Occult HBV infection in untreated HIV-infected adults in Côte d'Ivoire

N’Dri-Yoman, Thérèse; Anglaret, Xavier; Messou, Eugène; Attia, Alain; Polneau, Sandrine; Toni, Thomas; Chenal, Henri; Seyler, Catherine; Gabillard, Delphine; Wakasugi, Naomi; Eholié, Serge; Danel, Christine

doi:10.3851/imp1641

Cited by 38 publications

(28 citation statements)

References 22 publications

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“…Similar rates (32–42%) have been found in previous studies in Uganda and elsewhere in sub-Saharan Africa [32–35]. This pattern may be due to false-positive anti-HBc test results, rare in a high prevalence population such as this, or be transient and occur during the resolution phase of acute HBV.…”

Section: Discussionsupporting

confidence: 86%

Hepatitis B serological markers and plasma DNA concentrations

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Dunn

Zachary

et al. 2017

Aids

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Objectives:To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings.Design:Baseline analysis of a randomized controlled trial.Methods:DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999). HBV serological markers [antibody to HBV core antigen, HBV surface antigen (HBsAg), antibody to HBV surface antigen, HBV ‘e’ antigen (HBeAg), and antibody to hepatitis B ‘e’ antigen] and plasma HBV DNA viral load were measured retrospectively on stored baseline samples. Logistic regression was used to examine associations with baseline demographic and clinical factors.Results:The rate of HBsAg positivity was significantly higher in Zimbabwe than Uganda (12.2 vs. 7.7%, adjusted odds ratio = 1.54, P < 0.001) despite a similar prevalence of antibody to HBV core antigen (56.3 vs. 52.4%) in the two settings. Overall, HBsAg positivity was associated with male sex (adjusted odds ratio = 1.54, P < 0.001) but not with age, WHO disease stage, or CD4+ cell count. HBeAg was detected among 37% of HBsAg-positive patients, with higher rates among those with advanced WHO stage (P = 0.02). Also in HBsAg-positive patients, HBV DNA was undetectable in 21%, detectable but below the level of quantification in 14%, and quantifiable in 65%. A total of 96% of HBeAg-positive and 70% of HBeAg-negative patients had detectable HBV DNA; 92 and 28% of patients, respectively, had HBV DNA viral load more than 2000 IU/ml.Conclusion:High rates of HBV coinfection were observed, highlighting the importance of ensuring that coinfected patients receive an antiretroviral regimen, whether first-line or not, that is active against both viruses.

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Section: Discussionsupporting

confidence: 86%

Hepatitis B serological markers and plasma DNA concentrations

Price

Dunn

Zachary

et al. 2017

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“…The 38% HBeAg positivity among HBsAg-positive women in our study is similar to the 33% found in HIV-infected, pregnant women in Uganda and Rwanda [26], but higher than the 0% to 22% reported from smaller studies of HIV-infected, pregnant women from Cameroon and Cote d’Ivoire [30,31]. The prevalence of occult HBV infection in this study was 0.8%, which contrasts with the 10%–20% observed in HIV-infected patients in South Africa [32–34] and Cote D’Ivoire [35]. Although variations across studies in the detection of these various HBV serological markers may reflect differences in the size, demography and stage of HIV disease of the study populations and the genotypic distribution of endemic HBV strains, the usage of assays with disparate performance characteristics likely contributed.…”

Section: Discussioncontrasting

confidence: 73%

Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants

Chasela

Kourtis

Wall

et al. 2014

Journal of Hepatology

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Background & Aims The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants. Methods Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age. Results One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age. HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ≥8 log10 IU/ml in three infants of mothers who did not. Conclusions HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses. Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.

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“…This has probably underestimated the prevalence of HBV infection. Indeed, in one study conducted in Côte d’Ivoire, 10% of HBsAg-negative patients had detectable HBV DNA [29]. Third, the lack of molecular data concerning the HDV as HDV RNA testing has become a more compelling tool for recognizing active replication.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hepatitis B and delta according to HIV-type: a multi-country cross-sectional survey in West Africa

et al. 2017

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BackgroundIn West Africa where HIV-1 and HIV-2 co-circulate, the co-infection with hepatitis B virus (HBV) and hepatitis Delta virus (HDV) is not well described. This study aimed at estimating the prevalence of HBV and HBV/HDV co-infection according to HIV types and risk factors for HBV infection among West African HIV-infected patients.MethodA cross-sectional survey was conducted within the IeDEA West Africa cohort from March to December 2012 in Côte d’Ivoire (three sites), Burkina Faso and Mali (one site each). All HIV-infected adult patients on antiretroviral therapy (ART) or not who attended one of the participating HIV clinics during the study period and agreed to participate were included. Blood samples were collected and re-tested for HIV type discrimination, HBV and HDV serology as well as HBV viral load. Logistic regression was used to identify risk factors for HBV infection.ResultsA total of 791 patients were included: 192 HIV-1, 447 HIV-2 and 152 HIV-1&2 dually reactive. At time of sampling, 555 (70.2%) were on ART and median CD4+ cell count was 472/mm3 (inter-quartile range [IQR]: IQR: 294–644). Sixty-seven (8.5%, 95% CI 6.6–10.6) patients were HBsAg positive without any difference according to HIV type (7.9% in HIV-1, 7.2% in HIV-1&2 dually reactive and 9.4% in HIV-2; p = 0.61). In multivariate logistic analysis, age ≤ 30 years old (adjusted odds ratio [aOR] 5.00, 95% CI 1.96–12.76), age between 31 and 49 years old (aOR 1.78, 95% CI 1.00–2.21) and male gender (aOR 2.15, 95% CI 1.25–3.69) were associated with HBsAg positivity. HBV DNA testing was performed in 36 patients with blood sample available (25 on ART) and 8 (22.2%) had detectable HBV DNA. Among the HBsAg-positive individuals, 14.9% (95% CI 7.4–25.7) were also positive for anti-HDV antibody without any difference according to HIV type (28.6% in HIV-1, 14.3% in HIV-2 and 0.0% in HIV-1&2 dually reactive; p = 0.15).ConclusionHBV and HBV/HDV co-infection are common in West Africa, irrespective of HIV type. Therefore, screening for both viruses should be systematically performed to allow a better management of HIV-infected patients. Follow-up studies are necessary to determine the impact of these two viruses on HIV infection.

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Occult HBV infection in untreated HIV-infected adults in Côte d'Ivoire

Abstract: Background

Cited by 38 publications

References 22 publications

Hepatitis B serological markers and plasma DNA concentrations

Hepatitis B serological markers and plasma DNA concentrations

Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants

Prevalence of hepatitis B and delta according to HIV-type: a multi-country cross-sectional survey in West Africa

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