Prevalence of HIV and Its Co-Infection with Hepatitis B/C Virus Among Chronic Liver Disease Patients in Ethiopia

Yayehyirad Tassachew; Tamrat Abebe; Yeshambel Belyhun; Tezazu Teffera; Abate Bane Shewaye; Hailemichael Desalegn; Henok Andualem; Abiy Kinfu; Andargachew Mulu; Adane Mihret; Rawleigh Howe; Abraham Aseffa

doi:10.2147/HMER.S365443

Prevalence of HIV and Its Co-Infection with Hepatitis B/C Virus Among Chronic Liver Disease Patients in Ethiopia

Hepat Med. 2022 May 13:14:67-77. doi: 10.2147/HMER.S365443. eCollection 2022.

Authors

Yayehyirad Tassachew^{1

2

3}, Tamrat Abebe¹, Yeshambel Belyhun⁴, Tezazu Teffera⁵, Abate Bane Shewaye^{6

7}, Hailemichael Desalegn⁸, Henok Andualem⁹, Abiy Kinfu¹⁰, Andargachew Mulu², Adane Mihret^{1

2}, Rawleigh Howe², Abraham Aseffa²

Affiliations

¹ Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
² Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.
³ School of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
⁴ School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
⁵ Department of Surgery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
⁶ Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁷ Adera Medical Center PLC, Addis Ababa, Ethiopia.
⁸ Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
⁹ Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
¹⁰ Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia.

Abstract

Background: The efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however, mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV.

Objective: The study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver disease (CLD) patients in Ethiopia.

Methods: Three hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC) (n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV testing algorithm was employed to screen HIV infection.

Results: Regardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were co-infected with HBV (HBsAg⁺HBcAb⁺) and HCV (anti-HCV⁺ HCV-RNA⁺), respectively, and 86.7% (13/15) exhibited a marker of HBV exposure (total HBcAb⁺). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than non-HCC patients [8.6% (11/128) vs 1.8 (4/217), p=0.005 and 3.9% (5/128) vs 0.9% (2/217), p=0.1]. The rate of HIV mono-infection was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients.

Conclusion: The frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in people living with HIV.

Keywords: HBV; HCC; HCV; HIV; non-AIDS liver diseases.

Grants and funding

An indirect fund was secured for this study from Addis Ababa University, Hawassa University, and AHRI. The sponsors had no involvement in any of the stages from study design to submission of this manuscript for publication.