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High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana

High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana

Background,We aimed to determine the prevalence of hepatitis B virus (HBV) infection among people with human immunodeficiency virus (PWH) in rural and periurban communities in Botswana.Methods.PWH from a previous population-based study, the Botswana Prevention Combination Project, which enrolled adu...

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Main Authors: Sharon R Mutenga, Bonolo B Phinius, Motswedi Anderson, Irene Gobe, Margaret Mokomane, Wonderful T Choga, Gorata Mpebe, Molly Pretorius-Holme, Rosemary Musonda, Tendani Gaolathe, Mompati Mmalane, Roger Shapiro, Joseph Makhema, Shahin Lockman, Vlad Novitsky, Max Essex, Sikhulile Moyo, Simani Gaseitsiwe
Other Authors: Department of Applied Biological Sciences and Biotechnology, Faculty of Science and Technology, Midlands State University, Gweru, Zimbabwe.
Format: research article
Language:English
Published: Oxford University Press 2023
Subjects:
Africa,
Botswana
hepatitis B virus
human immunodeficiency virus
occult HBV
Online Access:https://cris.library.msu.ac.zw//handle/11408/5653
https://doi.org/10.1093/ofid/ofac707
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Summary:Background,We aimed to determine the prevalence of hepatitis B virus (HBV) infection among people with human immunodeficiency virus (PWH) in rural and periurban communities in Botswana.Methods.PWH from a previous population-based study, the Botswana Prevention Combination Project, which enrolled adults in 30 communities across Botswana (2013–2018), were screened for HBV surface antigen (HBsAg) and HBV core antibody (anti-HBc). HBsAg-positive (HBsAg+) samples were further screened for HBV core immunoglobulin M antibodies (anti-HBc immunoglobulin M [IgM]) and HBV e antigen (HBeAg). We quantified HBV viral load on participants who tested positive (n = 148) and negative for HBsAg (n = 381). Results.Of 3304 participants tested, 271 (8% [95% confidence interval {CI}, 7%–9%]) were HBsAg+ while 1788 (56% [95% CI, 54%–57%]) of 3218 PWH whom we tested had positive anti-HBc. Approximately 88% of HBsAg+ participants were on antiretroviral therapy (ART), 40% and 56% of whom were receiving lamivudine- and tenofovir-containing ART, respectively. Male sex (relative risk ratio [RRR], 1.8 [95% CI, 1.2–2.7]) and the northern geographic region (RRR, 2.5 [95% CI, 1.4–4.7]) were independent predictors of HBV infection (HBsAg+). Of 381 persons with negative HBsAg who were tested for occult HBV, 126 (33% [95% CI, 29%–38%]) had positive HBV DNA. Eleven participants were highly viremic with high HBV viral load while on a lamivudine- or tenofovir-containing regimen. Ten (91%) of these participants also had positive HBeAg serology, while 4 (36%) had positive anti-HBc IgM serology. Conclusions.The prevalence of HBV was high among PWH in Botswana while on ART regimens with activity against HBV.