Hepatitis B and C infections in HIV-1 and non-HIV infected pregnant women in the Brong-Ahafo Region, Ghana

Abstract

Background Hepatitis B (HBV) or hepatitis C (HCV) virus co-infections in HIV are alarming during pregnancy due to the risk of vertical transmission and the eventual adverse effects on neonates. This study was conducted to ascertain the sero-prevalence of HIV/HBV and HIV/HCV co-infections, evaluate the effect of the co-infections on the immunological and virological characteristics and assess the association between some demographic and lifestyle characteristics and risk of HBV, HCV, HIV/HBV and HIV/HCV co-infections among pregnant women living in the Brong-Ahafo Region of Ghana. Methods This comparative cross-sectional study was conducted at the anti-retroviral therapy (ART) clinics of the St. Elizabeth Hospital and the Holy Family Hospital, Brong-Ahafo Region, Ghana. A total of 248 consecutive consenting pregnant Ghanaian women, 148 diagnosed with HIV [HIV (+)] and 100 who were HIV negative [HIV (-)], were recruited. Validated questionnaire was used to obtain demographic and lifestyle data. Venous blood samples were obtained and HCV status, HBV profile, CD4+ T cell count, and HIV-1 RNA load were determined. Results The sero-prevalence of HIV (+) /HBV, HIV (+) /HCV, HIV (-)/HBV, and HIV (-)/HCV infections were 22 (14.9%), 6 (4.1%), 10 (10.0%), and 12 (12.0%) respectively. HIV-1 viral load was not significantly different between HIV/HBV, HIV/HCV co-infection and HIV mono-infection. However, CD4+ T lymphocyte count (364 vs 512 vs 514 cells/μl; p = 0.0009) was significantly lower in HIV/HBV co-infection compared to HIV/HCV and HIV mono-infection respectively. There was no significant association between demographic and lifestyle characteristics and risk of HBV and HCV infections in HIV positive and negative subjects except for late diagnosis of HIV and history of sharing razors blades and pins, where increased odds of HIV (+) /HBV and HIV (-)/HBV infection were observed. Conclusions The prevalence of HIV (+)/HBV (14.9%), HIV (+)/HCV (4.1%), HIV (-)/HBV (10.0%), and HIV (-)/HCV (12.0%) are high among pregnant women in the Brong Ahafo Region of Ghana. HIV/HBV is associated with reduced CD4+ T lymphocyte count but not HIV-1 viral load. Early diagnosis of HIV and intensification of routine antenatal HBV and HCV are essential to abate the risk of maternal to child transmission.

Hepatitis B and C Viruses’ Infection and Associated Factors among Pregnant Women Attending Antenatal Care in Hospitals in the Amhara National Regional State, Ethiopia

“…Studies have documented that there was a coinfection of HBV and HCV among pregnant women, similar to our findings [ 36 , 43 ]. This implies that HBV and HCV have the same route of transmission.…”

“…However, there was no coinfection of HCV and HIV in this study. This is in contrast to studies done in Ghana (4.1%) and southern Ethiopia (1.8%) of the coinfection of HCV/HIV investigated [ 36 , 43 ]. The difference might be due to the test kit employed, awareness of transmission methods, exposure to risk factors, and geographic location.…”

“…This implies that HBV and HCV have the same route of transmission. In high endemic areas, coinfection of HBV and HCV is more dangerous in pregnant women and their infants than monoinfection [ 29 , 36 , 43 ]. In contrast to this finding, no coinfection of these viruses was detected in studies conducted in Ethiopia and elsewhere [ 20 , 44 ].…”

Sero-prevalence of human immunodeficiency virus–hepatitis B virus (HIV–HBV) co-infection among pregnant women attending antenatal care (ANC) in sub-Saharan Africa (SSA) and the associated risk factors: a systematic review and meta-analysis

“…In East Africa, five (5) studies were from Ethiopia [ 27 – 31 ], 2 (two) from Malawi [ 32 , 33 ], 2 (two) from Rwanda [ 34 , 35 ], 1 (one) from Tanzania [ 36 ] and 3 (three) from Uganda [ 35 , 37 , 38 ]. In West Africa, 2 (two) studies were from Burkina Faso [ 39 , 40 ], 3 (three) from Ghana [ 41 – 43 ], 1 (one) from Ivory Coast [ 44 ], 1 (one) from Mali [ 45 ] and 9 (nine) from Nigeria [ 18 , 46 – 53 ]. In southern Africa region, both studies were from South Africa [ 14 , 54 ].…”

Molecular characterization of Glucose-6-Phosphate Dehydrogenase: do single nucleotide polymorphisms affect hematological parameters in HIV positive patients?

“…An explanation could be the higher number of females in this study compared to males. The consistently higher number of HIV positive females compared to males in Kumasi justifies the gender disparity [34,35].…”