TITLE:
Immunovirological Evaluation of Triple Antiretroviral Therapy Tenofovir/Lamivudine/Dolutegravir (TLD) in HIV/HBV Co-Infected Patients in N’Djamena, Chad
AUTHORS:
Hidir Tidjani Abakar, Abderrazzack Adoum Fouda, Ahmat Mahamat Ahmat, Abakar Oumar Mahamat, Djelassem Ferdinand, Zita Aleyo Nodjikouambaye, Lina Djonkreo, Youssouf Abdessalam Irobey, Abdel-Aziz Brahim Kotto, Mahamat Abdramane Mabrouk, Lombaye Nazaїr, Hassoumi Manah, Mahamat Nour Aguid, Henry Yandai Fissou, Adawaye Chatté
KEYWORDS:
Evaluation, Viral Loads, CD4, TLD, Co-Infection, HIV, HBV, N’Djamena, Chad
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.16 No.2,
May
12,
2026
ABSTRACT: HIV remains a major global public health problem. HIV infection alters the natural history of HBV and worsens the prognosis for patients with chronic hepatitis B. Since the advent of ARVs, chronic infection with the forgotten hepatitis B virus (HBV) has become relevant again in the population of people living with HIV (PLWH). Viral load plays a crucial role in patient classification and treatment initiation. This is a prospective longitudinal cohort; patient recruitment took place at the start of antiretroviral treatment (at treatment initiation), and the study lasted 6 months, from July 2025 to January 2026. The study population consisted of male and female patients over 18 years of age. It was carried out in patients co-infected with HIV/HBV and placed on TLD triple antiretroviral therapy. We included in the study, all Patients co-infected with HIV/HBV eligible for antiretroviral treatment of both sexes, followed at the CHU-RN, CHU-ATC and APMS. The VISITECT CD4 Advanced Disease rapid test is an immunochromatographic assay that estimates full length CD4 protein associated with CD4+ T cells in human whole blood, and is directly correlated with CD4+ T cells levels. For the viral loads of HIV RNA and HBV DNA we used the BIOCENTRIC device. The extraction technique used was that recommended by BIOCENTRIC. For amplification, the main components of the Generic HIV viral loads and Generic HBV viral loads amplification Kits (BIOCENTRIC) were used. In total, 129 patients were included in the study, of whom 59.7% were women, i.e. a sex ratio of 0.67. The average age was 35 (±2) years (p = 0.036). Regarding the clinical stages, about 35.7% were at clinical stage I, 40.3% were at clinical stage II, and 20.2% were at clinical stage III. Regarding HBV DNA detectability, 97.7% were positive for detectable HBV DNA. The failure rate of CD4+ T lymphocytes ≤ 200 cells/µL was 65.9% at the start of antiretroviral treatment initiation at (M0); after 6 months (M6) of treatment the level of CD4 T Lymphocytes ≤ 200 cells/µL was 16.3%. The viral load RNA HIV was high (≥ 1000 copies/ml) at M0 (62.8%) followed by 13.2% after 3 months of treatment and 3.9% after 6 months of treatment in the population studied. The majority of participants in the study exhibited encouraging outcomes regarding viral load, with 6.2% viral loads below 1000 copies/ml at sixth month. The HBV DNA viral load is high ≥ 2000 IU/mL in 52.7% at the initiation of treatment at zero months (M0); after 3 months of treatment 7.0% and after 6 months of treatment 4.9%. The therapeutic regimen studied presents an efficacy profile and constitutes a relevant first-line option in the management of HIV/HBV co-infected patients in Chad. Nevertheless, prolonged longitudinal follow-up remains necessary in order to assess the durability of the virological response and the long-term evolution of hepatic parameters.