Prevalence, Genetic Diversity and Drug Resistance of Hepatitis B Virus among Hiv-Infected Patients Attending Kisii Teaching and Referral Hospital, Kisii County, Kenya
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Date
2025-06
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Kenyatta University
Abstract
The Hepatitis B Virus (HBV) infections continue to pose a global public health concern. The emergence of liver cirrhosis and liver cancer incidences have been increasing. HBV co-infection with HIV-1 has been on an upward trajectory, exacerbating the accompanying severe complications that include liver cirrhosis and, eventually, cancer that could lead to mortalities. Based on the shared transmission routes of HBV and HIV infections and the upsurge of incidences of infections associated with these viral infections, the need to confirm the status of disease burden in the country, particularly Kisii County, is inevitable. This study was conducted to assess the prevalence, genetic diversity, and drug resistance of HBV among HIV-infected patients at Kisii Teaching and Referral Hospital in Kisii County, Kenya. A cross-sectional study was conducted, and participants were randomly recruited. Administration of a structured questionnaire was conducted, and demographic data was acquired from 400 consenting eligible HIV-infected patients. Blood samples were drawn, and HBV infection HBsAg serostatus was confirmed. The samples confirmed to be HBsAg-positive were isolated, and viral DNA was extracted using the Qiagen Viral DNA Mini Kit, following the manufacturer's guidelines. The HBV–pol gene was then amplified and directly sequenced using the automated ABI 377 DNA sequencer (Applied Biosystem, Foster City, USA). The produced sequences were phylogenetically analysed using the Molecular Evolutionary Genetics Analysis (MEGA X version 10.4) software. The risks associated with HBV infections were statistically analyzed using two-way ANOVA. Of the 400 individuals who participated in this study, 221(55.2%) were female and 179 (44.8%) were male, all aged between 18 and 69 with an average age of 40.09 years. Majority of the study particpants (301/400) had tertiary levels of education. Age, gender and marital status were identified as significant risk factors associated with HBV infections. The overall prevalence of 11.75% (47/400) HBV-HBsAg was detected in this study. The analysis of the phylogenetic relationships of the 47 samples revealed that all sequences were of HBV genotype A. HBV nucleos(t)ide drug resistance mutations; rt1814V (1), rt180FSQ rt202L/E, I169K/L, rtV173K/G (2), rt202H/F/K (3), 180Q/S/F (3), and rt181G (4) were detected in 4 (8.5%) patients. This study, therefore, confirms that HBV genotype A is the most predominant in the country, with a low proportion of HBV-HIV co-infected patients being infected with drug-resistant strains. In addition, this study shows that in order to entirely suppress infections in co-infected individuals with HIV and HBV, dual antiviral therapy is required.
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science (Medical Microbiology) in the School of Pure and Applied Sciences of Kenyatta University, June, 2025
1.Anthony Kebira
2.John Maingi