DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20182949

Epidemiological correlates with communicable viral co-infections of hepatitis B and hepatitis C and non-communicable diabetes among HIV ART naïve rural patients of Kanchipuram district: a prospective cohort study

A. Kasthuri, K. Mohana Krishnan, S. K. Amsavathani

Abstract


Background: The objectives of the study were to study the epidemiological correlates of ART Naïve HIV cases; to study the incidence of co–infections among them; to find the incidence of onset of diabetes among them. Concomitant infection of hepatitis B virus, hepatitis C virus viruses leads to higher frequency of carrier state and severe manifestations of the disease in HIV patients. There is general agreement that the traditional risk factors for DM (increasing age, minority race, obesity) are still responsible for most of the increased risk in the HIV infected population.

Methods: This study was designed as a prospective cohort study and was done at the Meenakshi Medical College & Research institute, an academic and Tertiary medical centre in Kanchipuram, Tamil Nadu, South India. The study duration was from June 2004 to June 2010. SPSS 13 was used in the calculation of chi-square and percentages.

Results: Among 207 participants, mean age is 36.04 and the SD is 10.895. There is significant difference between the incidence of viral co-infections like hepatitis B and hepatitis C (p<0.001). There is significant difference between the incidence of onset of diabetes (p<0.001). The HbsAg and HCV co infection was comparatively lower than the urban population. Among the 50 HIV reactive, non diabetic patients without risk factors, only one found to be Diabetic and another found to be Pre diabetic after 6 months follow-up.

Conclusions: The cost of treatment escalates, when PLHA is co-infected either with viral infections or diabetes, and also their quality of life becomes poor. So, monitoring of CD4 and CD8 should be done as a routine and screening and early treatment should be made mandatory.

 


Keywords


Epidemiological correlates, CD4 count, Co-infection, Diabetes

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References


NACO. Antiretroviral therapy guidelines for HIV‐1 infected Adult and Adolescents including Post‐exposure prophylaxis, 2007.

Soriano V, Barreiro P, Nunez M. Management of chronic hepatitis B and C in HIV Co infected Patients. J Antimicrobial Chemothery. 2006;57:815–8.

Soriano V, Puoti M, Sulkowski M, Cargnel A, Benhamou Y, Peters M, et al. Care of patients Co infected with HIV and Hepatitis C virus. Updated recommendations from the HCV-HIV International Panel. AIDS. 2007;21:1073–89.

Nunez M, Soriano V. Management of patients co-infected with hepatitis B virus and HIV. Lancet Infect Dis. 2005;5:374–82.

Cooper CL, Breau C, Laroche A, Lee C, Garber G. Clinical outcomes of first antiretroviral regimen in HIV/Hepatitis C Virus co infection. HIV Med. 2006;7:32–7.

Cohen MS, Hellmann N, Levy JA, DeCock K, Lange J. The spread, treatment, and prevention of HIV‐1: Evolution of a global pandemic. J Clin Invest. 2008;118(4):1244‐54.

Penkower L, Dew MA, Kingsley L, Becker JT, Satz P, Schaerf FW, et al. Behavioral, Health and Psychosocial Factors and Risk for HIV Infection among Sexually Active Homosexual Men: The Multicenter AIDS Cohort Study. American J Public health. 1991;81;2.

Butt AA, McGinnis K, Rodriguez-Barradas MC, Crystal S, Michael, Goetz MB, et al. Justice. HIV Infection and the Risk of Diabetes Mellitus. AIDS. 2009;19:23(10):1227–34.

Floris-Moore M, Howard AA, Lo Y, Schoenbaum EE, Arnsten JH, Klein RS. Hepatitis C infection is associated with lower lipids and high-sensitivity C-reactive protein in HIV-infected men. AIDS Patient Care STD. 2007;21(7):479–91.

Alter MJ, Moyer LA. The importance of preventing hepatitis C virus infection among injection drug users in the United States. J Acquired Immune Deficiency Syndrome Hum Retrovirol. 1998;18(1):6–10.

