Wide variation in estimates of global prevalence and burden of chronic hepatitis B and C infection cited in published literature

Basnayake, S. K.; Easterbrook, Philippa

doi:10.1111/jvh.12519

Cited by 49 publications

(43 citation statements)

References 195 publications

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“…Research has underscored the impact of liver-related diseases [2,11,30,31*,50], including hepatitis C virus (HCV) [7,34,51], on premature mortality among HIV-positive PWID, with HIV – HCV co-infected individuals having a significantly increased risk of death [11]. A 15-year prospective cohort study investigating predictors of liver-related death in a cohort of PWID in Vancouver showed that HIV seropositivity was independently and positively associated with liver-related mortality [31*].…”

Section: Addressing Hepatitis C Virus- Related Mortalitymentioning

confidence: 99%

Reducing rates of preventable HIV/AIDS-associated mortality among people living with HIV who inject drugs

Parashar

Collins

Montaner

et al. 2016

Current Opinion in HIV and AIDS

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Purpose of review The modern antiretroviral therapy (ART) era has seen substantial reductions in mortality among people living with HIV. However, HIV-positive people who inject drugs (PWIDs) continue to experience high rates of suboptimal HIV-related outcomes. We review recent findings regarding factors contributing to premature and preventable mortality among HIV-positive PWID, and describe the promise of interventions to improve survival in this group. Recent findings The current leading causes of death among HIV-positive PWID are HIV/AIDS-related causes, overdose, and liver-related causes, including infection with hepatitis C virus. Elevated mortality levels in this population are driven by social–structural barriers to ART access and adherence, particularly criminalization and stigmatization of drug use. In contexts where opioid substitution therapy and ART adherence support programs are widely accessible, evidence highlights comparable levels of survival among HIV-positive PWID and people living with HIV who do not inject drugs. Summary The life-saving benefits of ART can be realized among HIV-positive PWID when it is paired with strategies that address barriers to evidence-based medical care. Joint administration of ART and opioid substitution therapy, as well as repeal of punitive laws that criminalize drug users, are urgently needed to reduce HIV and injection-related mortality among PWID.

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Section: Addressing Hepatitis C Virus- Related Mortalitymentioning

confidence: 99%

Reducing rates of preventable HIV/AIDS-associated mortality among people living with HIV who inject drugs

Parashar

Collins

Montaner

et al. 2016

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

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“…However, to date, no review has estimated the global burden of HBV co‐infection among PLHIV. Existing estimates suggest approximately 10% of PLHIV have chronic hepatitis B or 2‐4 million people, but were based on small numbers of studies with unclear methodology . Other reviews have focussed on specific regions or people who inject drugs (PWID) .…”

Section: Introductionmentioning

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

108

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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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“…Chronically infected patients have 15–60% lifetime risk for liver cirrhosis, liver failure and/or hepatocellular carcinoma [6–8]. Approximately 600,000 individuals die annually from complications of the infection [9, 10]. Currently, more than 2 billion people worldwide have been infected by HBV including almost 240 million with chronic infection.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B virus strains from Rwandan blood donors are genetically similar and form one clade within subgenotype A1

et al. 2017

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BackgroundRwanda is a central African country with about 12 million inhabitants. The 1994 genocide against the Tutsi destroyed much of the infrastructure, including the health system. Although this has improved significantly, many challenges remain to be addressed. In this study, the prevalence of serological markers of past and ongoing hepatitis B virus (HBV) infection and HBV vaccine related immunity was investigated in samples from blood donors from all regions of Rwanda.MethodsThe results from hepatitis B surface antigen (HBsAg) analyses of all (45,061) blood donations collected countrywide in 2014 from 13,637 first time and 31,424 repeat blood donors were compiled. Samples from 581 HBsAg negative blood donors were selected for further analysis for antibodies against HBV, anti-HBs and anti-HBc. Additional 139 samples from HBsAg positive donors were analyzed for HBeAg/anti-HBe (132 samples) and for HBV DNA. The S-gene was amplified by PCR, products sequenced, and phylogenetic analysis was performed.ResultsHBsAg was found in 4.1% of first time donors with somewhat higher prevalence among those from the Central and Eastern regions than from other parts of the country. Indications of past infection was found in 21% of the HBsAg negative donors, 4.3% had only anti-HBs suggesting HBV vaccination. HBeAg was detected in 28 (21%), anti-HBe in 97 (73%), and both HBeAg and anti-HBe in 4 of 132 HBsAg positive donors. HBV DNA was found in 85 samples, and the complete S-gene was sequenced in 58 of those. Phylogenetic analysis of the sequences revealed that all HBV strains belonged to subgenotype A1, and formed one clade in the phylogenetic tree. In addition, 12 strains from first time donors had a unique 18 amino acid deletion in the N-terminal part of the pre-S2 region.ConclusionThis study indicated that the prevalence of hepatitis B is intermediate in Rwanda and that the vaccination coverage is relatively low in young adults. All surveyed Rwandan blood donors were infected with similar subgenotype A1 strains, and a high frequency of those with anti-HBe had detectable HBV DNA. Several strains had in addition a unique pre-S2 deletion, the virulence of which needs to be further studied.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2149-z) contains supplementary material, which is available to authorized users.

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Wide variation in estimates of global prevalence and burden of chronic hepatitis B and C infection cited in published literature

Cited by 49 publications

References 195 publications

Reducing rates of preventable HIV/AIDS-associated mortality among people living with HIV who inject drugs

Reducing rates of preventable HIV/AIDS-associated mortality among people living with HIV who inject drugs

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

Hepatitis B virus strains from Rwandan blood donors are genetically similar and form one clade within subgenotype A1

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