Prevalence of HIV/HCV co-infection amongst HIV serodiscordant couples in Thika, Kenya
Waweru, Susan Wairimu
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Immune defects caused by Human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) co-infection could alter the course of secondary infection and dysregulated innate immune responses could contribute to a more rapid disease progression. The prevalence of HCV and HIV co-infection in Kenya varies with different risk groups. Currently, there is parity of data on the prevalence of HIV/HCV co-infection in Kenya. It is also not known how the CD4+ and CD8+ counts correlate with HIV viral load in HIV/HCV co- infected individuals. This study focused on determining the prevalence of HCV and how the CD4+ and CD8+ counts correlate with HIV viral load in HIV/HCV co-infected individuals amongst HIV serodiscordant couples in Thika. Plasma samples from HIV serodiscordant couples that had been collected over a period of 2 years (2006-2008) and stored at -20° C at the Clinical Trials Research Laboratory (CTRL) were used. All the samples from both HIV negative and positive participants were tested for HCV antibody using Murex anti-HCV (version 4.0) microelisa kit. HIV RNA viral load and CD4+/CD8+ counts were obtained from already archived data for the participants that were co-infected with HIV and HCV. A total of 385 samples from HIV serodiscordant couples were used in this study; 196 HIV positive samples and 189 HIV negative samples. Data was analyzed using mean (standard deviations), medians (inter-quartile range), Pearson correlation, Pearson chi square test, McNemar chi square test, ranksum test and t-test as appropriate using Stata version 12.1. Results obtained from this study showed that the mean age of the participants was 34.2 years. 192 of the participants were male (49.9%) and 193 (50.1%) were female. Overall, 13 (3.4%) of the participants were positive for HCV, most of whom 11(5.6%) were HIV positive, p= 0.013. There was no statistically significant difference between HCV infection on the basis of gender, 7 (3.6%) vs. 6 (3.1%), p= 0.785. A negative correlation was observed between HIV Viral load and CD4+ T cells amongst HIV/HCV co-infected participants without statistical significance; r= 0.600, p= 0.070. A positive correlation was observed between HIV Viral load and CD8+ T cells amongst HIV/HCV co-infected participants without statistical significance r= 0.4525, p= 0.162. There was a statistically significant higher median (IQR) HIV Viral load (copies/mL) at baseline among those positive for HIV/HCV co-infection than those who were HIV mono-infected, 89775 vs. 10695, P= 0.0436. Those positive for HIV/HCV co-infection had a lower median CD4+ (IQR) than those who were HIV mono-infected, however without statistical significance, 383 vs. 499, p=0.0772. Those positive for HIV/HCV co-infection had a higher median CD8+ (IQR) than those who are negative for HIV/HCV co-infection, however without statistical significance, p=0.2250. None of the serodiscordant couples were both found to be positive for HCV indicating that HCV may not have been transmitted sexually. A longitudinal study is recommended using a higher number of participants and also inclusion of more laboratory tests and parameters to give a better understanding of the effect of HIV/HCV co- infection on disease progression amongst participants.