Prevalence of HIV/HCV co-infection amongst HIV serodiscordant couples in Thika, Kenya

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dc.contributor.authorWaweru, Susan Wairimu
dc.date.accessioned2016-09-13T09:57:12Z
dc.date.available2016-09-13T09:57:12Z
dc.date.issued2016-04
dc.descriptionA thesis submitted in partial fulfilment of the requirement for the award of the degree of Master of Science in infectious diseases (Immunology) in the School of Medicine, Kenyatta University. April 2016en_US
dc.description.abstractImmune 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.en_US
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/14939
dc.language.isoenen_US
dc.publisherKenyatta Universityen_US
dc.titlePrevalence of HIV/HCV co-infection amongst HIV serodiscordant couples in Thika, Kenyaen_US
dc.typeThesisen_US
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