Coinfections with hepatitis B and C virus and syphilis among HIV-infected clients in Southern Ethiopia: a cross-sectional study

Abstract

Techalew Shimelis,1 Yayheyirad Tassachew,1 Agete Tadewos,1 Mesfin Worku Hordofa,1 Anteneh Amsalu,2 Birkneh Tilahun Tadesse,3 Endale Tadesse1 1Department of Medical Laboratory Science, College of Medicine and Health Sciences Hawassa University, Hawassa, 2Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, 3Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are hepatotropic viruses of public health significance worldwide. Despite their severe clinical impact in HIV-infected patients, there is inadequate information regarding the epidemiology of hepatitis/HIV coinfections in Ethiopia. Thus, this study aimed to determine the prevalence of HBV and HCV infections among HIV-infected patients at a tertiary hospital in Southern Ethiopia. Methods: Stored sera, which were originally collected for the investigation of syphilis among HIV-infected clients, were analyzed in this study. Samples were tested for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen using rapid diagnostic tests. Those samples that tested positive for HBsAg were further analyzed for hepatitis B e antigen. All sera were tested for antibody to HCV infection using rapid diagnostic test. Results: HBsAg was positive for 6.3% of the participants; of whom, 10% were positive for hepatitis B e antigen. The exposure rates to HBV (antibody to hepatitis B core antigen) and HCV (anti-HCV) infections were 22.4 and 3.1%, respectively. The rates of coinfections with HBV-syphilis, HCV-syphilis, and HBV-HCV were found to be 3.1, 0.6, and 1.3%, respectively. HBV exposure rate was significantly higher among participants in the age range 40–49 years (adjusted odds ratio [AOR], 1.98; 95% CI, 1.01–3.88) and those who had a CD4+ T cell count <200 cells/μL (AOR, 2.40; 95% CI, 1.13–5.10) and 200–349 cells/µL (AOR, 2.36; 95% CI, 1.28–4.35). Conclusion: The rates of HBV and HCV infections were found to be similar to other subpopulations in Ethiopia. Age and CD4+ T cell level influenced the rate of HBV exposure. As human immunodeficiency virus-hepatitis coinfections are clinically consequential in people living with human immunodeficiency virus/acquired immunodeficiency syndrome, the need to screen this population for HBV and HCV infections is critically important. Keywords: HBV, HCV, HIV, syphilis, coinfection, prevalence

Keywords

• HBV
• HCV
• HIV
• syphilis
• co-infection
• prevalence