ABSTRACT
OBJECTIVE: HIV positive individuals infected with viral hepatitis B (HBV) or C (HCV) are at an increased risk of progression to kidney and liver failures. Therefore, prior to initiation of antiretroviral therapy, early diagnosis and initiation of appropriate treatment protocols are imperative for co-infected individuals. This study evaluated the prevalence of HBV and HCV, and extent of liver and renal dysfunction among 90 newly diagnosed HIV patients attending the Cape Coast Teaching Hospital HIV clinic. RESULTS: Levels of alanine aminotransferase, aspartate-platelet ratio index and estimated glomerular filtration rate were used respectively to diagnose hepatotoxicity, liver fibrosis and chronic kidney disease (CKD). Association analyses were evaluated by Pearson's Chi-square test or Fisher's exact test and considered significant at p < 0.05. Using rapid diagnostic tests, 75.6% (n = 68) had HIV1 mono-infection, 24.4% (n = 22) had HIV1/HBV co-infection while 0.0% (n = 0) had HIV1/HCV co-infection. The prevalence of hepatotoxicity, liver fibrosis, and CKD were 7.8% (n = 7), 2.2% (n = 2), and 15.5% (n = 14) respectively. Similar proportions of HIV1/HBV and HIV1 were diagnosed with liver fibrosis (p = 0.431). In relation to hepatotoxicity Grade, a high proportion of HIV1/HBV were diagnosed with Grade 2 (p = 0.042). Also, severely reduced kidney function (CKD stage 4) was observed in only HIV1/HBV (n = 2, 9.1%, p = 0.053).
Subject(s)
HIV Infections/physiopathology , Hepatitis B/physiopathology , Hepatitis C/physiopathology , Kidney/physiopathology , Liver Cirrhosis/physiopathology , Liver/physiopathology , Renal Insufficiency, Chronic/physiopathology , Adult , Alanine Transaminase/blood , Aspartic Acid/blood , Blood Platelets/pathology , Coinfection , Cross-Sectional Studies , Female , Ghana/epidemiology , Glomerular Filtration Rate , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/virology , Hepatitis B/diagnosis , Hepatitis B/epidemiology , Hepatitis B/virology , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Hepatitis C/virology , Humans , Kidney/metabolism , Kidney/virology , Liver/metabolism , Liver/virology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/epidemiology , Liver Cirrhosis/virology , Liver Function Tests , Male , Middle Aged , Prevalence , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/virologyABSTRACT
Hepatitis B virus (HBV) infection is of public health importance worldwide. Vaccination against the infection, especially in early childhood has significantly reduced the public health impact. This pilot study was undertaken in Cape Coast Metropolitan area to assess the impact of the introduction of HBV vaccination in children. A cross-sectional multi-stage cluster sampling of 501 pupils from 30 public and private primary and junior high schools within the Cape Coast metropolis. A questionnaire covering basic demographic details and immunisation history were administered to the participants after consent and assent had been sought. Hepatitis B serological test for HBsAg, HBcAb, HBsAb, HBeAg and HbeAb was undertaken using Hepatitis B test kit and capillary blood from the participants. The general prevalence of HBcAb, HBsAg and HBsAb was found to be 3.6, 2.6 and 19.8% respectively. The prevalence of HBcAb was 2.6 and 6.1% among pupils delivered after and before the vaccine programme introduction respectively. Introduction of the vaccination programme in Ghana has had a positive impact on the HBV infection in Ghana.