Yoon C, Gulick RM, Hoover DR, Vaamonde CM, Glesby MJ. Case-control study of diabetes mellitus in HIV-infected patients. J Acquir Immune Defic Syndr. 2004;37(4):1464–9.

Mehta SH, Brancati FL, Strathdee SA, Pankow JS, Netski D, Coresh J, et al. Hepatitis C virus infection and incident type 2 diabetes. Hepatology. 2003;38(1):50–6.

Mann J, Chin J, Piot P, Quinn T. Int Epidemiol AIDS. Sci AM. 1988;259:82-9.

de Larranaga GF, Wingeyer SD, Puga LM, Alonso BS, Benetucci JA. Relationship between Hepatitis C virus (HCV) and insulin resistance, endothelial perturbation, and platelet activation in HIV-HCV-co infected patients under highly active antiretroviral treatment. Eur J Clin Microbiol Infect Dis. 2006;25(2):98–103.

Maeno T, Okumura A, Ishikawa T, Kato K, Sakakibara F, Sato K, et al. Mechanisms of increased insulin resistance in non-cirrhotic patients with chronic Hepatitis C virus infection. J Gastroenterol Hepatol. 2003;18(12):1358–63.

Lecube A, Hernandez C, Genesca J, Simo R. Proinflammatory cytokines, insulin resistance, and insulin secretion in chronic Hepatitis C patients: A case-control study. Diabetes Care. 2006;29(5):1096–101.

Schambelan M, Benson CA, Carr A, Currier JS, Dube MP, Gerber JG, et al. Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: Recommendations of an International AIDS Society-USA Panel. J Acquir Immune Defic Syndr. 2002;33:257–75.

Brar I, Shuter J, Thomas A, Daniels E, Absalon J. A comparison of factors associated with prevalent diabetes mellitus among HIV-Infected antiretroviral-naive individuals versus individuals in the National Health and Nutritional Examination Survey cohort. J Acquir Immune Defic Syndr. 2007;45(1):66-71.

Visnegarwala F, Chen L, Raghavan S, Tedaldi E. Prevalence of diabetes mellitus and dyslipidemia among antiretroviral naive patients co infected with hepatitis C virus (HCV) and HIV-1 compared to patients without co infection. J Infect. 2005;50(4):331–7.

Yoon C, Gulick RM, Hoover DR, Vaamonde CM, Glesby MJ. Case-control study of diabetes mellitus in HIV-infected patients. J Acquired Immune Deficiency Syndrome. 2004;37(4):1464–9.

Hommes MJT, Romijn JA, Endert E, Schattenkerk JKME, Sauerwein HP. Insulin sensitivity and insulin clearance in Human immunodeficiency virus infected men. Metabolism. 1991;40:651–6.

Mother to child transmission of HIV infection. The European Collaborative Study. Lancet.1988;2(8619):1039‐43.

Nduati R, John G, Mbori‐Ngacha D, Richardson B, Overbaugh J, Mwatha A, et al. Effect of breastfeeding and formula feeding on transmission of HIV‐1: a randomized clinical trial. JAMA. 2000;283(9):1167‐74.

Titti F, Rezza G, Verani P, Butto S, Sernicola L, Rapicetta M, et al. HIV, HTLV‐1, and HBV infections in a cohort of Italian intravenous drug abusers: Analysis of risk factors. J Acquir Immune Defic Syndr. 1988;1(4):405‐11.

NACO. Annual report. 2009-10.

Holmberg SD. The estimated Prevalence and incidence of HIV in 96 large metropolitan areas. American J of Public Health. 1996; 86:64-654.

NACO. Annual report. 2010-2011.

Korzeniewska-Kosela M, FitzGerald JM, Vedal S, et al. Spectrum of tuberculosis in patients with HIV infection in British Columbia: Report of 40 cases. CMAJ. 1992;146(11):1927–34.

Chan DJ. Factors affecting sexual transmission of HIV-1: Current evidence and implications for prevention. Curr HIV Res. 2005;3:223–41.

Furber AS, Maheswaran R, Newell JN, Carroll C. Is smoking tobacco an independent risk factor for HIV infection and progression to AIDS? A systemic review, Sexually Transmitted Infection. 2007;83:41-6.