Seroprevalence and viremia of hepatitis C virus among HIV-infected patients on ART with unsuppressed HIV viral load in Ethiopia

Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) share common transmission routes, resulting in a significant burden of co-infection. This study assessed the seroprevalence and viremia of HCV among people living with HIV (PLWH) on ART with unsuppressed viral load in Ethiopia. A cross-sectional study was conducted between June 2022 and February 2023 among 900 PLWH with unsuppressed viral loads. Plasma samples were screened for HCV antibodies by ELISA, and positives were confirmed for HCV RNA using the Abbott m2000sp/rt PCR system. Data were analyzed using SPSS V 26, applying chi-square tests and logistic regression to assess associations. Among 900 participants, 59.3% were females. Overall HCV seroprevalence was 5.4%, with higher rates among females (5.8%) and those aged 40–49 years. Active HCV viremia was confirmed in 14.3% of ELISA-positive cases (0.8% overall). Non-DTG regimens showed higher HCV co-infection (9.7%) than DTG-based regimens (4.4%, p = 0.062). HCV RNA positivity was more frequent in males and participants with medium HIV viral loads. A subset of PLWH with unsuppressed viral load showed evidence of HCV exposure and active infection. The result also indicates the exitance of active co-infection HIV/HCV. The data may also reflect spontaneous clearance of HCV or a high rate of past, resolved infections.