Hepatitis B Virus Co-Infection: Yet Another Reason for Early Initiation of Treatment in HIV Infected Individuals
318
terferon
[7]. In addition, we reported that type of first
line regimen lacks association in contrary to the expected
effect of Lamivudine on HBV clearance. In addition we
have found that though only 25 (6%) of the total 380
ART initiated study groups were taking TDF-3TC com-
bined regimen, they accounted for 10% of HBsAg posi-
tive individuals, high proportion than any other regimen.
As we recalled otherwise this finding challenged impor-
tance of combination therapy containing tenofovir and
lamivudine as part of combination antiretroviral treat-
ment as it is superior in terms of HBV DNA suppression
than was tenofovir or lamivudine administered alone.
Since the mean duration of ART follow up was 28
months (more than 2 years), it was possible to explain
such findings with emergence of mutant strains [7,15,18,
21,22]. But emergence of resistant mutation should be
decided after a detectable HBV viral load measured as
HBV DNA copies in serum or plasma.
5. Conclusion
This study analyzes the effect of HBV co-infection in
HIV patients on immune recovery before and after initia-
tion of HAART. We have shown that HBV co-infection
has a significant and immediate negative effect on CD4
cell count and affiliated immune recovery before HAA-
RT but such effects subside after initiation of the anti-
HIV treatment. As a result, HBV infection is another
important issue to consider for rapidly initiating HAART
among HIV-infected individuals in chronic care. Whe-
ther such drug resistance strains of HBV do exist, as also
reported by other studies, as well as its effect on immune
recovery, CD4 cell count requires further studies.
6. Acknowledgements
The authors thank Debre Berhan University for financial
support, Debre Berhan Hospital and health centers and
staff, and the study participants for their participation.
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