Sero-prevalence of Hepatitis B and C viral co-infections among HIV-1 infected ART-naïve individuals in Kumasi, Ghana

BACKGROUND: The study assessed the hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection paradigm among the human immunodeficiency virus (HIV) infected patients attending a tertiary hospital in Ghana. Also, the immunological and virological characterisation of these viruses, prior to antiretroviral therapy (ART) initiation was investigated. METHOD: A total of 400 HIV infected (HIV type-1) treatment naïve subjects ≥18 years were enrolled and tested for HBsAg and anti-HCV. Hepatitis B virus serological profile was performed on samples that were HBV positive. CD4+ T-cell count and HIV-1 RNA viral loads were determined using BD FacsCalibur analyzer (USA) and COBAS AmpliPrep/COBAS TaqMan Analyzer (USA) respectively. RESULTS: The overall prevalence of HBV/HCV co-infection among the HIV-1 patients was 18.0%. The prevalence of HIV-HBV and HIV-HCV co-infections were 12.5% and 5.5% respectively. The prevalence of active viral hepatitis (HBeAg-positive) among HIV-HBV co-infected patients was 40%. None of the patients had anti-HBc IgM. HIV-HBV co-infection was associated with lower CD4+ T-cell count as well as higher HIV-1 viral load compared to both HIV mono- infection and HIV-HCV co- infection (p<0.05) respectively. HBeAg positivity was associated with severe immunosuppression and higher HIV viral load. Patients aged 18-33 years [aOR = 9.66(1.17-79.61); p = 0.035], male gender [aOR = 2.74(1.15-6.51); p = 0.023], primary education [aOR = 9.60(1.21-76.08); p = 0.032], secondary education [aOR = 14.67(1.82-118.08); p = 0.012] and being single [aOR = 2.88(1.12-7.39); p = 0.028] were independent risk factors of HIV-HBV co-infections but not HIV-HCV co-infections. CONCLUSION: The present study highlights the predominance of HBV exposure among the HIV infected patients in Ghana. HBV coinfection was associated with severe immunosuppression and higher HIV-1 viral load.