Hepatitis B in Ethiopia: Viral Load, Affordability, and Patient Perspectives at a Tertiary Hospital in Addis Ababa, Ethiopia

Abstract

<title>Abstract</title> <bold>Background</bold> Hepatitis B virus (HBV) is a leading cause of liver infections, often resulting in chronic illness and liver cancer. It affects millions of people worldwide, with a particularly high burden in Africa, especially Ethiopia. Despite its prevalence, access to HBV viral load testing is limited, and its affordability has not been well documented, particularly in Ethiopia, making it challenging to diagnose and treat the disease effectively. Therefore, this study aimed to quantify the HBV viral load, affordability, knowledge, attitudes, and practices related to this disease among HBV-infected patients at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia, in 2024. <bold>Methods</bold> A cross-sectional study was conducted from January to April 2024 using quantitative and qualitative data from 256 participants. Affordability was assessed using household income and expenditure on HBV viral load (VL) tests, with VL quantification performed using the Cobas®6800. Knowledge, attitudes, and practices (KAPs) were measured using a Likert scale. Data management and analysis were conducted using SPSS version 25, with a significance level set at p &lt; 0.05. <bold>Results</bold> A total of 256 participants were included in this study, 53.1% of whom were females. Compared with female participants, male participants demonstrated a significantly greater likelihood of having a high viral load (AOR = 2.49, 95% CI: 1.26–4.92, p = 0.01). Individuals with co-infections exhibited a substantially increased likelihood of having a high viral load (AOR = 8.38, 95% CI: 3.76–12.29, p &lt; 0.01). Regarding KAP concerning HBV infection, 50% of the participants demonstrated good knowledge, 38.3% exhibited a positive attitude, and 57.8% reported good practices. Urban residents (AOR = 0.11, 95% CI: 0.02–0.60, p = 0.01), higher-income earners (AOR = 0.14, 95% CI: 0.05–0.43, p &lt; 0.01), and individuals who had undergone viral load testing within the previous month (AOR = 0.01, 95% CI: 0.09–0.17, p &lt; 0.03) all demonstrated significantly lower odds of experiencing catastrophic expenditures. <bold>Conclusion</bold> This study highlights the importance of tailored HBV management strategies, including targeted interventions, such as gender- and co-infection-specific approaches, comprehensive infection prevention and control, and enhanced public health education. Reducing financial barriers to HBV diagnosis and care, especially for vulnerable populations, is crucial.