HBV and HCV prevalence and treatment eligibility assessment at a primary health facility in Ghana

Abstract

Background: Viral hepatitis continues to be of global public health importance, especially hepatitis B and C. Hepatitis B and C account for most of the mortality and morbidity attributable to these viral infections. There is lack of accessibility to diagnostic tools, assessment for the eligibility for treatment and treatment in most LMICs, including Ghana. Assessment for HBV treatment is expensive and not widely available throughout Ghana. TREAT-B, a new, affordable and widely available assessment tool for HBV treatment eligibility, offers a cost-effective alternative to the international and local guidelines currently in use. Aim: To determine the prevalence of HBV and HCV in a cohort of patients and to assess the HBV infected for treatment eligibility. Materials and methods: A cross-sectional study of individuals diagnosed with hepatitis B infection was undertaken to assess their eligibility for treatment using local and international treatment guidelines. An additional retrospective review of records of patients screened for hepatitis B and C viruses over the period was undertaken. Questionnaires on socio-demographic were self-administered. Blood was taken for haematological analysis, liver function test, hepatitis B serological tests and DNA extraction for hepatitis B genotyping and drug sensitivity determination. Results: From the retrospective review, 3358 individuals had complete data for further analysis. Prevalence for HBV and HCV was estimated at 4.3% and 1.9% respectively. Males were 3 times more likely to be HBV positive compared to females (AOR=2.8, 95% CI: 1.8-4.2, p-value < 0.001). Those who were born after the introduction of after the UCVHB had higher odds of having HBV compared to those who were born before (AOR=3.6, 95% CI: 2.5-5.3, p-value < 0.001). Assessment of 74 HBV positive patients found, 20%, 9.5%, 4.7% and 4.7% were eligible for treatment according to the TREAT-B, the WHO simplified, Ghanaian and AASLD guidelines respectively. Conclusion: The burden of HBV and HCV infections remain high in Ghana and policies must be implemented to treat individuals eligible.