Hepatitis B and asymptomatic malaria coinfection in Sub-Saharan African immigrants: epidemiological and clinical features of HBV infection

Abstract

Introduction: Here, we conducted an epidemiological study of hepatitis B virus (HBV) mono-infected and asymptomatic malaria/HBV coinfected immigrants and further discussed the possibility of malaria disease modifying the clinical presentation of HBV infection. Methods: A total of 195 African immigrants were examined for HBV infection or coinfection with HBV and asymptomatic malaria. HBV infection was diagnosed using serological tests and confirmed by PCR; furthermore, we performed a pan-Plasmodium-specific-nucleic-acid-sequence-based-amplification (NASBA) assay to detect asymptomatic malaria infection. The stage/grade of the liver disease was determined using echotomography and elastometry. Results: PCR-NASBA results confirmed that 62 of 195 subjects (31.8%) were positive for Plasmodium infection, whereas 41 of 195 subjects (21%) tested positive for HBV chronic hepatitis (HBV-DNA positive). Among the HBV-positive subjects, 26 (63.4%) of them were mono-infected patients (Group A), whereas 15 (36.6%) patients had HBV chronic hepatitis and asymptomatic malaria coinfections (Group B). The HBV-DNA median levels were 1.4×10 5 IU/mL in HBV-mono-infected patients and 2.0×10 5 IU/ mL in coinfected patients. Echotomography and hepatic elastometry presented similar findings for both groups of patients. Conclusions: Coinfected patients seem to present with the same clinical symptoms of the liver disease as HBV mono-infected patients.

Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

“…Of the 22 included studies, 13 studies [ 9 – 11 , 14 , 16 , 17 , 24 , 26 , 28 , 31 , 32 , 34 , 35 ] were conducted before 2015, while three studies [ 23 , 29 , 30 ] were conducted in or after 2015. One study was conducted during 2013–2015, while five studies [ 8 , 15 , 27 , 33 , 36 ] did not specify the year of study conducted. Among the 22 included studies, approximately half of the studies (12/22; 54.5%) were carried out in Nigeria [ 10 , 15 , 16 , 26 , 28 – 31 , 33 – 36 ], while the remaining 10 studies were carried out in Brazil [ 9 , 14 , 17 , 32 ], Ghana [ 8 , 23 , 25 ], Central African Republic [ 24 ], Italy [ 27 ], and The Gambia [ 11 ].…”

“…One study was conducted during 2013–2015, while five studies [ 8 , 15 , 27 , 33 , 36 ] did not specify the year of study conducted. Among the 22 included studies, approximately half of the studies (12/22; 54.5%) were carried out in Nigeria [ 10 , 15 , 16 , 26 , 28 – 31 , 33 – 36 ], while the remaining 10 studies were carried out in Brazil [ 9 , 14 , 17 , 32 ], Ghana [ 8 , 23 , 25 ], Central African Republic [ 24 ], Italy [ 27 ], and The Gambia [ 11 ]. Twenty of the 22 included studies used cross-sectional designs, while two studies used retrospective designs.…”

“…The study conducted among African immigrants in Italy reported a high prevalence of Plasmodium spp. and HBV co-infection and suggested that this finding was due to the participants having acquired semi-immunity with submicroscopic levels of parasitaemia, resulting in no sign or symptoms of malaria before detection [27]. The subgroup analysis of the years of studies revealed that the pooled prevalence estimate of Plasmodium spp.…”

“…The full texts of 102 articles that met the inclusion criteria were screened. Finally, 9 studies [8][9][10][23][24][25][26][27][28] were included in the quantitative synthesis. Thirteen additional studies [11,[14][15][16][17][29][30][31][32][33][34][35][36] were identified and included after reviewing the references of the nine included studies and additional searches of other databases.…”

Establishment of reference sequences of hepatitis B virus genotype B subgenotypes

“…Hepatitis B virus (HBV) is an important global public health problem that has infected approximately 2 billion people worldwide and has more than 240 million chronic carriers [1,2]. About 6 million people die annually from primary adverse outcomes such as liver failure, cirrhosis and hepatocellular carcinoma (HCC) [3].…”