Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana

Abstract

BackgroundViral hepatitis continues to play significant role in causing morbidity and mortality in sub-Saharan Africa. Apart from the few population based studies available, not many have investigated the burden of these viruses in jaundiced patients. Among the few studies, hepatitis E is the least studied among jaundiced patients. This study was aimed at describing the frequency, distribution and risk of the different hepatitis viruses among jaundiced patients reporting to the second largest teaching hospital in Ghana.MethodsFrom November, 2015 to April, 2016, a cross-sectional study was conducted among jaundiced patients attending the Komfo Anokye Teaching Hospital. Between 3–5 ml of blood was collected from each patient and screened for viral hepatitis agents using both serologic and molecular-based assays.ResultsIn the 155 patients recruited, hepatitis B was the most prevalent [54.2% (95% CI = 46.0%–62.2%)] followed by hepatitis E [32.9% (95% CI = 25.6–40.9%)]. Most cases of hepatitis E occurred as co-infections with hepatitis B (18%), with the predominant clinical feature being hepatocellular carcinoma. Risk factor variable analysis showed middle and older aged individuals were more at risk of hepatitis B exposure whereas younger age groups (<18 years) were more at risk of hepatitis E virus infection.ConclusionHepatitis viruses are still important in the viral aetiology of jaundice in Ghana. Hepatitis B and hepatitis E co-infections could play significant roles in causing severe disease. A more aggressive approach needs to be adopted in order to reduce the morbidity and mortality associated with hepatitis causing viruses in Ghana and other developing countries.

Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and meta-analysis

“…One study [36] was conducted among a symptomatically jaundiced population with 155 participants from an urban setting in the Ashanti region. This region is the most populous in Ghana.…”

Hepatitis E virus as an agent of hepatocellular carcinoma

“…In addition, it was pointed out that the cancer patients may have been at greater risk of HEV exposure as they likely received a higher number of blood transfusions than the controls, and also that their immunosuppression could have favored chronic HEV infection. Also, among 32 Ghanaian HCC patients with jaundice, HEV was detected in two cases alone (6%) and in nine cases in co-infection with HBV (28%) (Owusu et al, 2018). Hence, the majority of HEV cases co-occurred with HBV infection.…”

Knowledge, risk of infection, and vaccination status of hepatitis B virus among rural high school students in Nanumba North and South Districts of Ghana

“…In a systematic review of studies on HIV/HBV co-infection conducted across most regions in Ghana, researchers found an HIV/HBV co-infection rate of between 2.4% and 13.6% with a general co-infection rate of 13.6% [12]. In studying the etiology of viral hepatitis in 155 jaundiced patients in a teaching hospital in Ghana, researchers found that 54.2% of them tested positive for hepatitis B and 32.9% tested positive for hepatitis E [13]. The risk of infection to any disease or condition is dependent upon several factors, which may reduce or increase the risk.…”