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Hepatitis B Virus in People who Inject Drugs and Men who Have Sex With Men With HIV in India: A Cross-sectional Study

Talia A Loeb1, Mihili P Gunaratne1, Syed Iqbal2

  • 1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Open Forum Infectious Diseases
|July 18, 2024
PubMed

Insights

People with HIV (PWH) and coinfection with hepatitis B virus (HBV) increases mortality risk. This study found high HBV infection prevalence and low vaccination rates in people who inject drugs (PWID) and men who have sex with men (MSM) with HIV in India.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Public Health

Background:

  • Hepatitis B virus (HBV) coinfection in people with HIV (PWH) is associated with increased mortality.
  • Populations like people who inject drugs (PWID) and men who have sex with men (MSM) are at high risk for HBV, but data from low- and middle-income countries (LMICs) are limited.

Purpose of the Study:

  • To determine the prevalence of HBV serological markers (HBsAg, anti-HBc, anti-HBs) in a sample of PWID and MSM with HIV in India.
  • To identify correlates of HBV infection and chronic HBV among these populations.
  • To assess HBV vaccination status in this high-risk group.

Main Methods:

  • Screened 2198 participants (PWID and MSM with HIV) across 15 Indian cities for HBV serological markers.
  • Utilized logistic regression models to assess correlates of ever being infected with HBV and chronic HBV.
  • Accounted for site-level clustering in the statistical analysis.

Main Results:

  • Overall HBV infection prevalence was 75.6% in PWID and 46.9% in MSM (P < .01).
  • Chronic HBV prevalence was higher in PWID (14.1%) vs MSM (9.5%) (P < .01).
  • Correlates of infection included unstable housing and injection paraphernalia sharing in PWID, and history of injection drug use and gender identity in MSM. Vaccination status was <10% in both groups.

Conclusions:

  • High prevalence of HBV infection and low vaccination rates underscore the need for routine screening and catch-up vaccination among PWID and MSM with HIV in India.
  • The significant prevalence of isolated anti-HBc reactivity necessitates further research into the risk of HBV reactivation in this serological pattern.
Abstract

Keywords:
HBVHIVMSMPWIDserosurvey India elimination

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