{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:59:12Z","timestamp":1781528352602,"version":"3.54.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Co-infection with multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus (HIV) represents a major global public health challenge. The coexistence of these conditions with chronic hepatitis B infection further complicates clinical management due to overlapping drug toxicities, limited treatment options, and challenges with patient adherence, particularly in resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation and clinical findings<\/jats:title>\n                    <jats:p>A 37-year-old woman living with HIV presented to a clinic in Ghana\u2019s Central Region with symptoms suggestive of pulmonary tuberculosis (TB). Further evaluation led to the diagnosis of rifampicin-resistant pulmonary TB, chronic hepatitis B infection, and chronic renal impairment. Her clinical course was complicated by adverse drug reactions, chronic renal disease and intermittent interruptions in antiretroviral therapy due to drug stockouts. These factors posed significant challenges to treatment continuity and tolerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite significant clinical and systemic challenges, the patient completed a 12-month MDR-TB regimen with documented microbiological cure. Antiretroviral therapy for HIV is ongoing, while the hepatitis B infection and chronic renal disease are under clinical monitoring without specific antiviral treatment or dialysis due to cost constraints. This case highlights the critical importance of integrated, multidisciplinary care in the management of complex co-infections. It also draws attention to persistent health system constraints, including drug shortages, limited diagnostic capabilities, and financial barriers to accessing healthcare, which must be addressed to improve outcomes for patients with similar high-risk profiles in low-resource settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1801109","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:47:06Z","timestamp":1781527626000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated management of multidrug-resistant tuberculosis, HIV, and hepatitis B co-infection in Ghana: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Stanley","family":"Yaidoo","sequence":"first","affiliation":[{"name":"Awutu Senya East Health Directorate, Ghana Health Service","place":["Kasoa, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith Maame Tanoa","family":"Yelbert","sequence":"additional","affiliation":[{"name":"University of Ghana Medical Centre","place":["Legon, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodger","family":"MacScott-Lutterodt","sequence":"additional","affiliation":[{"name":"Greater Accra Regional Hospital","place":["Accra, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Nkumah","family":"Obeng","sequence":"additional","affiliation":[{"name":"Awutu Senya East Health Directorate, Ghana Health Service","place":["Kasoa, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephannie Kafui","family":"Amenya","sequence":"additional","affiliation":[{"name":"Awutu Senya East Health Directorate, Ghana Health Service","place":["Kasoa, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.4081\/idr.2016.6570","article-title":"Tuberculosis 2015: burden, challenges and strategy for control and elimination","volume":"8","author":"Raviglione","year":"2016","journal-title":"Infect Dis Rep"},{"key":"ref2","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12981-016-0107-x","article-title":"Prevalence of HIV and hepatitis B coinfection in Ghana: a systematic review and meta-analysis","volume":"13","author":"Agyeman","year":"2016","journal-title":"AIDS Res Ther"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/1097581","article-title":"Predictors of adverse TB treatment outcome among TB\/HIV patients compared with non-HIV patients in the Greater Accra regional hospital from 2008 to 2016","volume":"2020","author":"Hayibor","year":"2020","journal-title":"Tuberc Res Treat"},{"key":"ref5","doi-asserted-by":"crossref","DOI":"10.1101\/2024.10.08.24315084","article-title":"The Double Burden of TB\/HIV co-infection: evidence from Central Region of Ghana","author":"Lugutuah","year":""},{"key":"ref6","doi-asserted-by":"publisher","first-page":"18360","DOI":"10.1038\/s41598-022-23316-4","article-title":"Survival rate and predictors of mortality among TB\/HIV co-infected adult patients: retrospective cohort study","volume":"12","author":"Lelisho","year":"2022","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1186\/s12879-023-08505-4","article-title":"The metabolic consequences of HIV\/TB co-infection","volume":"23","author":"Herbert","year":"2023","journal-title":"BMC Infect Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1186\/s12879-023-08575-4","article-title":"Prevalence and risk factors of tuberculosis among people living with HIV\/AIDS in China: a systematic review and meta-analysis","volume":"23","author":"Qi","year":"2023","journal-title":"BMC Infect Dis"},{"key":"ref9","year":"2022"},{"key":"ref10","year":""},{"key":"ref11","volume-title":"Consolidated Guidelines for HIV care in Ghana: Test, Treat and Track","year":"2022"},{"key":"ref12","volume-title":"Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring","year":"2021"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1801109\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:47:07Z","timestamp":1781527627000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1801109\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":12,"alternative-id":["10.3389\/fmed.2026.1801109"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1801109","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1801109"}}