Revista de SIDA e investigación clínica

Background and Aim: Hepatitis Delta Virus (HDV) infection has been mainly studied in HIV negative patients, while data on HIV-1 positive patients are limited. We investigated the virological pattern as well as biochemical and clinical features of liver disease and immune status in HIV-1 positive patients with delta hepatitis. Their clinical characteristics were compared with those of anti-HDV negative, hepatitis B surface antigen (HBsAg) positive/HIV+ patients.
Methods: This retrospective study included HBsAg positive subjects with anti-HDV serology available, during the period 2010-2017. Biochemical and virological parameters were obtained at last visit in 2017 for each patient. Potential determinants for HDV positivity were examined by applying multivariate regression model.
Results: Of 78 HBsAg positive patients 19 (24.4%) were found anti-HDV+. Anti-HDV+ patients were more frequently intra venous drug users, anti-HCV positive and HBV e antigen (HBeAg) negative. Additionally, the patients had more severe liver disease and necro inflammatory activity (assessed by transient elastography and transaminases levels, repectively) than the counterpart of anti-HDV- patients. A suppressive effect of HDV over HCV was also revealed in anti-HDV+ subjects. By multivariate analysis, years of ART (OR 1.22; CI 0.986-1.43, p=0.014) and sexual exposure vs. IVDU (OR 0.08; CI 0.556-0.986, p=0.004) were independently associated with anti-HDV positivity.
Conclusion: Our data underlines the need for continuing prevention program that includes HBV vaccination, screening and monitoring in population at high risk, as well as development of an alternative treatment option for HDV.

Psychosocial disorders such as depression, anxiety and stress are more prevalent among HIV/AIDS patients compared to the general population. These psychosocial disorders impact negatively on HIV AIDS patients on highly active anti-retroviral therapy (HAART). This study determined how these psychosocial disorders impact CD4+ cell counts of HIV/AIDS patients receiving HAART in a peri-urban hospital in Kumasi, Ghana. This cross-sectional study included randomly selected 138 HIV/AIDS patients receiving HAART. DASS-21 questionnaire was used to determine the depression, anxiety and stress levels of participants. Venous blood sample was collected from each participant for the estimation of CD4+ cell counts. The mean age of the study sample was 45.2 ± 10 years, with about 79% of them being females. The prevalence of depression, anxiety and stress among the participants were 87%, 78.3%, 71% respectively. The median (Inter-quartile range, IQR) CD4+ count of participants with depression compared to nondepressed [340.8 (261, 713) cells/μL vs. 418 (242, 481.2) cells/μL; p ≤ 0.0001], anxiety compared to non-anxious [318 (124, 540) μL vs. 438 (267, 487) μL; p ≤ 0.0001] and stress disorders compared to non-stressed [370 (251, 467) μL vs. 484 (424.5, 752.3) μL; p ≤ 0.0001] were significantly lower. Depression and anxiety correlated negatively with CD4+ cell count of participants [Depression; (r=-0.13, p=0.556), Stress; (r=-0.2, p=0.359)]. This study shows that depression, anxiety and stress have negative impact on CD4+ cell counts of HIV/AIDS patients receiving HAART.