Characterization of HBV Among HBV/HIV-1 Co-Infected Injecting Drug Users from Mombasa, Kenya

Kibaya, Rukia; Lihana, Raphael; Kiptoo, Michael; Songok, Elijah; Ng’ang’a, Zipporah; Osman, Saida; Ishizaki, Azumi; Bi, Xiuqiong; Okoth, Fredrick; Ishiguro, Hiroshi; Lwembe, Raphael

doi:10.2174/1570162x13666150121113217

Cited by 13 publications

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“…All A genotypes isolated belonged to subgenotype A1 while genotype D isolates belonged to subgenotype D6. The dominance of HBV subgenotype A1 is consistent with other previous studies among blood donors, 61 , 62 HIV/HBV co-infected drug users, 63 jaundiced outpatients 36 and patients with liver disease (HCC) 36 in Kenya and India. 64 HBV subgenotype A1 is believed to be endemic in Africa 36 and mainly found in the eastern, central and southern Africa.…”

Section: Discussionsupporting

confidence: 91%

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Oyaro¹,

Wylie²,

Chen³

et al. 2018

South. Afr. j. HIV med.

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BackgroundDrug users act as reservoirs and transmission channels for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections to the general population worldwide. Periodic epidemiological studies to monitor the prevalence and genetic diversity of these infections to inform on interventions are limited.Objective of the studyThe objective of this study was to determine the predictors of HIV infection and genetic diversity of HBV and HCV among drug users in Kenya.Materials and methodsA cross-sectional study on previous drug use history among drug users was conducted in three Kenyan cities using a respondent-driven sampling method between January 2011 and September 2012. Blood samples were collected and analysed for the presence of HBV, HCV and HIV serological markers and to determine the genotypes of HBV and HCV.ResultsThe overall prevalence of HBV, HCV and HIV among drug users was 4.3%, 6.5% and 11.1%, respectively, with evidence of HBV/HIV, HCV/HIV and HBV/HCV/HIV co-infections. The HBV circulating genotypes were A1 (69%) and D6 (19%), whereas HCV genotypes were 1a (72%) and 4a (22%). Injection drug use was a significant predictor of HIV/HCV infections. Younger age (30 years; aOR (adjusted odds ratio) = 0.50, 95% CI (confidence interval): 0.33–0.76; p < 0.001) and early sexual debut (aOR = 0.54, 95% CI: 0.40–0.82; p < 0.05) were negatively associated with detection of any of the three infections. Injecting drug use was positively associated with HCV infection (aOR = 5.37, 95% CI: 2.61–11.06; p < 0.001).ConclusionThis high level of genetic diversity exhibited by HBV and HCV isolates requires urgent implementation of harm reduction strategies and continuous monitoring for effective management of the patients.

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Section: Discussionsupporting

confidence: 91%

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Oyaro¹,

Wylie²,

Chen³

et al. 2018

South. Afr. j. HIV med.

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“…Some single studies reported very high prevalence, including China (59.6%), Iran (44.2%) and Myanmar (41.9%) . There was only one study from sub‐Saharan Africa (Kenya) which reported a prevalence of 13.9% …”

Section: Resultsmentioning

confidence: 99%

Prevalence and burden of HBV co‐infection among people living with HIV: A global systematic review and meta‐analysis

Platt

French

McGowan

et al. 2019

Journal of Viral Hepatitis

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Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV‐HBsAg co‐infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co‐infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002‐2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV‐exposure category. The global burden of co‐infection was estimated by applying regional co‐infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta‐analysis to estimate the odds of HBsAg among PLHIV compared to HIV‐negative individuals. We identified 506 estimates (475 studies) of HIV‐HBsAg co‐infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV‐HBsAg co‐infection is 7.6% (IQR 5.6%‐12.1%) in PLHIV, or 2.7 million HIV‐HBsAg co‐infections (IQR 2.0‐4.2). The greatest burden (69% of cases; 1.9 million) is in sub‐Saharan Africa. Globally, there was little difference in prevalence of HIV‐HBsAg co‐infection by population group (approximately 6%‐7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%‐16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV‐negative individuals. There is therefore, a high global burden of HIV‐HBsAg co‐infection, especially in sub‐Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth‐dose. Findings also highlight the importance of targeting PLHIV, especially high‐risk groups for testing, catch‐up HBV vaccination and other preventative interventions. The global scale‐up of antiretroviral therapy (ART) for PLHIV using a tenofovir‐based ART regimen provides an opportunity to simultaneously treat those with HBV co‐infection, and in pregnant women to also reduce mother‐to‐child transmission of HBV alongside HIV.

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“…Briefly, these interventions include immunization; timely hepatitis B birth dose (HB-BD) for prevention of mother to child transmission; infection, blood and surgical safety in healthcare settings; harm reduction in people who inject drugs (PWID) and effective treatment for hepatitis [2]. Kenya is classified as highly endemic for HBV [3][4][5][6][7][8][9][10] with one study reporting a prevalence of 4.5% among health care workers (HCWs) [3]. Measures to combat the disease are therefore desperately needed [2].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study

Maina

Bii

2020

BMC Public Health

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Background: Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya's Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC). Methods: This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data. Results: Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC. Conclusions: Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students.

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Characterization of HBV Among HBV/HIV-1 Co-Infected Injecting Drug Users from Mombasa, Kenya

Cited by 13 publications

References 0 publications

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities

Prevalence and burden of HBV co‐infection among people living with HIV: A global systematic review and meta‐analysis

Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study

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