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


Journal

Journal of viral hepatitis
ISSN: 1365-2893
Titre abrégé: J Viral Hepat
Pays: England
ID NLM: 9435672

Informations de publication

Date de publication:
03 2020
Historique:
received: 16 08 2019
accepted: 09 09 2019
pubmed: 12 10 2019
medline: 26 3 2021
entrez: 12 10 2019
Statut: ppublish

Résumé

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.

Identifiants

pubmed: 31603999
doi: 10.1111/jvh.13217
pmc: PMC7383613
doi:

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

294-315

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Department of Health
ID : 12/3070/13
Pays : United Kingdom

Informations de copyright

© 2019 World Health Organization; licensed by John Wiley & Sons Ltd.

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Auteurs

Lucy Platt (L)

Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.

Clare E French (CE)

NIHR Health Protection Research Unit in Evaluation of Interventions, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Catherine R McGowan (CR)

Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.
Humanitarian Public Health Technical Unit, Save the Children UK, London, UK.

Keith Sabin (K)

UNAIDS, Geneva, Switzerland.

Erin Gower (E)

Centre for Disease Control and Prevention, Atlanta, USA.

Adam Trickey (A)

NIHR Health Protection Research Unit in Evaluation of Interventions, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Bethan McDonald (B)

Oxford School of Public Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.

Jason Ong (J)

Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.

Jack Stone (J)

NIHR Health Protection Research Unit in Evaluation of Interventions, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Philippa Easterbrook (P)

World Health Organisation, Geneva, Switzerland.

Peter Vickerman (P)

NIHR Health Protection Research Unit in Evaluation of Interventions, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

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