Prevalence and factors associated with Hepatitis B infection among people living with HIV attending Arua Regional Referral Hospital, Uganda

Abstract

Background: Liver diseases are a major cause of morbidity and mortality among HIV/HBV co-infected individuals. Globally, Hepatitis B virus infection (HBV) accounts for an estimated 257 million cases with more than 600,000 deaths annually. Its prevalence is estimated at 3.5% and 6.1% globally and in Africa respectively accounting for 7.4% among people living with HIV, most of whom live in sub-Saharan Africa (71%; 1.96 million). HBV increases risk of mortality and morbidity among PLWHIV yet West Nile has the third highest HBV prevalence in Uganda, a factor that could be attributed to the low vaccination completion rates due to unaffordable vaccination prices as well as the limited knowledge about HBV among the population. Objective: To determine the prevalence and factors associated with Hepatitis B among people living with HIV attending Arua regional referral hospital. Methods: Between February 2020 and April 2020, 427 people living with HIV and attending Arua regional referral hospital Anti-retroviral Therapy clinic were enrolled in a cross sectional study. A semi-structured questionnaire was administered to the participants; blood samples were drawn and screened for HBsAg using Vaxpert HBsAg rapid kits. Data was analyzed using STATA15. P-values <0.05 were considered statistically significant. Results: The prevalence of hepatitis B among the population in this study was 9.1%, (C.I; 6.40, 11.87), with women having a higher prevalence (10.3%) than men (7.1%). Factors associated with hepatitis B were; marital status (aOR = 0.17, p = 0.004) and religion (Christian Vs. Islam, aOR=3.66, p=0.035). Other factors such as age, gender, education, marital status, number of sexual partners, history of transfusion and vaccination were not significantly associated with hepatitis B. Conclusion: The prevalence of hepatitis B among people living with HIV was high. Religion and history of marital status were associated with hepatitis B. Ministry of Health should enforce implementation of routine screening of HBV among people living with HIV in order to diagnose co-infections and appropriately manage this population.