ABSTRACT
Aim: One third of HIV patients are co- infected with HCV. As HIV patients live longer this coinfection and its complications such as liver cirrhosis, hepatic carcinoma, metabolic syndrome are emerging as major manifestations of the disease that need to be dealt with promptly in order to avoid a reduction of the positive effects of highly active antiretroviral therapy (HAART) on HIV/AIDS introduced in 1996. Another system that could be affected by co-infection is the skeletal system. It has been shown that HIV itself and in combination with HCV could lead to a reduction in bone mineral density (BMD) predisposing to pathological fractures. It is thus important to determine the state of calcium metabolism among our HIV/HCV patients in order to forestall negative impacts on our patients who have been stable on HAART for several years. The majority of our patients are on combination therapy of Zidovudine, Lamivudine and Nevirapine. The hepatic complications of HIV/HCV co-infection have been well established. In our previous studies signs of hepatic inflammation have been demonstrated by raised aspartate transaminase (AST) and alanine transaminase (ALT) levels. However in this study we wish to also demonstrate liver damage through estimation of bilirubin levels. Methodology: Antibodies to HIV were determines using Unigold and determine. immunochromatographic device was used to detect anti-HCV. Total bilirubin and calcium were analyzed using vitros DT-60 card reader. Results: The majority of our patients were female. In group I up to %80. There was a statistically significant elevation of total bilirubin levels in HIV/HCV co-infected patients when compared to HIV mono-infected patients. There were statistically significant changes in calcium levels between the groups Conclusion: Information on HIV/HCV co-infection and its effects on calcium metabolism in this clinical instance appears to be scarce. Intensification of research is required to firmly establish the role of HIV/HCV co-infection on calcium metabolism in our clinical instance.
ABSTRACT
Introduction: It is becoming clear that a major complication of HIV patients on HAART is coinfection with hepatitis C and its attendant sequalae such as liver cirrhosis and carcinoma. The aim is to determine the prevalence of anaemia, transaminitis in these co-infected patients. Materials and Methods: Three groups of patients were studied. There were a total of 44 male and 106 females included in the study. No children were among. Those co-infected with both HIV and HCV (group I), HIV only (group II) and negative for both viruses (Group III). Each group consists of 50 patients each. HIV status was determined utilizing determine and Unigold to detect HIV antibodies. HCV was determined by detecting the anti-HCV antibody (IgG) using third generation ELISA kit from DIA.PRO, Italy. The haematological indices were determined using the Sysmex haematology analyser. Liver transaminases were determined from the sera of the participants using Randox kits and absolute CD4 positive lymphocyte cells were determined using Partec cyflow (SL Green). The results were statistically analysed. Results: No case of anaemia was detected. CD4 counts in group I patients (HIV /HCV positive) and group II patients were clearly reduced. The CD 4 counts were markedly reduced when compared to the controls (group III) P<0.005. The liver enzymes were markedly raised in coinfected patients. Conclusion: The major observations in our group of co-infected patients was marked transaminitis and reduced CD 4 counts in co-infected patients. It is necessary to determine HCV genotypes to explain why our patients have not presented with increased cirrhosis and hepatic carcinoma.
ABSTRACT
Aims: A commercial rapid test kit for anti-Hepatitis C Virus (anti-HCV) detection was evaluated and compared for diagnosis of hepatitis C by detection of immunoglobulin G(IgG) antibodies against a third generation Enzyme Immunoassay(EIA) as gold standard. Methodology: A total of 560 patient serum samples were subjected to rapid screening with rapid test (immunochromatographic) strip supplied by Global Diagnostics and commercially prepared IgG capture EIA by DIA.PRO, Italy. Results: Of the 560 samples, anti HCV was detected in 31(5.54%) by ELISA, whereas only 17(3.04%) by strip method. This gives 100% specificity as no false positive was observed, but with 68.8% sensitivity. The number of false negative results was 14. The positive and negative predictive values were 100% and 97.42% respectively. Conclusion: The result pattern shows that sensitivity is compromised. It is therefore recommended that third generation ELISA is used for blood donors screening, to reduce transmission of hepatitis C virus through blood transfusion. When need arises to use strip for anti-HCV testing, such strip should be validated locally before its adoption because kits are directed against known range of strains of HCV and have minimum titer of antibody below which detection becomes impossible.