Seroprevalence of Hepatitis B and C among HIV-Positive Adults on Antiretroviral Therapy in a Rural District of Western Tanzania

Getera Isack Nyangi^1,

¹District Medical Officer and Public Health Researcher, Kakonko District Council, Tanzania

Cite this paper:
Getera Isack Nyangi. Seroprevalence of Hepatitis B and C among HIV-Positive Adults on Antiretroviral Therapy in a Rural District of Western Tanzania. American Journal of Epidemiology and Infectious Disease. 2026; 14(1):9-13. doi: 10.12691/ajeid-14-1-2

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections are important causes of morbidity and mortality among people living with HIV (PLHIV), particularly in sub-Saharan Africa. Although several studies have documented the burden of HIV–hepatitis co-infection in urban and peri-urban settings in Tanzania, data from rural western regions remain limited. This study aimed to determine the seroprevalence of HBV and HCV among HIV-positive adults receiving antiretroviral therapy (ART) in Kakonko District, western Tanzania. A facility-based cross-sectional study was conducted among HIV-positive adults aged ≥ 18 years attending three Care and Treatment Clinics in Kakonko District. Participants were selected using simple random sampling. Sociodemographic and clinical data were collected using a structured questionnaire. Finger-prick blood samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using rapid immunochromatographic assays. Data were analyzed using Stata version 16, and seroprevalence was calculated with 95% confidence intervals. A total of 283 HIV-positive adults on ART were included in the analysis. Females accounted for 66% of participants, and 63% were aged below 45 years. More than half of the participants had been on ART for over five years, and 98% were receiving a tenofovir–lamivudine–dolutegravir (TLD)-based regimen. None of the participants tested positive for HBsAg or anti-HCV antibodies. No cases of dual HBV/HCV infection were identified, yielding a seroprevalence of 0% for HBV, HCV, and HBV/HCV co-infection. No evidence of HBV or HCV co-infection was found among HIV-positive adults receiving ART in Kakonko District. Long-term ART use and effective HIV prevention and care interventions may have contributed to these findings. Continued routine hepatitis screening and integration of viral hepatitis services within HIV care programs are recommended to sustain low co-infection rates.

Keywords:
HIV Hepatitis B Hepatitis C Co-infection Antiretroviral therapy Rural Tanzania

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Chandra N, Joshi N, Raju YSN, Kumar A, Teja VD. Hepatitis B and/or C co-infection in HIV infected patients: A study in a tertiary care centre from South India. OpenEpi. 2012. Available from: https://www.openepi.com.
[2]	Mårdh O, Quinten C, Amato-Gauci AJ, Duffell E. Mortality from liver diseases attributable to hepatitis B and C in the EU/EEA–descriptive analysis and estimation of 2015 baseline. Infect Dis. 2020; 52(9): 625–637.
[3]	Operskalski EA, Kovacs A. HIV/HCV co-infection: Pathogenesis, clinical complications, treatment, and new therapeutic technologies. Curr HIV/AIDS Rep. 2011; 8(1): 12–22.
[4]	Weldemhret L. Epidemiology and challenges of HBV/HIV co-infection amongst HIV-infected patients in endemic areas: Review. HIV/AIDS Research and Palliative Care. 2021; 13: 485–490.
[5]	World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Geneva: WHO; 2021. Available from: https:// www.who.int/ publications/ i/item/ 9789240027077.
[6]	Barth RE, Huijgen Q, Taljaard J, Hoepelman AIM. Hepatitis B/C and HIV in sub-Saharan Africa: An association between highly prevalent infectious diseases. Int J Infect Dis. 2010; 14(12): e1024 – e1031.
[7]	Maina DN, Nyerere AK, Gicho RW, Mwangi JM, Lihana RW. Prevalence and factors associated with hepatitis B and C co-infection among HIV-1-infected patients in Kenya. Available from: https://www.eahealth.org.
[8]	Seyoum E, Demissie M, Worku A, Mulu A, Abdissa A, Berhane Y. HIV, hepatitis B virus, and hepatitis C virus co-infection among HIV positives in antiretroviral treatment program in selected hospitals in Addis Ababa: A retrospective cross-sectional study. PLoS ONE. 2022; 17(4): e0267230.
[9]	Hoffmann CJ, Dayal D, Cheyip M, McIntyre JA, Gray GE, Conway S, et al. Prevalence and associations with hepatitis B and hepatitis C infection among HIV-infected adults in South Africa. Int J STD AIDS. 2012; 23(10).
[10]	Hawkins C, Christian B, Ye J, Nagu T, Aris E, Chalamilla G, et al. Prevalence of hepatitis B co-infection and response to antiretroviral therapy among HIV-infected patients in Tanzania. AIDS. 2013; 27(6): 919–927.
[11]	Nagu TJ, Bakari M, Matee M. Hepatitis A, B, and C viral co-infections among HIV-infected adults presenting for care and treatment at Muhimbili National Hospital in Dar es Salaam, Tanzania. BMC Public Health. 2008; 8: 416.
[12]	Kamenya T, Damian DJ, Ngocho JS, Philemon RN, Mahande MJ, Msuya SE. The prevalence of hepatitis B virus among HIV-positive patients at Kilimanjaro Christian Medical Centre Referral Hospital, Northern Tanzania. Pan Afr Med J. 2017; 28 275.
[13]	Mirambo MM, Kidenya BR, Silago V, Mkumbo E, Mujuni A, Mmanga KJ, et al. Hepatitis B and Hepatitis C among Human Immunodeficiency Virus-Infected Patients at a District Hospital in Mwanza, Tanzania. World J AIDS. 2019; 9(1): 1–10.
[14]	Ministry of Health, United Republic of Tanzania, National AIDS Control Programme. National Integrated HIV, Viral Hepatitis and STI Management Guidelines. 2023. Available from: https://cubemd.net/wp-content/uploads/2024/10/National-Intergrated-HIV-Hepatitis-and-STI-Management-Guidelines-October-18-2023_-compressed.pdf.
[15]	Soomro R, Shah IA, Saboor A, Bhutto AUB, Memon S. Sensitivity and specificity of hepatitis B virus screening via rapid immunoassay chromatographic test. Cureus. 2021; 13(1): e12909.
[16]	Tang W, Chen W, Amini A, Boeras D, Falconer J, Kelly H, et al. Diagnostic accuracy of tests to detect hepatitis C antibody: a meta-analysis and review of the literature. BMC Infect Dis. 2017; 17(Suppl 1): 695.
[17]	Annison L, Hackman H, Eshun PF, Annison S, Forson P, Antwi-Baffour S. Seroprevalence and effect of HBV and HCV co-infections on the immuno-virologic responses of adult HIV-infected persons on anti-retroviral therapy. PLoS ONE. 2022; 17(11): e0278037.
[18]	Price H, Dunn D, Pillay D, Bani-Sadr F, de Vries-Sluijs T, Jain MK, et al. Suppression of HBV by tenofovir in HBV/HIV coinfected patients: a systematic review and meta-analysis. PLoS ONE. 2013; 8(7): e68152.
[19]	Teagle A. People on HIV treatment less likely to have unsafe sex, SA study finds. Pretoria: Human Sciences Research Council; 2022 Sep 28. Available from: https://hsrc.ac.za/news/public-health/ people-on-hiv-treatment-less-likely-to-have-unsafe-sex-sa-study-finds.