{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:08:26Z","timestamp":1763662106278,"version":"3.44.0"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>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 <jats:italic><jats:italic>Heliobacter pylori, Salmonella typhi, Plasmodium falciparum<\/jats:italic><\/jats:italic>, and <jats:italic><jats:italic>Toxoplasma gondii<\/jats:italic><\/jats:italic> 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. <jats:italic><jats:italic>H. pylori, S. typhi, P. falciparum<\/jats:italic><\/jats:italic>, and <jats:italic><jats:italic>T. gondii<\/jats:italic><\/jats:italic> were screened for, from the blood using lateral flow immunochromatographic assays. <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> infection was further confirmed by blood film microscopy. LFM\u2019s 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<jats:bold>.<\/jats:bold> Seventy-five,75(62.5%) of the participants were males, and 51.7% were 21-to-30-years old. Prevalence of <jats:italic><jats:italic>H. pylori, S. typhi, T.gondii<\/jats:italic><\/jats:italic> and <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> were 40.8% (95% CI: 32.5\u201349.8), 2.5% (95% CI: 0.8\u20137.1), 19.2% (95% CI: 13.1\u201327.1), and 2.5% (95% CI: 0.8\u20137.1) respectively. Levels of Alanine transaminase (ALT) were higher in HBV-H.pylori coinfected persons compared with HBV-only (33.5vs23.5IU,p\u2009&lt;\u20090.001). HBV-infected persons in the GAR have high prevalences of <jats:italic><jats:italic>H. pylori<\/jats:italic><\/jats:italic> and <jats:italic><jats:italic>T. gondii<\/jats:italic><\/jats:italic> coinfections. Some LFM\u2019s 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.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005132","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:21:46Z","timestamp":1757092906000},"page":"e0005132","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Helicobacter pylori, Salmonella typhi, Plasmodium falciparum, and Toxoplasma gondii infections and levels of liver function markers among Hepatitis B Virus infected Ghanaians: A cross-sectional study in the Greater Accra Region"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-2569","authenticated-orcid":true,"given":"Eric NY","family":"Nyarko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebenezer K","family":"Amakye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel K","family":"Ofori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-4473","authenticated-orcid":true,"given":"Michael","family":"Appiah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4745-8505","authenticated-orcid":true,"given":"Manfred","family":"Anim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9810-2720","authenticated-orcid":true,"given":"Nathaniel L","family":"Lartey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Ametepe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evans A","family":"Adu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-2322","authenticated-orcid":true,"given":"Justice","family":"Kumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derrick N. 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Serum metabolome signatures characterizing co-infection of Plasmodium falciparum and HBV in pregnant women. 2023.","DOI":"10.21203\/rs.3.rs-2160899\/v1"},{"key":"pgph.0005132.ref020","doi-asserted-by":"crossref","unstructured":"Helegbe G, et al. 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