Prevalence and viral suppression of hepatitis B virus infection among people living with HIV on antiretroviral therapy in Sierra Leone.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES

Sexually Transmitted Infections Pub Date : 2024-07-26 DOI:10.1136/sextrans-2023-056042

Jin-Wen Song, Sulaiman Lakoh, Si-Yuan Chen, Mohamed Boie Jalloh, Stephen Sevalie, Mamadu Baldeh, Mohamed K Nyambe, Victoria Donicia Nicholas, George Yendewa, Fu-Sheng Wang, Guang Yang

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引用次数: 0

Abstract

Objective: Sub-Saharan Africa is one of the regions with the highest burdens of HIV and hepatitis B virus (HBV), but data on the impact of antiretroviral therapy (ART) on HBV DNA suppression is limited. In this study, we aimed to determine the prevalence and associated factors of a positive hepatitis B surface antigen (HBsAg) among people living with HIV, and assess the suppression of ART on HBV replication in people living with HIV in Sierra Leone.

Methods: A cross-sectional study was designed to recruit people living with HIV aged 18 years or older in ten public hospitals in Sierra Leone between August 2022 and January 2023. Statistical analyses were performed using R software. Logistic regression analysis was used to assess factors independently associated with positive HBsAg and HBV DNA suppression.

Results: Of the 3106 people living with HIV recruited in this study, 2311 (74.4%) were women. The median age was 36 years, 166 (5.3%) had serological evidence of HBV vaccination. The overall prevalence of HBsAg positivity was 12.0% (95% CI: 10.9% to 13.2%). Male sex (adjusted OR (aOR) 2.11, 95% CI: 1.67 to 2.68; p<0.001) and being separated (aOR 1.83, 95% CI: 1.06 to 3.16, p=0.031; reference group: being married) were independent predictors of HBsAg seropositivity. Among 331 people living with HIV and HBV receiving ART, 242 (73.1%) achieved HBV DNA suppression (below 20 IU/mL). HBV suppression rate was higher in HIV-virally suppressed patients than those with unsuppressed HIV viral load (p<0.001). In addition, the male sex was more likely to have unsuppressed HBV DNA (aOR 1.17, 95% CI: 1.17 to 3.21; p=0.010).

Conclusions: We reported a high prevalence of HBsAg seropositivity and low HBV immunisation coverage in people living with HIV in Sierra Leone. In addition, we observed that ART can efficiently result in a viral suppression rate of HBV infection. Therefore, achieving the global target of eliminating HBV infection by 2030 requires accelerated access to care for people living with HIV and HBV, including HBV testing, antiviral treatment and hepatitis B vaccination.

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塞拉利昂接受抗逆转录病毒疗法的艾滋病毒感染者中乙型肝炎病毒感染的流行率和病毒抑制率。

目的：撒哈拉以南非洲是艾滋病毒和乙型肝炎病毒（HBV）负担最重的地区之一：撒哈拉以南非洲是艾滋病毒和乙型肝炎病毒（HBV）感染率最高的地区之一，但有关抗逆转录病毒疗法（ART）对 HBV DNA 抑制作用的数据却很有限。在这项研究中，我们旨在确定艾滋病毒感染者中乙型肝炎表面抗原（HBsAg）阳性的流行率和相关因素，并评估抗逆转录病毒疗法对塞拉利昂艾滋病毒感染者中 HBV 复制的抑制作用：设计了一项横断面研究，于 2022 年 8 月至 2023 年 1 月期间在塞拉利昂的 10 家公立医院招募 18 岁或以上的 HIV 感染者。使用 R 软件进行统计分析。逻辑回归分析用于评估与 HBsAg 阳性和 HBV DNA 抑制独立相关的因素：在本研究招募的 3106 名艾滋病毒感染者中，2311 人（74.4%）为女性。年龄中位数为 36 岁，166 人（5.3%）有接种过 HBV 疫苗的血清学证据。HBsAg 阳性的总体流行率为 12.0%（95% CI：10.9% 至 13.2%）。男性性别（调整后 OR (aOR) 2.11，95% CI：1.67 至 2.68；p结论：我们报告了塞拉利昂 HIV 感染者中 HBsAg 血清阳性率高和 HBV 免疫覆盖率低的情况。此外，我们还发现抗逆转录病毒疗法可以有效抑制 HBV 感染。因此，要实现到 2030 年消除 HBV 感染的全球目标，就必须加快为艾滋病毒感染者和 HBV 患者提供护理服务，包括 HBV 检测、抗病毒治疗和乙肝疫苗接种。

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来源期刊

Sexually Transmitted Infections 医学-传染病学

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.