Characterization of occult hepatitis B in high-risk populations in Kenya

Jepkemei, Kiptoon Beatrice; Ochwoto, Missiani; Swidinsky, Ken; Day, Jacqueline; Gebrebrhan, Henok; McKinnon, Lyle R.; Andonov, Anton; Oyugi, Julius; Kimani, Joshua; Gachara, George; Songok, Elijah; Osiowy, Carla

doi:10.1371/journal.pone.0233727

Cited by 23 publications

(29 citation statements)

References 47 publications

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“…The prevalence is however low compared to a prevalence of between 8.3% to 30.8% Table 3 Drug resistance conferring mutations from the current study These mutations were identified using two online tools Geno2Pheno HBV database (HBVdb) (https ://hbv.geno2 pheno .org/) and HBVseq program from HIV Stanford database (https ://hivdb .stanf ord.edu/HBV/HBVse q/devel opmen t/HBVse q.html). The mutations are listed for each of the sample where they occurred reported by Jepkemei et al [37] among different high risk groups of HBV infection [37]. Majority of the mutations in the P gene described in this study were primary drug resistance mutations that decrease susceptibility to nucleoside analogues.…”

Section: Discussionmentioning

confidence: 70%

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Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya

Aluora

Muturi

Gachara

2020

Virol J

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Background Hepatitis B virus (HBV) causes significant morbidity and mortality globally primarily due to its ability to cause hepatitis, liver cirrhosis and hepatocellular carcinoma. The Kenya National Blood Transfusion Services screens for Hepatitis B antibodies using the chemiluminescent microparticle immunoassay method. This test does not inform on the genotypic characteristics of the virus or the actual presence of the virus in blood. This study therefore sought to determine the serologic and genotypic profiles of HBV circulating among the voluntary blood donors in Nairobi. Methods Blood samples were collected in plain and EDTA vacutainers and tested for the Hepatitis B surface antigen (HBsAg). HBV DNA was then extracted from plasma, its overlapping P/S gene amplified and sequenced. The resulting sequences were used to analyze for the circulating genotypes and mutations within the P and S genes. Bivariate statistical analysis was used to determine the association between demographic factors and HBV infection. Results A seroprevalence of 2.3% (n = 7) was reported. The age group 19–28 years was significantly associated with HBV infection. Nine samples were positive for HBV DNA; these included 2 HBsAg positive samples and 7 HBsAg negative samples. Genotype A, sub genotype A1 was found to be exclusively prevalent while a number of mutations were reported in the “a” determinant segment of the major hydrophilic region of the S gene associated with antibody escape. RT mutations including mutation rt181T in the P gene conferring resistance against Lamivudine and other ʟ-nucleoside drugs were detected. Conclusion There is a high prevalence of occult HBV infections among these blood donors and therefore the testing platform currently in use requires revision.

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Section: Discussionmentioning

confidence: 70%

“…conducted later on who reported a prevalence of 2.25% of OBI among HIV patients [ 35 , 36 ]. The prevalence is however low compared to a prevalence of between 8.3% to 30.8% reported by Jepkemei et al [ 37 ] among different high risk groups of HBV infection [ 37 ].…”

Section: Discussionmentioning

confidence: 79%

Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya

Aluora

Muturi

Gachara

2020

Virol J

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“…Across the region, prevalence of HBV was approximately similar in Co ˆte d'Ivoire, Burkina Faso and Mali with a prevalence of 8.5% among PLHIV [23]. Among FSW, a study in South African found a prevalence of 4% in 2017 and another one in Kenya a prevalence of 10.1% in 2020 [6,24]. Those results…”

