Hepatitis B serological markers and plasma DNA concentrations

Abstract

Objectives:To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings.Design:Baseline analysis of a randomized controlled trial.Methods:DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999). HBV serological markers [antibody to HBV core antigen, HBV surface antigen (HBsAg), antibody to HBV surface antigen, HBV ‘e’ antigen (HBeAg), and antibody to hepatitis B ‘e’ antigen] and plasma HBV DNA viral load were measured retrospectively on stored baseline samples. Logistic regression was used to examine associations with baseline demographic and clinical factors.Results:The rate of HBsAg positivity was significantly higher in Zimbabwe than Uganda (12.2 vs. 7.7%, adjusted odds ratio = 1.54, P < 0.001) despite a similar prevalence of antibody to HBV core antigen (56.3 vs. 52.4%) in the two settings. Overall, HBsAg positivity was associated with male sex (adjusted odds ratio = 1.54, P < 0.001) but not with age, WHO disease stage, or CD4+ cell count. HBeAg was detected among 37% of HBsAg-positive patients, with higher rates among those with advanced WHO stage (P = 0.02). Also in HBsAg-positive patients, HBV DNA was undetectable in 21%, detectable but below the level of quantification in 14%, and quantifiable in 65%. A total of 96% of HBeAg-positive and 70% of HBeAg-negative patients had detectable HBV DNA; 92 and 28% of patients, respectively, had HBV DNA viral load more than 2000 IU/ml.Conclusion:High rates of HBV coinfection were observed, highlighting the importance of ensuring that coinfected patients receive an antiretroviral regimen, whether first-line or not, that is active against both viruses.

Hepatitis B virus infection among sexually active individuals in Nigeria: a cross-sectional study

“…Furthermore, findings from Ejele et al, (2005) [ 23 ] and Olokoba et al, (2009) [ 24 ] in the country recorded far lower prevalence rates, of 1.1% and 2.4% respectively. This variation could be as a result of the study populations as studies have shown varying HBV prevalence among diverse groups and regions in the country and in fact across sub Saharan Africa [ 5 , 6 , 25 ]. The type of test kit used in screening may also be considered although this bias is inherent for all studies [ 25 ].…”

“…This variation could be as a result of the study populations as studies have shown varying HBV prevalence among diverse groups and regions in the country and in fact across sub Saharan Africa [ 5 , 6 , 25 ]. The type of test kit used in screening may also be considered although this bias is inherent for all studies [ 25 ].…”

“…However, an altered pattern of liver apolipoprotein A-I isoforms in males may also be a plausible biological explanation [ 27 ]. Studies have shown that males are less likely to clear HBV infection and at a higher risk of progressing to chronic infection [ 25 , 28 ].…”

“…A reverse trend was however observed among pregnant women although these differences did not reach significant levels because of the small sample size. HBV infected pregnant women and younger people are likely to be more infectious [ 25 ] than persons on treatment for sexually transmitted infections although this group at a higher risk of chronic HBV infection. This pattern strongly favors the view that perinatal and vertical transmission does not contribute significantly to high levels of chronic HBV infection in endemic countries.…”

Immunological Efficacy of Tenofovir Disproxil Fumarate-Containing Regimens in Patients With HIV-HBV Coinfection: A Systematic Review and Meta-Analysis

“…Various studies have shown/reported various degrees of HBsAg loss and/or different seroconversion rates but found differences between coinfections and mono-infections, with higher rates in cases of coinfection. Cumulative HBsAg seroclearance rates of 5% to 22% have been reported (Jaroszewicz et al, 2012; Kosi et al, 2012; Maylin et al, 2012; Zoutendijk et al, 2012; Hamers et al, 2013; Matthews et al, 2013; Boyd et al, 2015; Huang and Nunez, 2015; Boyd et al, 2016; Lucifora and Protzer, 2016; Price et al, 2017). A recent meta-analysis focused exclusively on the suppression of HBV with TDF-containing ART (Price et al, 2013).…”