Introduction: With improved access to Antiretroviral therapy (ART) and HIV becoming a chronic disease, coinfections such as hepatitis B, hepatitis C and tuberculosis are a major cause of morbidity and mortality among people living with HIV(PLHIV). There is paucity of data regarding prevalence of these coinfections from South India and this study was conducted with the aim to fill this gap and to study the association between age, gender and mode of transmission of HIV with acquisition of these coinfections. Materials and Methods: A retrospective study was conducted among 842 PLHIV registered in the ART clinic in a tertiary care centre in South India during the 5 year period from January 2019 to December 2023.Prevalence of hepatitis B, hepatitis C and tuberculosis among the cohort was studied; association of age, gender and mode of transmission of HIV with acquisition of these coinfections was analysed using Chi square test and Fishers exact test. Results: Of the 842 PLHIV, the prevalence of HIV/HBV, HIV/HCV and HIV/ TB coinfections were 1.1%, 0.8% and 12.8% respectively. Heterosexual route was the major mode of HIV transmission among HBV and HCV coinfected individuals. Age and mode of transmission of HIV were found to be significantly associated with HIV TB coinfection. Majority of HIV TB coinfected (71%) had CD4 T cell count <200cells/mm3. Conclusion: Since there is regional variation in the prevalence of HIV and the various coinfections, it is important to understand regional dynamics to focus on preventive measures. Our study highlights that counselling and awareness together with strengthening of HBV vaccination strategies and harm reduction interventions are the way forward in combating viral hepatitis. TB, being a major coinfection in PLHIV has to be screened at every healthcare visit and appropriate treatment initiated to reduce the mortality associated with it.