Seroprevalence of Hepatitis B Virus and Hepatitis C Virus Coinfection in People Living with HIV at the Al Nadjma Multipurpose Center in N'Djamena, Chad

Abstract

Introduction: Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) are all bloodborne viruses that share similar routes of transmission. People with HIV who become infected with HBV or HCV are at increased risk of liver-related morbidity and mortality, which are common in our region. Chad is part of sub-Saharan Africa, which is a highly endemic region. Objective: The objective of this study was to assess the seroprevalence of HIV-HBV and HIV-HCV coinfection in patients at the Al Nadjma Multipurpose Center in N'Djamena, Chad. Patients and Methods: This was a cross-sectional, descriptive study with prospective data collection over a 12-month period from 1 January to 31 December 2023. Data were entered using Microsoft Word and analysed using SPSS software. We obtained informed consent from all individuals screened. Data confidentiality was maintained in accordance with the Declaration of Helsinki. Results: Of the 1,000 patients with HIV who were followed during the study period, 76 patients were coinfected with HBV (7.6%), 8 patients with HCV (0.8%), and 4 patients with both HBV and HCV (0.4%). The mean age of the patients was 33 ±5 years. There was a male predominance, with a sex ratio of 1.05. Having multiple sexual partners was the most frequent risk factor, reported by 21.3% (n=17). Merchants were the most represented occupational group, accounting for 25% (n=20), and married individuals accounted for 47.5% (n=38). Patients who had entered the voluntary HIV testing programme represented 96.2% (n=77). Body mass index was normal in 62.5% (n=50) of patients. Fever was the most frequent symptom, reported in 51% (n=41) of patients, and 63.8% (n=51) of patients were at WHO clinical stage 1. All patients were infected with HIV type 1. Virologically, after 6 months of antiretroviral therapy, the viral load was undetectable in 75% (n=60) of patients, and at 12 months, all patients had an undetectable viral load. Blood tests revealed moderate anaemia in 12.5% (n=10) of patients and leukopenia in 6.3% (n=5), while platelet counts were normal in all patients. Biochemical tests showed elevated transaminases in 33.33% (n=5) of patients, and renal function tests were normal in all patients. Abdominal ultrasound, performed in 6.2% (n=5) of patients, was normal. Conclusion: In this study, the seroprevalence of HBV and HCV was low in people living with HIV compared with the general population; however, this reflects the substantial burden of HIV-HBV and HIV-HCV coinfection in the country and highlights the importance of systematic screening for early patient management.