Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts

Brown, Robin; Goulder, Philip; Matthews, Philippa C.

doi:10.12688/wellcomeopenres.17601.3

Cited by 21 publications

(10 citation statements)

References 142 publications

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“…In the said study with PWH being older was only a predictor in univariate analysis similar to the current study [4]. Predictors of HBsAg vary across studies which might be due to lifestyle practices, genotypes as well as host genetics [10,48].…”

Section: Discussionsupporting

confidence: 62%

“…The South African study also did not show relationship status as well as the number of lifetime partners as predictors of HBsAg positivity similar to the current study [10]. Most studies reported more HBV in males ,however, for the current study, sex was not a predictor of HBsAg positivity [4,45,47,48]. In a study in PWH in the same communities, the male sex and northern geographic region were independent predictors of HBsAg positivity unlike in the current study.…”

Section: Discussioncontrasting

confidence: 58%

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Hepatitis B Virus Prevalence Among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana

Anderson,

Mangogola,

Phinius

et al. 2024

Preprint

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(1) Background: We determined the prevalence of hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened hepatitis B surface antigen (HBsAg) from archived plasma samples of people without HIV (n=2135) randomly selected from the Botswana Combination Prevention Program (BCPP) (2013–2018). We sequenced 415 bp of the surface region using BigDye sequencing chemistry. (3) Results: The median age of participants was 31 (IQR: 24–46) and 64% (1360/2135) were female. HBsAg prevalence was 4.0% (86/2135) [95% CI: 3.3 – 4.9]) and ranged between 0%–9.2%. Older participants (>35 years) had increased odds of HBsAg positivity (OR: 1.94; 95% CI: [1.32–2.86]; p = 0.001. Thirteen samples were sequenced and 7 (53.8%) were genotype A, 3 (23.1%) were genotype D and genotype E each. Clinically significant mutations were identified in the surface region, but no classic drug resistance mutations were identified. (4) Conclusions: We report an HBV prevalence of 4.0% (95% CI 3.3 – 4.9) among people without HIV in rural and pe-ri-urban communities in Botswana with varying rates in different communities. A comprehen-sive national HBV program is required in Botswana to guide HBV prevention, testing and management.

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Section: Discussionsupporting

confidence: 62%

Section: Discussioncontrasting

confidence: 58%

Hepatitis B Virus Prevalence Among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana

Anderson,

Mangogola,

Phinius

et al. 2024

Preprint

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“…Differences in disease susceptibility between men and women have been reported in other diseases as well and might be attributed to differences in behavior and biology. For example, women have been shown to possess a stronger immune response against HBV ( Brown et al, 2022 ) and renal cancer patients ( Ning et al, 2023 ). In the current study, there was no difference in CD4+ T-cell counts or HIV viral load between OBI + and OBI − participants at baseline.…”

Section: Discussionmentioning

confidence: 99%

Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana

Anderson,

Phinius,

Phakedi

et al. 2024

Front. Microbiol.

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AimThis study aimed to determine the kinetics of occult hepatitis B virus infections (OBI) among people with HIV (PWH).MethodsThe study used archived plasma samples from longitudinal HIV natural history studies. We identified new OBI cases and assessed risk factors for OBI using Cox proportional hazards regression analysis.ResultsAt baseline, 8 of 382 [(2.1%) (95% CI: 1.06–4.1)] samples tested positive for hepatitis B surface antigen (HBsAg+). Of the 374 HBsAg-negative samples, 76 had sufficient sample volume for HBV DNA screening. OBI positivity (OBI+) at baseline was reported in 11 of 76 [14.7 95% CI (8.3–24.1)] HBsAg-negative (HBsAg−) participants. Baseline HBsAg-negative samples with sufficient follow-up samples (n = 90) were used for analysis of newly identified OBI cases. Participants contributed 129.74 person-years to the study and were followed for a median of 1.02 years (IQR: 1.00–2.00). Cumulatively, there were 34 newly identified OBI cases from the 90 participants, at the rate of 26.2/100 person-years (95% CI: 18.7–36.7). Newly identified OBI cases were more common among men than women (61.1% vs. 31.9%) and among participants with CD4+ T-cell counts ≤450 cells/mL (p-value = 0.02). Most of the newly identified OBI cases [55.9% (19/34)] were possible reactivations as they were previously HBV core antibody positive.ConclusionThere was a high rate of newly identified OBI among young PWH in Botswana, especially in men and in participants with lower CD4+ T-cell counts. OBI screening in PWH should be considered because of the risk of transmission, possible reactivation, and risk factors for the development of chronic liver disease, including hepatocellular carcinoma.

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“…The physical, psychological and social impacts of hepatitis B are strongly influenced by sex and gender: men have higher rates of infection, progression to chronic infection, and complications, related to biological and social factors [ 35 ]. However, women are frequently diagnosed through antenatal screening, which provides access to treatment but presents psychosocial challenges such as health risks to unborn children and exposure to stigma and discrimination due to presumed immorality [ 25 , 27 , 35 ].…”

Section: Intersectionality and Hepatitis Bmentioning

confidence: 99%

An Intersectional Approach to Hepatitis B

Lemoh

Xiao

Tran

et al. 2023

IJERPH

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Hepatitis B is a chronic condition, primarily associated with hepatitis B viral infection in early life. The failure of prevention and appropriate management can lead to subsequent liver cirrhosis and cancer. Hepatitis B most commonly affects people born in Asia and Sub-Saharan Africa and their global diasporas. The physical, psychological, and social impacts of hepatitis B are strongly influenced by sex and gender. Inequities in access to timely, sensitive diagnosis and effective management arise from interactions between structural inequalities related to race, ethnicity, Indigenous/settler status, class, and geography. The biomedical response to hepatitis B has led to advances in prevention, diagnosis, and treatment, but many affected communities have explanatory health belief models that differ from that of biomedicine. We argue that an intersectional approach, led by affected people and communities, can integrate biomedicine with the lived experience and social context that give purpose to and shape all personal, communal, clinical, and public health responses to hepatitis B. This approach has the potential to enable a consciously equitable, effective response to the biopsychosocial complexities of hepatitis B, improve the health and wellbeing of people living with hepatitis B, and reduce hepatitis B-associated mortality.

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Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts

Cited by 21 publications

References 142 publications

Hepatitis B Virus Prevalence Among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana

Hepatitis B Virus Prevalence Among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana

Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana

An Intersectional Approach to Hepatitis B

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