Prevalence of hepatitis B surface antigen and serological markers of other endemic infections in HIV-infected children, adolescents and pregnant women in Sierra Leone: A cross-sectional study

Abstract

To assess the prevalence of serological markers of HBV and endemic acute and chronic infections (HAV, HCV, CMV, HTLV-1/2 and syphilis) in HIV-infected children, adolescents and pregnant women in Sierra Leone. Method: We conducted a cross-sectional study at the national children's and women's hospitals in Freetown. Logistic regression was used to assess predictors of HBsAg positivity. Results: 183 HIV-infected participants were enrolled, comprising children (n = 88), adolescents (n = 47) and pregnant women (n = 48). All participants (100%) were CMV IgG-positive, while 56.8%, 93.6% and 100% of children, adolescents and pregnant women, respectively, were HAV IgG-positive. The prevalence of HCV, HTLV-1/2 and syphilis were <4%. HBV markers were distributed as follows-children: HBsAg (2.3%), HBeAg (0%), anti-HBc (5.7%); adolescents: HBsAg (17.0%), HBeAg (6.4%), anti-HBc (27.7%); and pregnant women: HBsAg (18.8%), HBeAg (4.2%), anti-HBc (77.1%). Age >10 years, i.e., being born pre-2009 before implementation of routine hepatitis B immunization (aOR 5.05 [1.18À21.28]; p = 0.029) and CD4 count <350 cells/mm 3 (aOR 3.97 [1.07À14.71]; p = 0.039) predicted HBsAg positivity. Conclusion: A high burden of chronic HBV and other endemic infections was observed among HIVinfected patients born pre-2009 before implementation of routine HBV immunization in Sierra Leone, warranting targeted screening and immunization of this high-risk population.

Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone

“…Current international ART treatment guidelines recommend a dual NRTI-backbone in combination with an INSTI or a boosted-PI with a high genetic barrier to developing resistance such as darunavir/ritonavir (DRV/r) in the treatment of HIV-infected individuals [ 12 , 19 , 20 , 21 ]. Sierra Leone is an INSTI-naïve stetting, as INSTI-based ART was only recently introduced in 2021.…”

“…Firstly, patients failing first-line ART based on the 2017 ART guidelines in Sierra Leone have limited options for second-line therapy, as estimated by the GSS ( Table 2 ). Secondly, with high rates of HIV/HBV coinfection in this setting (up to 22% based on previous studies by our group) [ 11 , 12 ]—a large proportion of patients on 3TC-based and/or TDF-sparing ART regimens are likely to be receiving suboptimal treatment for both HIV and HBV infections, heightening their risk for progression to AIDS, liver cirrhosis, and end-stage liver disease. Thus, screening for HBV in all HIV-infected patients before ART initiation and at the time of switching ART is essential to guiding optimal ART choice.…”

“…In 2018, fewer than half (49%) of PLWH in Sierra Leone knew their HIV status, and 41% of HIV-diagnosed patients were receiving ART, while only 26% of those on treatment were virally suppressed, the latter being likely due to a combination of poor treatment adherence and high prevalence of HIVDR in this setting [ 3 ]. In addition, recent studies by our group have observed other challenges in the local HIV care continuum, including high rates of late-stage HIV presentation [ 9 ], AIDS-associated in-hospital mortality [ 10 ], and high prevalence of HIV/HBV [ 11 , 12 ]. This is further compounded by the fact that as Sierra Leone and other LMICs have moved towards implementing integrase strand transfer inhibitor (INSTI)-based regimens as first-line ART, there is a dearth of country-specific studies to inform HIVDR prevention and management strategies due to limited laboratory testing capability.…”

Factors Associated with HBsAg Seropositivity among Pregnant Women Receiving Antenatal Care at 10 Community Health Centers in Freetown, Sierra Leone: A Cross-Sectional Study

“…Although there are currently no nationally representative studies, Sierra Leone is regarded as a hyperendemic country, with an estimated countrywide HBV seroprevalence rate of 8% to 10% [8,9]. Pregnant women appear to be disproportionately impacted by the HBV epidemic, yet few studies have described the epidemiology of HBV in this vulnerable group in Sierra Leone [10]. A handful of small studies conducted among pregnant women in Sierra Leone have reported HBsAg seroprevalence rates ranging from 6% to 18.8% [10][11][12].…”

Soroprevalência de HTLV em gestantes: revisão integrativa

“…Os meios de propagação do vírus, comumente, ocorrem por aleitamento materno, por transmissão vertical, sexual e parenteral (Ramos-Rincón et al, 2021;Yendewa et al, 2021). Na epidemiologia, determinam precauções para o controle e prevenção aos cônjuges, pais, filhos, ou seja, aos que mantêm maior contacto com um soroprevalênte (Aquilo, Ramos, 2019).…”