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Hepatitis B serological markers and plasma DNA concentrations.
Huw Price1, David Dunn2, Tamale Zachary3
1Centre for Sexual Health and HIV Research, Mortimer Market Centre, University College London
AIDS (London, England)
|March 23, 2017
Summary
Hepatitis B virus (HBV) coinfection is common in HIV-infected adults in sub-Saharan Africa. Many patients have detectable HBV DNA, requiring antiretroviral therapy active against both viruses.
Area of Science:
- Infectious Diseases
- Hepatology
- Virology
- Public Health
Background:
- Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection is a significant global health challenge, particularly in sub-Saharan Africa.
- Understanding the serological profile and viral load of HBV in coinfected individuals is crucial for effective management and treatment strategies.
- Previous studies have highlighted varying prevalence rates and clinical associations of HBV/HIV coinfection across different regions.
Purpose of the Study:
- To investigate the prevalence of hepatitis B (HBV) serological markers and plasma DNA concentrations in a large cohort of untreated HBV/HIV-coinfected individuals.
- To analyze the association of HBV markers and viral load with demographic and clinical factors in these coinfected patients.
- To inform treatment guidelines for HBV/HIV coinfected individuals in sub-Saharan African settings.
Main Methods:
- Baseline data from a randomized controlled trial (DART) involving HIV-infected adults in Uganda and Zimbabwe were analyzed.
- HBV serological markers (anti-HBc, HBsAg, anti-HBs, HBeAg, anti-HBe) and plasma HBV DNA viral load were measured retrospectively.
- Logistic regression models were employed to assess associations between HBV markers and demographic/clinical characteristics.
Main Results:
- Hepatitis B surface antigen (HBsAg) positivity was significantly higher in Zimbabwe (12.2%) compared to Uganda (7.7%).
- HBsAg positivity was associated with male sex but not with age, WHO disease stage, or CD4 cell count.
- HBeAg was detected in 37% of HBsAg-positive patients, and a significant proportion (65%) had quantifiable HBV DNA viral load, with higher viral loads observed in HBeAg-positive individuals.
Conclusions:
- High rates of HBV coinfection underscore the need for integrated management strategies in HIV care.
- Antiretroviral therapy regimens should be selected considering activity against both HIV and HBV to improve patient outcomes.
- Further research is needed to optimize treatment and monitoring protocols for HBV/HIV coinfected populations in resource-limited settings.
