This retrospective cross-sectional study analyzed data collected between 2013 and 2023 at the Pietro Annigoni Biomolecular Research Center (CERBA) in Ouagadougou. It included all individuals tested for HIV and HCV, regardless of gender, status, or diagnostic context. In addition, a prospective study was conducted in 2024 as part of a community-based HIV and HCV screening campaign in Ouagadougou. Participants in World Hepatitis Day underwent serological screening for HIV and HCV, performed as part of premarital, prenatal, or ongoing therapeutic monitoring.

The data were collected from information available in the CERBA databases, as well as during viral hepatitis and HIV prevention and screening campaigns. The variables studied included sex, age, and serological results related to HIV and hepatitis C virus (HCV).

A venous blood sample was taken from each participant. Five milliliters were collected, one in a dry tube and the other in a tube containing EDTA. After centrifugation of the samples at 3000 rpm for 10 minutes, the resulting plasma or serum was used for laboratory analyses. When these analyses were not performed on the same day, the samples were stored at −20˚C or −80˚C. Additionally, whole blood stains were recorded on dried-type paper. Blood spot (DBS) samples were prepared and stored at room temperature. Whole blood was also stored at −80˚C for subsequent molecular biology analyses. Between 2013 and 2024, immunology reagents and automated systems underwent significant developments, leading to the gradual replacement of many diagnostic reagents used at the beginning of the study period.

HIV serological screening of patients was performed using two rapid tests: Determine^® (Abbott Laboratories, Tokyo, Japan) and SD Bioline (Standard Diagnostics, Inc., Korea). In cases of discordant results between these two tests for the same individual, a third confirmatory test was immediately recommended, in accordance with the national algorithm. For this step, the ImmunoComb^®II HIV-1&2 Bispot kit (Orgenics, Yavne, Israel) was used [17]. Currently, when uncertainties persist after the use of these three tests, the sample in question is sent either to the Cobas 6000 analyzer for the “Elecsys HIV combi PT” test (Roche Diagnostics GmbH, Mannheim, Germany), which allows for the simultaneous detection of HIV-1 p24 antigen, anti-HIV-1 and anti-HIV-2 antibodies, or to a qualitative analysis by polymerase chain reaction (PCR). DNA extraction from dried blood spots (DBS) were detected using the QIAamp DNA Blood Mini Kit (QIAGEN, Hilden, Germany), according to the manufacturer’s instructions. HIV-1 proviral DNA detection was then performed using the Applied system. Biosystems GeneAmp^® PCR System 9700 associated with the “Generic HIV DNA Cell” kit (Biocentric, Bandol, France), following the protocol recommended by the manufacturer.

Screening for hepatitis C virus (HCV) was performed using the Elecsys kit Anti-HCV II (Roche Diagnostics GmbH, Mannheim, Germany). If necessary, a further analysis by qualitative polymerase chain reaction (PCR) was performed.

The data were compiled using Microsoft Excel 2016 software. Statistical analyses were performed with SPSS version 20.0 and EpiInfo7. A p-value less than 0.05 was considered statistically significant.

The HOSCO/CERBA Institutional Ethics Committee approved this study by Resolution No. 2024-07-CE dated May 15, 2024. The confidentiality and anonymity of information from patient registers and files were rigorously respected.

The study population comprised 2576 participants, including 1133 women (43.98%) and 1443 men (56.02%). The subjects’ ages ranged from 2 to 72 years, with a mean of 30.05 ± 10.78 years. The 15 - 29 age group represented the largest proportion, at 56.17% (1447/2576) of the sample (Table 1).

In the population studied from 2013 to 2024, the HIV prevalence was 2.06% (53/2576), with a mean age of 35.43 ± 4.19 years (Table 2). For hepatitis C virus (HCV), a prevalence of 3.38% (87/2576) was observed, associated with a mean age of 29.08 ± 9.91 years. Statistical analysis revealed no significant difference between HIV-infected and uninfected individuals (p = 0.392), nor between subjects with hepatitis C and those without (p = 0.395); Table 2.

Table 1. Sociodemographic characteristics of the population from 2013 to 2024.

Table 2. HIV and HCV test results according to patients’ average ages.

