Screening for anti-HCV antibodies in a cohort of people living with HIV at “Zia Angelina“ Medical Centre, Kampala, Uganda

¹Dipartimento di Scienze Mediche e Chirurgiche, Università “Magna Graecia”, Catanzaro, Italy, ²Zia Angelina Health Centre of Kampala, Kampala, Uganda, ³Dipartimento di Scienze Mediche e Chirurgiche, Università “Magna Graecia”, Catanzaro, Italy, ⁴UOC Malattie Infettive, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy, ⁵Sezione Malattie Infettive, Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy

^&Corresponding author
Francesco De Maria, Dipartimento di Scienze Mediche e Chirurgiche, Università “Magna Graecia”, Catanzaro, Italy

To the editors of the Pan African Medical Journal    

People living with HIV (PLWH) in low-income countries face a high burden of communicable diseases, with co-infections such as the Hepatitis C virus (HCV) remaining a major concern. The consequences of HCV are more severe in individuals with HIV, and yet, in countries like Uganda, routine screening for HCV among PLWH is not standard. Our pilot study aimed to estimate the prevalence of HIV-HCV co-infection in this population at the Zia Angelina Medical Centre, a category III health facility in Namugongo, near Kampala [1,2]. Between January and October 2021, 300 HIV-positive individuals were called for anti-HCV antibody testing using a fourth-generation rapid test (LABOQUIK). Of these, 279 (93%) presented for screening. Only two patients (0.7%), both female, tested positive for anti-HCV antibodies. Among them, one showed abnormal liver enzyme values. The limited number of confirmed positive cases suggests a low prevalence of HCV among PLWH in this Ugandan setting [3].

While our findings align with previous reports suggesting stable or declining HCV trends in this population, several limitations must be acknowledged. The reliance on serological testing without confirmatory HCV RNA assays may underestimate prevalence due to false negatives during the window period or interference from co-endemic infections such as malaria [4,5]. Moreover, our sample size, although higher than similar studies in comparable settings, limits generalizability [6]. Despite these limitations, this study contributes valuable local data to the sparse literature on HIV-HCV co-infection in Uganda. It underscores the feasibility of implementing integrated screening models in outpatient HIV care, even in resource-constrained environments. Given the WHO's target of eliminating viral hepatitis as a public health threat by 2030, our experience highlights the urgent need to expand routine HCV screening among PLWH using reliable diagnostic algorithms, including RNA testing where feasible [7-10].

Conclusion    

This study confirms the feasibility and relevance of combined screening programs for co-infections in HIV-positive populations in Uganda. Despite its limitations, the study provides updated local data that can support public health efforts toward viral hepatitis elimination.

Competing interests     

The authors declare no competing interests.

Authors´ contributions     

Francesco De Maria: conceptualization, data analysis, writing, original draft. Fernando Rico González: methodology, data validation, writing, review, and editing. Alice Joy Namuwonge: Data collection, clinical coordination. Carlo Torti: supervision, manuscript review. All the authors have read and agreed to the final version of this manuscript.

References