Association between Hepatitis C Virus Infection and the Immunologic, Hematologic Parameters in HIV-Positive Adults in a Tertiary Health Facility in Southeastern Nigeria

Background: Three-quarters of liver-related diseases and deaths are caused by Hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV) infected individuals. Data on HCV and HIV co-infection in Nigeria in general and Umuahia metropolis, in particular, are scarce. Thus, to close this gap, we examined the relationship between HCV- infection and the immunologic, hematologic profile of HIV- infected patients, and determined the prevalence of HCV infection among patients.

Methods: This cross-sectional study examined 143 blood samples of HIV-infected patients 18 years and older collected between August 2016 and November 2016 in the ART clinic of the Federal Medical Centre, Umuahia, Nigeria. We analyzed samples for HCV antibodies using the rapid ELISA technique; CD4 count using the Cyflow machine, white blood cell count (WBC) and packed cell volume (PCV) using the Sysmex machine. Prevalence and associations were determined using frequency distribution and χ2 test and α level set at .05.

Results: One hundred and eighteen (83%) subjects were on ART and 25 (18%) non-ART. Fifty two (36%) subjects were males and 91 (64%) were females. The age range was 18 - 71 years and a mean of 40.64 years. HCV prevalence was 14%. Prevalence by gender was 11% male and 15% female. Prevalence by ART status was 60.0% ART and 3.4% Non-ART. There was statistically significant associations between HCV and ART status (χ2 = 32.3, P= .001); between HCV and CD4 cell count (χ2 = 8.87, P = .031) but no associations between HCV and WBC (χ2 = 1.615, P > .05) and PCV (χ2 = 1.002, P > .05). Prevalence was more in the CD4 ≤ 200 cells/ml groups (40%) and the 31-50 age groups (40.0%).

Conclusion: HCV/HIV co-infection was associated with low CD4 cell count and being female. It is therefore essential to maintain the CD4 cell of HIV-positive individuals at a number> 300 cells/ml to prevent possible co-infection with HCV, and this will help avoid additional disease and financial burden on people living with HIV/AIDS in Nigeria.