Hepatitis B prevalence and risk factors among adults living with HIV in South Africa: a clinic-based cohort study.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
31 Aug 2024
Historique:
received: 05 05 2024
accepted: 12 08 2024
medline: 1 9 2024
pubmed: 1 9 2024
entrez: 30 8 2024
Statut: epublish

Résumé

People living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening for Hepatitis B virus may influence management of antiretroviral therapy for PLHIV, but risk factors for co-infection have not been well defined. The objective of this study was to identify risk factors for HBV infection among PLHIV in South Africa. We conducted a cross-sectional analysis of a prospective, clinic-based cohort study of adults seeking HIV testing from 2013-2017 in Umlazi township, South Africa. Patients newly diagnosed with HIV were enrolled and subsequently tested for Hepatitis B surface antigen positive (HBsAg +). We used a Poisson linear regression model to assess which factors, pertaining to sociodemographic status, medical history, clinical symptoms, mental health were associated with HBV. Among 3,105 PLHIV participants in South Africa, 6% were positive for HBV. Males had a higher HBV prevalence (10.4%) than females (5.2%). Within the HBV-positive group, the mean age was 33.2 years, with 38.3% females and 43.9% having completed high school or higher. About 39.9% reported alcohol use, 24.7% had a smoking history, and 8.3% reported substance use in the past year. Older participants born before 1995, when routine infant HBV vaccination was introduced, were more likely to have HBV. In multivariable analyses, smoking history increased HBV risk in females (aPR = 2.58; 95% CI 1.47-2.52), while alcohol use decreased HBV risk in males (aPR = 0.36; 95% CI 0.19-0.70). In a South African cohort, roughly one in 16 PLHIV had HBV co-infection, and this rate was higher in males. The most prominent risk factors for HBV infection in PLHIV were alcohol use, higher income, and smoking history, which may help inform targeted treatment and prevention strategies. Creating HBV-specific screening and prevention strategies for PLHIV may be useful for reducing HBV infections.

Sections du résumé

BACKGROUND BACKGROUND
People living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening for Hepatitis B virus may influence management of antiretroviral therapy for PLHIV, but risk factors for co-infection have not been well defined. The objective of this study was to identify risk factors for HBV infection among PLHIV in South Africa.
METHODS METHODS
We conducted a cross-sectional analysis of a prospective, clinic-based cohort study of adults seeking HIV testing from 2013-2017 in Umlazi township, South Africa. Patients newly diagnosed with HIV were enrolled and subsequently tested for Hepatitis B surface antigen positive (HBsAg +). We used a Poisson linear regression model to assess which factors, pertaining to sociodemographic status, medical history, clinical symptoms, mental health were associated with HBV.
RESULTS RESULTS
Among 3,105 PLHIV participants in South Africa, 6% were positive for HBV. Males had a higher HBV prevalence (10.4%) than females (5.2%). Within the HBV-positive group, the mean age was 33.2 years, with 38.3% females and 43.9% having completed high school or higher. About 39.9% reported alcohol use, 24.7% had a smoking history, and 8.3% reported substance use in the past year. Older participants born before 1995, when routine infant HBV vaccination was introduced, were more likely to have HBV. In multivariable analyses, smoking history increased HBV risk in females (aPR = 2.58; 95% CI 1.47-2.52), while alcohol use decreased HBV risk in males (aPR = 0.36; 95% CI 0.19-0.70).
CONCLUSIONS CONCLUSIONS
In a South African cohort, roughly one in 16 PLHIV had HBV co-infection, and this rate was higher in males. The most prominent risk factors for HBV infection in PLHIV were alcohol use, higher income, and smoking history, which may help inform targeted treatment and prevention strategies. Creating HBV-specific screening and prevention strategies for PLHIV may be useful for reducing HBV infections.

Identifiants

pubmed: 39215251
doi: 10.1186/s12879-024-09746-7
pii: 10.1186/s12879-024-09746-7
pmc: PMC11365233
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

891

Subventions

Organisme : NIAID NIH HHS
ID : K23 AI108293
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI060354
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Megana Shivakumar (M)

Department of Global Health, University of Washington, 908 Jefferson St., 12th floor, Seattle, WA, 98104, USA.

Caitlin A Moe (CA)

Department of Global Health, University of Washington, 908 Jefferson St., 12th floor, Seattle, WA, 98104, USA.
Department of Epidemiology, University of Washington, Seattle, USA.

Ashley Bardon (A)

Global Health Center, Washington University, St. Louis, USA.

Meighan Krows (M)

Department of Global Health, University of Washington, 908 Jefferson St., 12th floor, Seattle, WA, 98104, USA.

Sabina Govere (S)

AIDS Healthcare Foundation, Durban, South Africa.

Mahomed Yunus S Moosa (MYS)

Department of Infectious Diseases, University of KwaZulu-Natal, Durban, South Africa.

Connie Celum (C)

Department of Global Health, University of Washington, 908 Jefferson St., 12th floor, Seattle, WA, 98104, USA.
Department of Medicine, University of Washington, Seattle, USA.

Paul K Drain (PK)

Department of Global Health, University of Washington, 908 Jefferson St., 12th floor, Seattle, WA, 98104, USA. pkdrain@uw.edu.
Department of Epidemiology, University of Washington, Seattle, USA. pkdrain@uw.edu.
Department of Medicine, University of Washington, Seattle, USA. pkdrain@uw.edu.

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