Abstract
Background: Viral hepatitis is a major global health problem. There is a paucity of data from Botswana on the seroprevalence of markers of hepatitis. The objective of the study was to determine the seroprevalence and risk factors of hepatitis B virus (HBV), hepatitis D virus (HDV) and hepatitis C virus (HCV) infections in patients with clinical features of hepatitis and/or altered liver function tests.Method: This cross-sectional study was done at Princess Marina Hospital (PMH) in Gaborone, Botswana, from February 2015 to July 2016. It involved 328 adult patients with any of the following: jaundice, history of liver disease and/or increased serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum bilirubin of 2 times the upper limit of normal (ULN).Results: Active or chronic active hepatitis (hepatitis B surface antigen [HBsAg] positive) was identified in 46.7% of patients. Antibodies to HDV infection were detected in 4.6% of the HBsAg-positive patients and antibodies to HCV infection in 4.3% of the study patients. Immunity against HBV infection was noted in 34.5% of patients. Human immunodeficiency virus (HIV) co-infection was self-reported by 42.7% of HBsAg-positive patients with known HIV status.Conclusion: High prevalence rate of HBV, HCV, HDV infection and HIV co-infection was observed in patients with liver disease attending PMH.
Highlights
Viral hepatitis is a serious public health problem, responsible for an estimated 1.4 million annual deaths globally, largely because of related liver cancer, cirrhosis and in a much lower proportion to acute liver failure.[1]Hepatitis B virus (HBV) and hepatitis C virus (HCV) contribute to 47% and 48% of these deaths, respectively.[1]
The aim of this study was to determine the serologic prevalence of viral hepatitis as a result of HBV, hepatitis D virus (HDV) and HCV and their risk factors amongst patients presenting with clinical features of hepatitis and/or altered liver function tests, attending Princess Marina Hospital (PMH), the main referral hospital in Botswana
The high prevalence of hepatitis B surface antigen (HBsAg) (46.7%), indicating active or chronic infection, in this study is in consensus with that reported earlier from Botswana (47%) during an outbreak of non-A non-B hepatitis infection in 1985.22 This is higher than the seroprevalence reported in studies from patients with liver disease in India (25.9%), Mongolia (29.2%), Sudan (30%) and Ethiopia (35.8%).[9,10,12,25]
Summary
Viral hepatitis is a serious public health problem, responsible for an estimated 1.4 million annual deaths globally, largely because of related liver cancer, cirrhosis and in a much lower proportion to acute liver failure.[1]Hepatitis B virus (HBV) and hepatitis C virus (HCV) contribute to 47% and 48% of these deaths, respectively.[1]. Viral hepatitis is a serious public health problem, responsible for an estimated 1.4 million annual deaths globally, largely because of related liver cancer, cirrhosis and in a much lower proportion to acute liver failure.[1]. Two billion people are estimated to have evidence of past or present infection with HBV worldwide.[1] Hepatitis B virus infection has resulted in 887 000 deaths in 2015, mostly from complications related to cirrhosis and hepatocellular carcinoma.[2] Co-infection of HBV and hepatitis D virus (HDV) occurs in 5% of HBV-infected individuals (approximately 15–20 million people) worldwide and leads to more severe liver disease.[3] Studies in Africa have reported the seroprevalence rate of HBV and HDV co-infections ranging from 0% – 0.6% in South Africa to 5% – 58% in Egypt with 8.39% in sub-Saharan Africa.[2,3,4]. The objective of the study was to determine the seroprevalence and risk factors of hepatitis B virus (HBV), hepatitis D virus (HDV) and hepatitis C virus (HCV) infections in patients with clinical features of hepatitis and/or altered liver function tests
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