Hepatitis C virus seroprevalence among people with sickle cell disease in Uganda: a cross-sectional study

Abstract

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.