Hepatitis B seroprevalence among HIV-positive adults in the Free State, South Africa.

Background: HIV and hepatitis B virus (HBV) coinfection impacts negatively on the prognosis for people living with HIV (PLHIV). HBV is relatively neglected compared to HIV in the South African setting, with limited coinfection seroprevalence data from the Free State.

Objectives: This study aimed to determine the seroprevalence of current and previous HBV in PLHIV in the Free State, South Africa.

Method: In this descriptive cross-sectional study, 1007 residual HIV viral load (VL) samples were selected and screened for markers of current HBV infection (hepatitis B surface antigen [HBsAg]) and previous exposure to HBV (total antibodies to hepatitis B core antigen [HBcTA]) between 01 February 2022 and 31 March 2022. Seroprevalence was assessed for municipal health districts, age, sex, and HIV VL categories.

Results: HBsAg seroprevalence was 6.26% and HBcTA seroprevalence was 36.05%. HBsAg seroprevalence was significantly higher in men at 8.12% as compared to women at 4.38% (P = 0.014). HBcTA seropositivity was also higher in men than in women, at 42.97% for men and 29.08% for women (P < 0.0001). Peak HBsAg and HBcTA positivity was observed among the 40-59-year age group in both men and women. No significant difference was found in HBV seroprevalence and exposure between districts or HIV VL categories.

Conclusion: These findings demonstrate that PLHIV in the Free State, South Africa, fall under the intermediate HBV prevalence category. HBV infection remains a public health concern and emphasis should be placed on identifying and addressing programmatic gaps regarding diagnosis and management.