Nyarko Eric Ny, Amakye Ebenezer K, Ofori Emmanuel K, Appiah Michael, Anim Manfred, Lartey Nathaniel L, Ametepe Samuel, Adu Evans A, Kumi Justice, Dodoo Derrick N D, Adom Monica, Owiredu Emmanuel, Kwafo Esther, Obirikorang Christian
Department of Chemical Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Greater Accra Region, Ghana.
Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Northern Region, Ghana.
PLOS Glob Public Health. 2025 Sep 5;5(9):e0005132. doi: 10.1371/journal.pgph.0005132. eCollection 2025.
Coinfection of humans with Hepatitis B Virus (HBV) and non-viral pathogens may worsen the outcome of HBV infection on the liver. This study determined the prevalence of Heliobacter pylori, Salmonella typhi, Plasmodium falciparum, and Toxoplasma gondii among Hepatitis B Virus (HBV)-infected persons in the Greater Accra Region (GAR) of Ghana and examined how such co-infections might affect the levels of selected liver function markers (LFM). The design was cross-sectional, involving 120 HBsAg-positive HBV-infected persons. Blood samples were collected. H. pylori, S. typhi, P. falciparum, and T. gondii were screened for, from the blood using lateral flow immunochromatographic assays. P. falciparum infection was further confirmed by blood film microscopy. LFM's and blood platelets were measured using clinical chemistry and reflective light suppression/silicon photomultiplier techniques respectively. Data were analyzed using SPSS v. 23.0, and GraphPad 7.0. Seventy-five,75(62.5%) of the participants were males, and 51.7% were 21-to-30-years old. Prevalence of H. pylori, S. typhi, T.gondii and P. falciparum were 40.8% (95% CI: 32.5-49.8), 2.5% (95% CI: 0.8-7.1), 19.2% (95% CI: 13.1-27.1), and 2.5% (95% CI: 0.8-7.1) respectively. Levels of Alanine transaminase (ALT) were higher in HBV-H.pylori coinfected persons compared with HBV-only (33.5vs23.5IU,p < 0.001). HBV-infected persons in the GAR have high prevalences of H. pylori and T. gondii coinfections. Some LFM's were elevated due to such coinfections. Care givers would need to widen their screening, monitoring, and diagnosis of HBV coinfections, beyond examination for malaria parasites, and monitor other possible causes of biochemical derangements among HBV-infected persons.
人类感染乙型肝炎病毒（HBV）的同时感染非病毒病原体可能会使HBV感染对肝脏造成的后果恶化。本研究确定了加纳大阿克拉地区（GAR）感染乙型肝炎病毒（HBV）的人群中幽门螺杆菌、伤寒沙门氏菌、恶性疟原虫和弓形虫的感染率，并研究了这种合并感染如何影响所选肝功能标志物（LFM）的水平。研究设计为横断面研究，涉及120名HBsAg阳性的HBV感染者。采集血样。使用侧向流免疫层析法从血液中筛查幽门螺杆菌、伤寒沙门氏菌、恶性疟原虫和弓形虫。恶性疟原虫感染通过血涂片显微镜检查进一步确认。分别使用临床化学和反射光抑制/硅光电倍增管技术测量LFM和血小板。使用SPSS v. 23.0和GraphPad 7.0对数据进行分析。75名（62.5%）参与者为男性，51.7%的参与者年龄在21至30岁之间。幽门螺杆菌、伤寒沙门氏菌、弓形虫和恶性疟原虫的感染率分别为40.8%（95%CI：32.5 - 49.8）、2.5%（95%CI：0.8 - 7.1）、19.2%（95%CI：13.1 - 27.1）和2.5%（95%CI：0.8 - 7.1）。与仅感染HBV的人相比，HBV - 幽门螺杆菌合并感染的人的丙氨酸转氨酶（ALT）水平更高（33.5对23.5IU，p < 0.001）。GAR地区感染HBV的人幽门螺杆菌和弓形虫合并感染的发生率很高。这种合并感染会使一些LFM升高。护理人员需要扩大对HBV合并感染的筛查、监测和诊断范围，除了检查疟原虫之外，还要监测HBV感染者生化紊乱的其他可能原因。
