Prevalence and determinants of hepatitis B surface antigen and anti-HCV seropositivity among patients tested at Mibilizi District Hospital, Rwanda

Abstract

Hepatitis B (HBV) and hepatitis C virus (HCV) infections are major contributors to chronic liver disease and hepatocellular carcinoma. Existing studies suggest an increase in hepatitis infection and associated factors, necessitating appropriate public health strategies to address this health concern. However, the general prevalence and factors of HBV and HCV remain largely unknown in Rwanda. Hence, we aimed to determine the prevalence and associated factors of HBV and HCV at Mibilizi Hospital, Rwanda. This retrospective cross-sectional study targeted 4221 patients who were tested for hepatitis infection, from which a sample of 384 participants were randomly selected at the Mibilizi District Hospital from January to December 2022. Data were collected from laboratory log-books and patient files using a standardized data collection form. Descriptive and analytical analyses were performed using Epi Info™ 7.2 (CDC, Atlanta, USA), with a 95% confidence interval and a significance threshold of 5%. Among 384 participants (mean age of 41 years ± 11.21), the majority were female (83.6%). The prevalence of HBV and HCV was 7.8% and 7.2%, respectively, while co-infection was observed in 1% of participants. Multiple logistic regression models showed that participants whose liver enzyme levels were 35–100IU/L had significantly higher likelihoods of HBV (aOR = 5.98; 95%CI: 2.08–17.16; p < 0.001) compared to those whose enzyme levels were < 35 IU/L. Married individuals had higher likelihoods of HCV (aOR = 2.57; 95%CI: 2.23–23.22; p = 0.039) than single participants. Additionally, participants with liver enzyme levels ranging from 35 to 100 IU/L (aOR = 4.87; 95%CI: 1.76–13.39; p < 0.001) or above 100 IU/L (aOR = 8.03; 95%CI:3.07–21.21; p < 0.001) were strongly associated with higher odds of HCV infection compared to those with enzyme levels below 35 IU/L. This study reveals a higher-than expected prevalence of HBV and HCV infections in the study population, underlining their continued significance as public health concern challenges. The identified associations between infection and determinants including liver enzyme levels, age, and marital status, indicate the urgent need for targeted, evidence-based interventions. Future longitudinal studies are warranted to elucidate causal pathways and better inform preventive measures.