Hepatitis B And Hepatitis C Viral Infections And Associated Factors Among Patients With Diabetes Visiting Gondar Referral Teaching Hospital, Northwest Ethiopia: A Comparative Cross-Sectional Study

Abstract

Background

The liver is the major site of Hepatitis B virus and Hepatitis C virus replications. Patients with diabetes tend to be at an increased risk for developing various forms of liver diseases. The infection of the liver can cause or exacerbate diabetes. On the other hand, diabetes can cause or intensify the severity of liver infection. This comparative cross-sectional study was conducted with the aim to determine the prevalence of Hepatitis B and Hepatitis C virus infections and associated factors among patients with diabetes visiting the University of Gondar referral teaching hospital, northwest Ethiopia.

Results

Out of the 610 participants (305 patients with diabetes, 305 people with no diabetes) of the study, 65 (10.7%) were positive for Hepatitis infections, of whom 44 (14.4%) and 21 (6.9%) were positive for at least one of the viruses in patients with diabetes and people with no diabetes, respectively. Out of the diabetic and non-diabetic groups of the study, 26 (8.5%) and 14 (4.6%) (95% CI, 0.96–4.02) were positive for Hepatitis B virus, respectively, while 23 (7.5%) and 7 (2.3%) (95% CI, 1.46–8.68) of the diabetes and non-diabetic groups were positive for Hepatitis C virus, respectively. History of blood transfusion (95% CI, 1.36–12.71) and unprotected sex (95% CI, 1.25–10.15) were significantly associated with Hepatitis B virus infection, while the type of diabetes (95% CI, 1.25–10.89) was associated with anti-Hepatitis C virus positivity.

Conclusion

Positivity for Hepatitis C virus was significantly associated with Type II diabetes. Blood transfusion and unprotected sex were risk factors for Hepatitis B virus infections. Further studies that elaborate temporal associations and find out explanations for the relationship between diabetes and Hepatitis C viral infections are of paramount importance.

Keywords:

• HBV
• HCV
• DM
• co-infection

Acknowledgments

We thank all the study participants, data collectors and supervisors for their participation. This manuscript was presented at the Department of Medical Laboratory Sciences, School of Allied Health Sciences, Addis Ababa University for a partial fulfilment of the requirements for MSc degree.

Abbreviations

Ab, Antibody; Ag, Antigen; ALP, Alkaline Phosphatase; AST, Aspartate Transaminase; CDC, Center for Disease Control; CHB, Chronic Hepatitis B Infection; CLD, Chronic Liver Disease; DM, Diabetic Mellitus; DNA, Deoxy Ribose nucleic acid; EIA, Enzyme Immunoassay; ELISA, Enzyme-Linked Immune Sorbent assay; HAV, Hepatitis A virus; HBc, Hepatitis B core; HBIG, Hepatitis B immune Globulin; HBsAg, Hepatitis B surface Antigen; HBV, Hepatitis B Virus; HCC, Hepatocellular Carcinoma; HCV, Hepatitis C Virus; OPD, Out Patient Department; RNA, Ribose Nucleic Acid; SOPS, Standard Operating Procedures; T1DM, Type 1 Diabetic Mellitus; T2DM, Type 2 Diabetic Mellitus; TMB, 3, 3ʹ, 5, 5ʹ-Tetramethylbenzidine.

Ethics Approval And Consent To Participate

Ethical clearance was obtained from the Department Research and Ethics Review Committee (DRERC) of Addis Ababa University, College of Health Sciences, School of Allied Health Sciences, Department of Laboratory Sciences with a protocol number of DRERC/224/16/MLS and the study was conducted in accordance with the declaration of Helsinki. Then, permission was obtained from the University of Gondar referral teaching hospital to access data from the study population. All eligible participants were informed that participation was voluntary and personal information obtained was coded to maintain confidentiality.

Availability Of Data And Material

The datasets used and/or analyzed during the study are available from the corresponding author on reasonable request.

Author Contributions

YM designed and implemented the study, collected data, undertook statistical analysis, performed data interpretation, and drafting the manuscript. TT, SA, TB, AF and KD participated in data analysis and data interpretation and reviewed the manuscript. All authors contributed toward the data analysis, drafting, and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.