High prevalence of co-infections with latent tuberculosis, syphilis and hepatitis B and C among people with HIV in Ghana: a call for integrating screening into routine care.

Background: People with HIV (PWH) are at risk of co-infections, such as latent tuberculosis (LTBI), hepatitis B (HBV), hepatitis C (HCV), and syphilis; hence, routine screening is critical. However, evaluation of routine screening is not being fully implemented in Ghana. This study assessed the prevalence of these co-infections among PWH in Accra, Ghana.

Methods: The HIV Cure Research Infrastructure Study (H-CRIS) followed 390 PWH from three HIV treatment centres in Accra. A cross-sectional study was conducted within this cohort, and participants were screened for LTBI, hepatitis B, hepatitis C, and syphilis using standardized assays. LTBI was detected using the QuantiFERON-TB Gold Plus assay. Syphilis testing included treponemal and non-treponemal assays. HBV and HCV were tested using rapid test kits. Data was collected on demographics, viral load, CD4 count, ART regimen, and therapy duration. Descriptive statistics used frequency and proportion, while inferential analysis employed chi-square tests, t-tests, and odds ratios (OR) to assess associations.

Results: Among 390 participants, median age: 45 years (IQR: 39-52 years), 69% (269/390) were virologically suppressed, and 80% (312/390) had CD4 counts above 350 cells/µL. The prevalence of co-infections was 12% (48/390) for HBV, 10.8% (42/390) for LTBI, 12.5% (40/320) for syphilis, and 1% (4/390) for HCV, with 2% (8/390) having more than two co-infections. LTBI was associated with age (> 60 years; OR = 3.5) and years of HIV diagnosis (> 10 years; OR = 2.2).

Conclusion: The significant burden of co-infections among PWH in Ghana highlights the urgent need to integrate routine screening into HIV care.