The prevalence of HIV was estimated at 3.19% (11/345) in individuals aged 45 - 59 years, while no cases were identified in children under 15 years of age (0%). Regarding hepatitis C virus (HCV), a significant prevalence of 4.10% (10/344) was observed in the 15 - 29 and 45 - 59 age groups. Furthermore, the prevalence of HIV was slightly higher in women (2.21%, 25/1133) than in men (1.94%, 28/1443). Conversely, hepatitis C showed a male predominance of 3.60% (52/1443) compared to a female prevalence of 3.09% (35/1133) (Table 3).

The 2024 HIV and hepatitis C virus (HCV) screening campaign included a total of 663 participants, comprising 289 women and 374 men. The mean age of the study population was 37.24 ± 13.54 years. The results revealed a seroprevalence of 1.51% for HIV and 1.36% for HCV (Table 4).

Table 3. Prevalence of HIV and HCV by age group and sex from 2013 to 2024.

Table 4. Sociodemographic characteristics of participants in the 2024 HIV and HCV screening campaign.

Regarding co-infection, the analysis included a total of 2576 individuals who simultaneously underwent HIV and HCV screening tests. The proportion of HIV+/HCV+ co-infection observed in this population was 0.39% (10/2576) (Table 5).

Among 2576 samples analyzed between 2013 and 2014 in this study, 53 positive cases were identified. The majority involved HIV‑1 (50 cases, 94.34%), followed by two cases of HIV‑2 (3.77%) and one case of HIV‑1/HIV‑2 co‑infection (1.89%). These findings highlight the predominance of HIV‑1 in the studied population (Table 5).

Table 5. Co-infection rates among 2576 HIV-positive and HIV-negative individuals from 2013 to 2024.

In this study, the evolution of HIV and HCV prevalence was modeled using two linear equations (Figure 1). Between 2013 and 2020, HCV prevalence showed a moderate decrease, from 4.29% to 3.84%, before experiencing a more pronounced decline to 1.51% in 2024. Regarding HIV, a slight increase was observed during the period 2013-2020 (from 2.22% to 2.76%), followed by a significant reduction to 1.36% in 2024 (Figure 1). Although year-to-year fluctuations were observed, the overall trend in HIV prevalence from 2013 to 2024 shows a progressive decrease.

Figure 1.Graph showing the evolution of HIV and HCV prevalence rates from 2013 to 2024.

The results of this research highlight the predominance of first-line treatments in the management of HIV-positive patients (83.44%), compared to 16.56% for second-line regimens. This distribution is consistent with Burkina Faso national data, which confirms the efficacy and accessibility of initial therapies, while emphasizing the essential role of second-line regimens in cases of resistance or treatment failure (Ministry of Health, 2023; CNLS, 2021-2025; WHO, 2025). This distribution reflects the satisfactory efficacy and accessibility of initial therapies, while underscoring that second-line treatments remain essential for patients experiencing treatment failure or drug resistance (Table 6).

Table 6. Current status of therapeutic treatment for HIV-positive patients

Like HIV infection, now controlled by antiretroviral therapy, hepatitis C virus (HCV) infection can be effectively managed with direct-acting antivirals (DAAs). The results of this study highlight the remarkable efficacy of these molecules in treating HCV, regardless of viral genotype and initial viral load in Burkina Faso [18]. Analysis of viral kinetics at 12 and 24 weeks shows that the combinations of sofosbuvir/daclatavir and sofosbuvir/velpatasvir induce complete viral suppression by week 12. This rapid virological response confirms the superiority of DAAs over previous treatment regimens and underscores their central role in the HCV eradication strategy (Table 7).

