Background Hepatitis B virus (HBV) infection and hypertension (HTN) are major public health concerns worldwide. Both conditions independently contribute to hepatic, renal, and metabolic disturbances. However, the combined impact of HTN on biochemical abnormalities in chronic HBV patients remains insufficiently characterized. The objective of the present work was to assess the biochemical profile of patients with HTN and/or chronic HBV infection at Laquintinie Hospital in Douala, Cameroon, and to determine the impact of HTN and its severity on hepatic, renal, and metabolic markers in HBV carriers. Methodology A comparative cross-sectional design was carried out in the hepato-gastroenterology department of Laquintinie Hospital from December 2022 to January 2024, involving 401 individuals. Following detection of the hepatitis B surface antigen (HBsAg) and measurement of blood pressure, the participants were separated into four groups, including 92 hypertensive patients with HBV infection (HTN+/HBV+), 73 hypertensive patients without HBV (HTN+/HBV-), 96 normotensive HBV-infected patients (HTN-/HBV+), and 140 healthy controls (HTN-/HBV). Hepatic, renal, and cardiac biochemical markers were assayed using enzymatic and colorimetric methods from commercial kits and automated biochemical analyzers. Frequencies of biochemical abnormalities were compared across groups. Logistic regression analysis was performed to evaluate associations between HTN and biochemical abnormalities in HBV-positive and HBV-negative patients. The relationship between HTN grade and biochemical disturbances in HBV carriers was also examined. Results Patients with both HTN and HBV infection (HTN+/HBV+) exhibited the most pronounced biochemical alterations, including significantly elevated liver enzymes, bilirubin, cystatin C, albuminuria, triglycerides, LDL cholesterol, and fasting glucose, along with reduced glomerular filtration rate (GFR) and potassium levels (p 1; p < 0.01) with elevated alanine aminotransferase (ALT; OR = 12.00), aspartate aminotransferase (AST; OR = 41.94), total bilirubin (OR = 33.81), cystatin C (OR = 39.00), renal insufficiency (OR = 36.93), albuminuria (OR = 14.00), hypertriglyceridemia (OR = 7.36), and elevated LDL cholesterol (OR = 8.84). Similar renal and metabolic associations were observed in HBV-negative hypertensive patients, though liver-specific markers were less affected. Increasing HTN grade showed limited additional impact on most biochemical parameters, with significant differences observed only for total bilirubin, total cholesterol, and potassium (p < 0.05). Conclusions The coexistence of HTN and chronic HBV infection is associated with significant hepatic, renal, and metabolic disturbances. While the presence of HTN markedly exacerbates biochemical abnormalities in HBV patients, increasing HTN severity confers limited additional impact. Integrated management strategies targeting both blood pressure control and viral disease are essential to reduce organ-related complications in this high-risk population.
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