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Hepatitis C virus seroprevalence among people with sickle cell disease in Uganda: a cross-sectional study
Winnie Kibone1, Conrad Muzoora2, Felix Bongomin3,4
1Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P. O. Box 166, Gulu, Uganda.
Insights
Hepatitis C virus (HCV) infection is highly prevalent in Ugandan individuals with sickle cell disease (SCD), particularly among those under 18 who have received multiple blood transfusions. Enhanced screening and prevention are crucial.
Area of Science:
- Hepatology
- Infectious Diseases
- Hematology
Background:
- Viral hepatitis poses a significant global health threat, leading to chronic liver disease, cirrhosis, and hepatocellular carcinoma.
- Individuals with sickle cell disease (SCD) face an elevated risk of hepatitis C virus (HCV) infection due to frequent blood transfusions.
- Limited recent data exists on HCV seroprevalence among SCD patients in Uganda, despite the country's high HCV burden.
Purpose of the Study:
- To determine the seroprevalence of HCV among patients with SCD.
- To describe the characteristics of HCV-infected individuals within this population.
- To assess co-infections with Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV).
Main Methods:
- A hospital-based cross-sectional study was conducted at Mulago National Referral Hospital (MNRH) in Kampala, Uganda.
- 119 participants with SCD were recruited, and data on sociodemographic, clinical, and behavioral factors were collected.
- HCV, HBsAg, and HIV rapid tests were performed, with data analyzed using SAS statistical package.
Main Results:
- The HCV seroprevalence among individuals with SCD was 12.6% (15/119).
- All HCV-positive participants were under 18 years old, with a higher proportion among those aged 9-17 years (66.7%).
- Nearly all HCV-positive individuals (93.3%) had a history of blood transfusions, with 53.3% reporting three or more transfusions. HIV and HBsAg prevalence were low (0.84% and 0% respectively).
Conclusions:
- A significant HCV seroprevalence was observed in Ugandan individuals with SCD.
- There is a critical need to strengthen routine HCV screening, linkage to care, and infection prevention strategies, particularly within transfusion services.
- Further research, including HCV RNA testing, is recommended to fully understand the burden of active infection and guide targeted interventions.
Background:
Viral hepatitis is a major cause of chronic liver disease, including cirrhosis and hepatocellular carcinoma, with significant morbidity and mortality. Individuals with sickle cell disease (SCD) are at increased risk of hepatitis C virus (HCV) infection due to frequent transfusions. Despite the high burden of HCV in Uganda, recent data on HCV seroprevalence among individuals with SCD are limited.
Objective:
To determine HCV seroprevalence and describe characteristics among patients with SCD receiving care at Mulago National Referral Hospital (MNRH), Kampala, Uganda.
Design:
Hospital-based cross-sectional study.
Methods:
Individuals with SCD attending the MNRH outpatient SCD clinic in Kampala, Uganda, were recruited between July and September 2025. Sociodemographic, clinical, and behavioral data were collected using a structured questionnaire. Anthropometric measurements were taken using standardized scales. HCV, hepatitis B surface antigen (HBsAg), and HIV rapid tests were performed. Data were analyzed using the SAS statistical package version 9.4.
Results:
There were 119 participants with SCD enrolled, with a mean age of 13.1 years, and 55.5% (n = 66) were male. Most participants had a SCD diagnosis for 6 years or longer. HCV seroprevalence was 12.6% (n = 15). All HCV-seropositive participants were less than 18 years, with nearly two-thirds of those aged 9-17 years (66.7%, n = 10). Nearly all HCV-seropositive participants had a history of blood transfusion (n = 14, 93.3%), with 53.3% (n = 8) reporting three or more transfusions. Only one participant (0.84%) tested positive for HIV, and none tested positive for HBsAg.
Conclusion:
This study revealed a high seroprevalence of HCV among individuals with SCD in Uganda. Strengthening routine HCV screening, linkage to care, and infection prevention, including within blood transfusion services, is needed. Larger studies incorporating HCV RNA testing are recommended to assess the true burden of active infection and risk factors among patients with SCD to inform targeted prevention, screening, and treatment strategies.
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