Prevalence, Clinicobiochemical, and Immunological Profile of Human Immunodeficiency Virus and Human Immunodeficiency Virus–Hepatitis B Virus Coinfected Patients in a Tertiary Care Hospital in South India

Abstract

Background: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) share common transmission routes, and coinfection is known to worsen immunological recovery in both conditions; Indian data on the clinicobiochemical profile of HIV–HBV coinfection remain limited. Methods: This cross-sectional observational study, conducted at the anti-retroviral therapy (ART) center, Government General Hospital, Vijayawada, over 6 months, aimed to determine the prevalence of HIV–HBV coinfection, compare demographic, clinical, biochemical, and immunological profiles between HIV-monoinfected and HIV–HBV coinfected patients, and assess the association between CD4 T-cell counts and opportunistic infections. Of 1,802 HIV-positive individuals screened for hepatitis B surface antigen, 101 were coinfected (cases), and 100 HIV-monoinfected patients served as controls; data were analyzed using the Statistical Package for the Social Sciences v25. Results: The prevalence of HIV–HBV coinfection was 5.6%. Coinfection was more frequent among males (66.3%) and rural residents (73.3%, P < 0.05), with heterosexual transmission predominating (82.2%). Coinfected patients had significantly lower mean CD4 counts (214 ± 86 vs. 328 ± 112 cells/μL; P < 0.001), more advanced centers for disease control and prevention Stage C disease (50.5% vs. 35.0%), and higher rates of elevated alanine aminotransferase (63.4% vs. 26.0%) and aspartate aminotransferase (74.3% vs. 31.0%; both P < 0.001). Opportunistic infections, particularly chronic diarrhea (43.6%) and pulmonary tuberculosis (21.8%), were more common in coinfected patients. Conclusion: HIV–HBV coinfection significantly worsens immunosuppression, accelerates hepatic injury, and increases the burden of systemic opportunistic infections. Routine HBV screening in all HIV patients, early initiation of dual-active ART, and targeted rural health interventions are warranted.