HEPATOCELLULAR INJURY AND METABOLIC DYSREGU LATION OF SELECTED BIOMARKERS IN HIV-1-HCV CO-IN FECTED INDIVIDUALS USING HEROIN IN MOMBASA COUNTY KENYA

Abstract

Background and study aim: Hepatocellular injury and metabolic dysreg ulation are significant complications in individuals co-infected with hu man immune deficiency virus (HIV-1) and hepatitis C virus (HCV), par ticularly those who use injection heroin. However, this is less recognized. The combined effect of viral pathogenesis, drug intoxication, compro mised bone mineralization and systemic inflammation contribute to accel erated liver damage and metabolic abnormalities including osteoporosis, but effective biomarker –based tools for early detection and monitoring remain limited. The current study aimed to characterize and quantify se lected biomarkers of hepatocellular injury and metabolic dysregulation in HIV-1 and HCV co-infected injection heroin users, with the intent of de veloping a laboratory based diagnostic and monitoring algorithm for early detection and disease progression assessment. Materials and Methods: This case control retrospective study was con ducted targeting injection heroin users stratified into HIV-1 and HCV co infected, mono infected and un-infected groups. A total of 289 samples from persons aged between18 to 65 years were analyzed for liver enzymes (ALP), metabolic indicators (Lipid profile, Calcium and Vitamin D3), and virological parameters (HIV RNA, HCV RNA and CD4 count). Statistical analyses included group comparisons and correlation modeling to evaluate biomarker association with disease severity. Results: The co-infected group exhibited significantly elevated liver en zymes compared to mono infected and uninfected participants (P <0.05). Strong correlations were observed between viral load, biomarker altera tions and duration of heroin use. The combined biomarker profile demon strated potential to distinguish early and advanced hepatic and metabolic impairment. Conclusion: HIV-1 and HCV co-infection in injecting heroin persons is associated with compounded liver injury and metabolic dysregulation that can be effectively assessed through selected biomarkers. These findings support the development of a biomarker –based diagnostic and monitoring algorithm to facilitate early detection and guide targeted clinical interven tions in this high-risk population to avert a rise in mortality rate. Key words: HIV-1-HCV co-infection, Injection heroin use, Hepatocellu lar injury, metabolic dysregulation, Biomarkers, Liver function, Diagnos tic algorithm, Lipid profile.