Section: Discussionmentioning

confidence: 63%

Prevalence of hepatitis B and C among female sex workers in Togo, West Africa

et al. 2021

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Background Hepatitis B and C are endemic in sub-Saharan Africa, with prevalence among the highest in the World. However, several challenges impede the progression towards the elimination of viral hepatitis by 2030 as suggested by the World Health Organization Global health sector strategy on viral hepatitis, including the lack of knowledge on the scale of this epidemic in the region. The aim of this study was to estimate the prevalence of hepatitis B and C among female sex workers (FSW) in Togo. Methods This ancillary study from a national cross-sectional bio-behavioral study was conducted in 2017 using a respondent-driven sampling (RDS) method, in eight towns of Togo among FSW. Socio-demographic, behavioral and sexual characteristics were assessed using a standardized questionnaire. Blood samples were collected for HIV, hepatitis B and C serological testing. Data were analyzed using descriptive analysis and a logistic regression model. Results Out of the 1,036 FSW recruited for this study, biological analyses for viral hepatitis were completed for 769 of them. The median age was 26 years [IQR: 22–33] and 49.8% (n = 383) had attained secondary school. The prevalence of hepatitis B was 9.9% [95% CI: (7.9–12.2)] and the prevalence of hepatitis C was 5.3% [95% CI: (3.9–7.2)]. Higher hepatitis B and C prevalence was associated with recruitment out of Lomé (aOR: 6.63; 95%CI: 3.51–13.40, p <0.001 and OR: 2.82; 95% CI: [1.37–5.99]; p<0.001, respectively) and, for hepatitis B, with never using condoms for vaginal intercourse (OR: 3.14; 95%CI: [1.02–8.71]; p<0.05). Conclusions Results from this study reveals high prevalence of hepatitis B and C among FSW in Togo and an opportunity for advocacy toward the introduction of immunizations and treatment in this population.

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“…This was lower than the 18.7% described by Jepkemei et al in a Kenyan study of a heterogeneous population of individuals at high risk of HBV infection, some of whom were HIV positive and on anti-retroviral therapy. This was mainly driven by the high prevalence among patients with symptomatic liver disease, who made up more than a third of the study population [19]. This prevalence is also much lower than what is described in other sub-Saharan countries where it ranges from 15.1 to 24% among the HIV infected [9,10,14,20].…”

Section: Discussionmentioning

confidence: 77%

Occult hepatitis B virus infection in a Kenyan cohort of HIV infected anti-retroviral therapy naïve adults

et al. 2021

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Background Occult hepatitis B virus (HBV) infection (OBI) is a phase of HBV infection characterised by the presence of HBV DNA in the absence of detectable hepatitis B surface antigen (HBsAg). OBI is of concern in the HIV-infected due to high prevalence and risk of HBV reactivation. The prevalence and clinico-demographic characteristics of OBI in anti-retroviral therapy (ART) naïve HIV infected adults in Kenya is unknown. Methods A cross sectional study carried was out at three sites in Kenya. HIV infected ART naïve adults were enrolled and demographic data collected. Blood samples were assayed for HBsAg, HBV DNA, alanine aminotransferase, aspartate aminotransferase, antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc). Data on CD4 count, HIV viral load and platelet count were obtained from medical records. Results Of 208 patients, 199 (95.7%) did not report HBV vaccination, 196 (94.2%) were HBsAg negative, 119 (57.2%) had no HBV markers, 58 (27.9%) had previous HBV infection (anti-HBc positive) and 11 (5.3%) had OBI. All 11 (100%) OBI patients were anti-HBc positive. OBI patients comprised 19.0% of HBsAg negative, anti-HBc positive patients. There was no difference in clinico-demographic characteristics between the overt HBV, OBI and HBV negative patients. Conclusion This was the first study on OBI in ART naïve HIV infected adults in Kenya. The lower OBI prevalence compared to other sub-Saharan African countries could be attributed to lower HBV exposure. Most patients were HBV unexposed and unimmunized, outlining the need to implement guideline recommended immunization strategies.

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Characterization of occult hepatitis B in high-risk populations in Kenya

Cited by 23 publications

References 47 publications

Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya

Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya

Prevalence of hepatitis B and C among female sex workers in Togo, West Africa

Occult hepatitis B virus infection in a Kenyan cohort of HIV infected anti-retroviral therapy naïve adults

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