Impact of HIV Co-infection and Antiretroviral Therapy on Tumor Necrosis Factor-Alpha (TNF-α), Fibrinogen, and Haptoglobin Markers in Hepatitis B and C Subjects

Abstract

Chronic hepatitis B virus (HBV) infection, when co-occurring with human immunodeficiency virus (HIV), significantly exacerbates liver inflammation and disease progression. This study assessed the impact of HIV co-infection and antiretroviral therapy (ART) on key inflammatory and acute phase markers—tumor necrosis factor-alpha (TNF-α), fibrinogen, and haptoglobin—in HBV-infected individuals.In the first analysis, levels of these biomarkers were compared between HBV/HIV co-infected subjects and healthy controls. The TNF-α level was significantly elevated in co-infected individuals (206.15 ± 21.43 pg/ml) compared to controls (190.15 ± 21.99 pg/ml) with a t-value of 3.769 and a p-value of 0.044, indicating heightened systemic inflammation. Conversely, fibrinogen levels were significantly lower in the co-infected group (8.2 ± 0.69 g/L) than in controls (9.33 ± 4.26 g/L), with a t-value of 3.391 and p-value of 0.037, suggesting altered acute phase protein synthesis. Haptoglobin levels were markedly higher in co-infected subjects (3.05 ± 1.0 g/L) versus controls (1.08 ± 0.09 g/L), with a statistically significant difference (t = 3.054; p = 0.040). Further analysis explored the effect of ART by comparing untreated HBV/HIV co-infected subjects with those on therapy. TNF-α levels were lower in the treated group (191.10 ± 19.45 pg/ml) compared to the untreated group (206.15 ± 21.43 pg/ml), with a statistically significant p-value of 0.040. Fibrinogen levels declined substantially in those on therapy (3.37 ± 4.15 g/L) versus untreated individuals (8.2 ± 0.69 g/L), showing a significant reduction (p = 0.030). Similarly, haptoglobin levels decreased in treated subjects (2.05 ± 0.03 g/L) compared to untreated (3.05 ± 1.0 g/L), with a p-value of 0.040. These findings demonstrate that HBV/HIV co-infection significantly alters inflammatory and acute phase responses, as reflected by elevated TNF-α and haptoglobin levels and reduced fibrinogen. Importantly, antiretroviral therapy appears to mitigate these effects, reducing TNF-α, fibrinogen, and haptoglobin concentrations, though levels remain abnormal relative to healthy controls. This underscores the importance of early HIV diagnosis and initiation of ART in co-infected patients to manage inflammation and reduce the risk of liver-related complications.