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The Incidence Of Hepatitis B And C In Hiv Patients In Chikun Local Government Area Of Kaduna State

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ABSTRACT

The study was aimed at determining the prevalence of HBV and HCV in HIV hospital outpatients in Chikun Local Government Area of Kaduna State. The study was guided by the following objectives; to determine the incidence of HCV in HIV patients with respect to gender, to determine the age distribution of HCV in HIV patients, to make suggestions and recommendation based on the findings of the study. More female HIV patients were infected with both hepatitis B and C, there were higher occurrence IN HCV and HBV among females than males in HIV patients. The age group of 30 – 39 shows 63% of HCV and HBV 37% , the study shows how many mixed with infection with HIV were frequent and suspects with the lower CD4 count due to HIV predisposed the patients to hepatitis virus infection. The occurrence of hepatitis maybe there due to the immune suppression of the immune system of this HIV outpatients. The study recommends that awareness programmes are to be promoted among HIV patients on HCV and HBV infections. The screening for HBV and HCV should incorporated among HIV positive patients, because early detections as well as treatments will help in reducing the complications due to HCV and HBV infections.

TABLE OF CONTENT

Title page

Declaration

Certification

Dedication

Acknowledgement
Abstract

Table of content

List of Tables


CHAPTER ONE: INTRODUCTION

1.1  Introduction

1.2  Statement of Problem

1.3  Justification

1.4  Aim

1.5  Objectives

CHAPTER TWO: LITERATURE REVIEW

2.1 What is Hepatitis?

2.2 Causes of Hepatitis

2.3 Types of Hepatitis

2.3.1Viral Hepatitis

2.3.2 Parasitic Hepatitis

2 .3.3 Bacterial hepatitis

2.3.4  Alcoholic Hepatitis

2.3.5 Toxic and Drug-induced Hepatitis

2.3.6 Non-alcoholic fatty liver disease

2.3.7 Autoimmune

2.3.8 Toxic and drug-induced hepatitis

2.3.9  Non-alcoholic Fatty Liver Disease

2.3.10 Autoimmune Hepatitis

2.3.11 Genetic Hepatitis

2.3.12 Ischemic Hepatitis

2.3.13 Steotohepatitis

2.4 Epidemiology of Hepatitis B in HIV patients

2.5 Epidemiology of Hepatitis C

2.6 Symptoms of Hepatitis

2.7 Diagnosis of Hepatitis

2.7.1 Viral Serology

2.7.2  Liver biopsy

2.7.3  Liver Function Test

2.7.4    Prevention and Controls

CHAPTER THREE: MATERIALS AND METHODS

3.1 Study Area

3.2 Study Population

3.3 Ethical Approval

3.4 Inclusion Criteria

3.5 Exclusion Criteria

3.6 Collection of Samples

3.7 Sample Screening

CHAPTER FOUR: RESULTS

4.1 Introduction:

4.2 HBV Result

4.3 HCV Result

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION

5.1 Discussion

5.2 Conclusion

5.3 Recommendation

References

Appendix

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Hepatitis is a medical condition defined as the inflammation of the liver characterised by the presence of inflammatory cells in the tissue of the organ (Bernal et al., 2013).

Hepatitis B is caused by hepatitis B virus. HBV hepadnavirus that can cause both acute and chronic hepatitis. Chronic hepatitis develops in the 15% of adults who are unable to eliminate the virus after an initial infection. Identified methods of transmission include blood (blood transfusion, now rare) unsanitary tattoos, sexually (through or bodily fluids), or via mother to child by breast feeding (minimal evidence of transplacental crossing).

However, in about half cases the sources of infection cannot be determined .blood contact can occur by sharing syringes in intravenous drug use shaving accessories such as razor blades, or touching wounds of infected persons. Needle-exchange programmes have been created in many countries as a form of prevention. Patients with chronic hepatitis B have antibodies against hepatitis B, but these antibodies are not of the affected live cells. The continuous production of virus combined with antibodies is a likely cause of the immune complex disease seen in these patients. A vaccine is available that will prevent infection from hepatitis B for life. Hepatitis B infectious result in 500,000 to 1,200,000 deaths per year  worldwide due to the complications of chronic hepatitis , cirrhosis , and hepatocellular carcinoma. Hepatitis B is endemic in a number of (mainly South-East Asian) countries, making cirrhosis and hepatocellular carcinoma big killers.

There are six treatment options approved by the U.S food and Drug administration (FDA) available for persons with chronic hepatitis B infection: alpha interferon, pegylated interferon, adefovir, entecavir, telbivudine and lamivudine. About 65% of persons on treatment achieve a sustained treatment.

Hepatitis C virus is caused by HCV and RNA virus that is a member of the flaviviridae family (CDC, 2010). HCV is mostly transmitted through exposure to infective blood, which may occur through transfusion of HCV contaminated blood and blood products, contaminated injection during medical procedure, and through injection drug use. Sexual and transplacental transmission are also possible (WHO, 2016). Hepatitis C usually leads to chronic hepatitis, culminating in cirrhosis in some people. It usually remains asymptomatic for decades (Stanaway et al., 2013).

Patients with hepatitis infection are susceptible to acute hepatitis if they are not immunised against this virus. HCV viral levels can be reduced to undetectable levels by a combination of interferon and antiviral drug Ribavirin . The genotype of the virus is the primary determinant of the rate of response to this treatment regimen, with genotype 1 being the most resistant (Xiong et al., 2010).

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of condition caused by infection with the human immunodeficiency virus(HIV) (Kramer et al., 2010). HIV infects vital cells in the human immune system such as helper T cells(specifically CD4 T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4­+ T cells through a number of mechanisms, including pyroptosis of abortively infected T cells, apoptosis of uninfected bystander cells, direct viral killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognise infected cells. When CD4+ T cells and the body becomes progressively more susceptible to opportunistic infections.

1.2 Statement of Problem

At present there are estimated 170million HCV carriers worldwide, most of who are thought to be the developing countries, including Nigeria (olokoba et al., 2010). HCV present with mild or no symptoms which could cause complications or even death. Early diagnosis will help in reducing complications due to HCV since there is no vaccine against it. The HIV immonucompromised patients have been reported to be predisposed to HBV and HCV infections globally. This mixed infections have led to high avoidable mortality rate due to the non-recognition and treatment of the viral hepatitis.

1.3    Justification for the Study

The need to determine the incidence of hepatitis C and hepatitis B virus infection in HIV  patients in Chikun local government area of Kaduna State is from the fact that this disease has killed many people due to ignorance. The need for investigative data on the incidence of hepatitis B and C in HIV patients from both private and public hospitals is paramount for the reduction of mortality rates among HIV patients currently recorded in Chikun Local government area.

1.4 Aim of Study

The main aim of this study was to determine the incidence secondary of hepatitis B and C in HIV patients in Chikun local government area of Kaduna State for effective therapeutic intervention.

1.5  Objectives of the Study

  1. To determine the incidence of HBV and HCV in HIV patients with respect to gender and age
  2. To determine the incidence distribution of HBV and HCV in HIV patients.

iii.            To make suggestions and recommendations based on my findings.

 


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