BMC Infect Dis. 2026 Feb 5. doi: 10.1186/s12879-026-12784-y. Online ahead of print.
ABSTRACT
BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections remain an important public health challenge among people living with HIV (PLHIV), with their heaviest toll borne in sub-Saharan Africa. These infections accelerate liver disease progression, complicate antiretroviral therapy (ART) management, and contribute to morbidity and mortality. This study assessed the seroprevalence of HBV and HCV and liver injury among PLHIV on ART in the Upper East Region of Ghana.
METHODS: In a cross-sectional survey, a total of 294 PLHIV receiving ART at three treatment sites were recruited between June and August, 2024. Sociodemographic and clinical data were obtained using a structured questionnaire after informed consent. Participants were screened for HBV serological markers and anti-HCV using a lateral flow rapid immunochromatographic test, and liver injury was evaluated biochemically by measuring serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Descriptive statistics were used to summarise participant characteristics and logistics regression to assess factors associated with HBV and HCV coinfections and liver injury.
RESULTS: The overall seroprevalence of viral hepatitis was 13.3% (95% CI: 9.6-17.7), with HBV (9.2%; 95% CI: 6.1-13.1) more common than HCV (4.1%; 95% CI: 2.1-7.0). HBV infection was significantly higher in males than females (17.5% vs. 7.4%; p = 0.025) and more common among participants with tertiary education (21.4%; 95% CI: 4.7-50.8) relative to those without formal education (4.5%; 95% CI: 1.7-9.6; p = 0.022). Urban residents showed higher but not statistically significant HBV seroprevalence than rural participants (14.9% vs. 7.3%; p = 0.050). HCV seroprevalence showed no significant sociodemographic associations. The seroprevalence of liver injury was 17.7% (95% CI: 13.5-22.5). Being a male was independently associated with liver injury (adjusted odds ratio [aOR]: 4.35; 95% CI: 1.81-10.47; p = 0.001). Older age was also a predictor: compared to participants aged 20-30 years, those aged 31-40 (aOR: 13.31; 95% CI: 1.37-129.76; p = 0.026), 41-50 (aOR: 20.01; 95% CI: 1.90-210.33; p = 0.013), and > 50 years (aOR: 15.62; 95% CI: 1.41-172.51; p = 0.025) had markedly increased odds. Longer ART duration was protective: individuals on ART for > 10 years had reduced odds of liver injury compared to those on ART for 1-5 years (aOR: 0.39; 95% CI: 0.16-0.97; p = 0.042).
CONCLUSION: The findings show that HBV and HCV are prevalent among PLHIV on ART in the Upper East Region of Ghana. Liver injury affects nearly one in five PLHIV in this setting. These findings highlight the need for targeted viral hepatitis B and C and liver enzymes monitoring and integration of hepatitis management into HIV care, particularly among older men and patients in the early years of ART in this population.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:41645131 | DOI:10.1186/s12879-026-12784-y
