Prevalence of HCV-HIV Co-Infection with Intravenous Drug Users in Central Punjab, Pakistan

Hepatitis C and acquired immunodeficiency syndrome (AIDS) are major viral infectious diseases around the world especially in developing nations with poor healthcare facilities. Owing to blood-borne transmission, sharing of needles by the Intravenous Drug Users (IDUs) aggravates the spread of Hepatitis C and AIDS. Human immunodeficiency virus (HIV), causative of AIDS, mainly leads to reduced immunity provoking increased vulnerability to opportunistic infections such as Hepatitis C virus (HCV). Here, we present co-occurrence of HCV and HIV in male IDUs from four major cities of Central Punjab, Pakistan. Initial screening for HIV and HCV was performed using ELISA and real-time PCR. A high HCV and HIV co-infection was revealed in Lahore (80.77%) followed by Faisalabad (81.93%), Sargodha (76%) and in Nankana (62%). A strikingly high level of co-infection was observed compared to single infection. These results suggest a high rise in HCV and HIV co-infection among the HIV positive IDUs. Estimate of the CD4 cell count showed a strong correlation of high HCV and HIV viral titre with low CD4 count. In co-infected individuals, a significantly decreased level of CD4 cells was seen in both medium high and very high viral load categories with a frequency of 19.23% and 76.92%, respectively. Taken together, current study highlights the increased prevalence of HCV co-infection in HIV infected IDUs with lower CD4 count. These results strongly support an immediate investigation of multiple viral infections routine IDUs to guide the eradication of these fatal viral diseases.