High incidence and persistence of hepatitis B virus infection in individuals receiving HIV care in KwaZulu-Natal, South Africa

Background Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude...

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Published in:BMC infectious diseases Vol. 20; no. 1; pp. 847 - 9
Main Authors: Msomi, Nokukhanya, Naidoo, Kogieleum, Yende-Zuma, Nonhlanhla, Padayatchi, Nesri, Govender, Kerusha, Singh, Jerome Amir, Abdool-Karim, Salim, Abdool-Karim, Quarraisha, Mlisana, Koleka
Format: Journal Article
Language:English
Published: London BioMed Central 16.11.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - drug therapy
AIDS-Related Opportunistic Infections - epidemiology
AIDS-Related Opportunistic Infections - virology
Analysis
Anti-HIV Agents - therapeutic use
Care and treatment
Coinfection - epidemiology
Coinfection - virology
Comorbidity
Complications and side effects
Confidence intervals
Diagnosis
Female
Follow-Up Studies
HBV incidence
Hepatitis
Hepatitis and co-infections
Hepatitis B
Hepatitis B - diagnosis
Hepatitis B - epidemiology
Hepatitis B - virology
Hepatitis B surface antigen
Hepatitis B Surface Antigens - immunology
Hepatitis B virus - immunology
HIV
HIV infections
HIV/HBV coinfection
Human immunodeficiency virus
Humans
Immunization
Immunosuppression
Incidence
Infectious Diseases
Internal Medicine
Laboratories
Male
Medical Microbiology
Medicine
Medicine & Public Health
Mycobacterium tuberculosis - isolation & purification
Parasitology
Patients
Prevalence
Research Article
Retrospective Studies
Risk analysis
Risk Factors
South Africa
South Africa - epidemiology
Tropical Medicine
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - epidemiology
Tuberculosis - microbiology
Viruses
Young Adult
South Africa
Africa
HBV incidence
South Africa
HIV/HBV coinfection
ISSN:1471-2334, 1471-2334
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Summary:Background Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude of the problem, and identify risk factors for HBV infection in HIV infected patients with and without TB in KwaZulu-Natal, South Africa. Methods This retrospective cohort analysis was undertaken in 2018. In-care HIV infected patients were included in the analysis. Results from clinical records were analysed to determine the prevalence, incidence, persistence and factors associated with HBsAg positivity in HIV-infected patients with or without TB co-infection. Results A total of 4292 HIV-infected patients with a mean age of 34.7 years (SD: 8.8) were included. Based on HBsAg positivity, the prevalence of HBV was 8.5% (363/4292) [95% confidence interval (CI): 7.7–9.3] at baseline and 9.4% (95%CI: 8.6–10.3%) at end of follow-up. The HBV incidence rate was 2.1/100 person-years (p-y). Risk of incident HBV infection was two-fold higher among male patients (HR 2.11; 95% CI: 1.14–3.92), while severe immunosuppression was associated with a greater than two-fold higher risk of persistent infection (adjusted risk ratio (RR) 2.54; 95% CI 1.06–6.14; p  = 0.004. Additionally, active TB at enrolment was associated with a two-fold higher risk of incident HBV infection (aHR 2.38; 95% CI: 0.77–7.35). Conclusion The provision of HIV care and treatment in high HBV burden settings provide a missed opportunity for HBV screening, immunization and care provision.
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ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-020-05575-6