The analysis revealed a fluctuating trend in HIV prevalence over the past twelve years. This has ranged between 1.8% and 10.6% over the period 2003-2022 [12] and is consistent with the prevalence rates reported by Simpore et al. (2005) and Yooda et al. (2015), who found 7.79% respectively in pregnant women [11] and 1.8% among blood donors [7]. The observed decrease could be attributed to the effects of awareness and screening campaigns, as well as increased initiation of and adherence to antiretroviral therapy. The 2024 value is consistent with regional estimates, which indicate an average prevalence of 1.4% in West Africa [19]. UNAIDS data for 2021 report prevalences of 1.1% in Liberia and 1.3% in Nigeria [20]. Comparatively, these rates remain lower than those observed in Kenya (4.9%) [21] and the Congo (5.5%) [22], but higher than those reported in Mali (0.33%) [23] and Morocco (0.015%) [24]. Among the 53 HIV-positive samples analyzed, 50 (94.34%) were identified as HIV-1, two (3.77%) as HIV-2, and one (1.89%) as a case of HIV-1/HIV-2 co-infection. These results corroborate data from the literature, which highlight the predominance of HIV-1 and the rarity of HIV-1/HIV-2 coinfections. Studies conducted in Senegal (90% HIV-1) [25], Benin (97.6% HIV-1) [26], and Mali (94.64% HIV-1) [27] confirm this trend. The observed prevalence was 1.9% in men and 2.2% in women. This overrepresentation of women is also reported in other studies, notably in Togo [28] and Mozambique [29], and could be explained by factors related to gender norms and sexual violence. Finally, a peak in seroprevalence was observed in the 45-59 age group (3.2%). For comparison, the Demographic and Health Survey of Burkina Faso (2010) [30] as well as the work of Zoungrana et al. in Mali (2017) [31] and of Téclessou et al. in Togo (2017) [28] highlighted a notable increase in cases in the 30-34 age group. Data analysis reveals a progressive decrease in HIV prevalence over the study period. This was estimated at 2.22% in 2013; 2.17% in 2016; 2.76% in 2020 and 1.36% in 2024. Statistical modeling established a linear relationship represented by the equation y = − 1.75 x + 12.59 . The divergence in studies could be related to the retrospective nature of the present study, the study population, the sample size, the test kits and laboratory techniques used, which may indeed partially explain these differences in results.

Similar to HIV, the prevalence of HCV did not show a statistically significant decrease between 2013 and 2024. It was estimated at 4.29% in 2013, 4.04% [32] in 2016, 3.84% in 2020, and 1.51% in 2024. These results are consistent with those reported by other authors, who found prevalences of 3.3% [10], 3.6% [33], and 4.4% [32][7]. Conversely, some studies reported higher rates, namely 6.07% [11], 8.5% [15], and 8.69% [34], while Simpore A.et al. 2022 observed a lower prevalence of 2.8% [35]. Similarly, as with HIV, the studied population, sample size, testing kits, and laboratory techniques used may partly explain these differences in results. Furthermore, the study is based on the combination of retrospective clinical data (2013-2023) and community-based screening data collected in 2024. While this complementary approach enhances the analysis, it may also introduce differences in demographic profiles and risk levels between the populations considered, which could affect the representativeness of the findings. In addition, the diagnostic reagents used for HIV and HCV screening evolved over the study period. All tests performed complied with national performance standards, and any discordant HIV or HCV results were systematically confirmed by PCR. Nevertheless, variations in the sensitivity or specificity of the reagents employed may have contributed to the fluctuations observed in positivity rates. These aspects should be acknowledged as a methodological limitation of the study.

To date, no resistance-associated substitutions (RAS) have been identified in Burkina Faso. In this perspective, promoting access to innovative treatments—particularly pan-genotypic direct-acting antivirals (DAAs) such as the Sofosbuvir/Daclatasvir and Sofosbuvir/Velpatasvir combinations against the hepatitis C virus—represents a strategic orientation of high therapeutic value. Furthermore, first- and second-line antiretroviral regimens [TDF (Tenofovir disoproxil fumarate)/3TC (Lamivudine)/DTG (Dolutegravir)] [AZT (Zidovudine)/3TC (Lamivudine) + DTG (Dolutegravir)], and [ABC (Abacavir)/3TC (Lamivudine) + DTG (Dolutegravir)] represent essential pillars in the fight against HIV and in improving the medical management of patients in Burkina Faso. Antiretroviral therapy (ART) remains the most effective strategy for controlling HIV-1 infection by suppressing viral replication in infected individuals, provided that resistance mutations are absent [36]. However, despite this effectiveness, ART does not eliminate infected cells for life. The persistence of HIV in cellular reservoirs, veritable viral sanctuaries, constitutes a major obstacle to its complete eradication in infected individuals [36][37]. Indeed, this retrovirus persists within CD4+ T lymphocytes, macrophages, and dendritic cells located in hard-to-reach anatomical sites such as lymph nodes, intestinal lymphoid tissue (GALT), the central nervous system (microglia), and the genital organs. However, the emergence of nanoparticles as vectors for innovative pharmaceutical products opens up promising therapeutic perspectives, likely to target these viral sanctuaries more effectively and overcome the limitations of conventional approaches [38].