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Anderson M, Mangogola T, Phinius BB, Mpebe G, Aimakhu CO, Choga WT, Phakedi B, Bhebhe LN, Ditshwanelo D, Baruti K, Mpofu-Dobo L, Othusitse L, Ratsoma T, Gaolathe T, Makhema J, Shapiro R, Lockman S, Moyo S, Gaseitsiwe S. Hepatitis B Virus Prevalence among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana. Microorganisms 2024; 12:1207. [PMID: 38930589 PMCID: PMC11205512 DOI: 10.3390/microorganisms12061207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: we determined the prevalence of the hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened for the 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. HBV 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 HBV positivity (OR: 1.94; 95% CI: [1.32-2.86]; p = 0.001). Thirteen samples were sequenced and seven (53.8%) were genotype A, three (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 peri-urban communities in Botswana with varying rates in different communities. A comprehensive national HBV program is required in Botswana to guide HBV prevention, testing and management.
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Affiliation(s)
- Motswedi Anderson
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Africa Health Research Institute, Durban 4013, South Africa
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Thabo Mangogola
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Pan-African University (Life and Earth Sciences Institute), University of Ibadan, Ibadan 200132, Nigeria;
| | - Bonolo B. Phinius
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Gorata Mpebe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Christopher O. Aimakhu
- Pan-African University (Life and Earth Sciences Institute), University of Ibadan, Ibadan 200132, Nigeria;
| | - Wonderful T. Choga
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Basetsana Phakedi
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Lynnette N. Bhebhe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Doreen Ditshwanelo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Kabo Baruti
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Linda Mpofu-Dobo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences and Biotechnology, Faculty of Sciences, Botswana International University of Science and Technology, Private Bag 16, Palapye, Botswana
| | - Lebogang Othusitse
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Tsholofelo Ratsoma
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Tendani Gaolathe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Faculty of Medicine, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Roger Shapiro
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Shahin Lockman
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Sikhulile Moyo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Stellenbosch, Private Bag X1, Matieland 7602, South Africa
- School of Health Systems and Public Health, University of Pretoria, Private Bag X20, Pretoria 0028, South Africa
| | - Simani Gaseitsiwe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Anderson M, Phinius BB, Phakedi BK, Mudanga M, Bhebhe LN, Tlhabano GN, Motshosi P, Ratsoma T, Baruti K, Mpebe G, Choga WT, Marlink R, Glebe D, Blackard JT, Moyo S, Kramvis A, Gaseitsiwe S. Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana. Front Microbiol 2024; 15:1342862. [PMID: 38784816 PMCID: PMC11112038 DOI: 10.3389/fmicb.2024.1342862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Aim This study aimed to determine the kinetics of occult hepatitis B virus infections (OBI) among people with HIV (PWH). Methods The 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. Results At 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. Conclusion There 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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Affiliation(s)
- Motswedi Anderson
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Bonolo B. Phinius
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | | | - Mbatshi Mudanga
- Botswana – University of Maryland School of Medicine Health Initiative, Gaborone, Botswana
| | - Lynnette N. Bhebhe
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Girlie N. Tlhabano
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Patience Motshosi
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Tsholofelo Ratsoma
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Kabo Baruti
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Gorata Mpebe
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
| | - Wonderful T. Choga
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Richard Marlink
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, United States
| | - Dieter Glebe
- Institute of Medical Virology, National Reference Centre for Hepatitis B Viruses and Hepatitis D Viruses, Justus Liebig University of Giessen, Giessen, Germany
| | - Jason T. Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Sikhulile Moyo
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Simani Gaseitsiwe
- Research Laboratory, Botswana Harvard Health Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Baruti K, Phinius BB, Phakedi B, Mpebe G, Choga W, Bhebhe L, Mulenga G, Moraka NO, Ratsoma T, Pretorius-Holme M, Makhema J, Shapiro R, Lockman S, Moyo S, Jongman M, Anderson M, Gaseitsiwe S. High prevalence of hepatitis delta virus among people with hepatitis B virus and HIV coinfection in Botswana. J Infect Public Health 2023; 16:1736-1741. [PMID: 37734129 PMCID: PMC10589822 DOI: 10.1016/j.jiph.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/12/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Approximately 15-20 million people worldwide are infected with hepatitis delta virus (HDV), which is approximately 5 % of people with chronic hepatitis B virus (HBV). Sub-Saharan Africa has high HDV prevalence, leading to worse clinical outcomes among people who are HIV/HBV/HDV tri-infected. There are limited data on HDV prevalence among people with HIV (PWH) who are HBV-infected and uninfected in Botswana. We, therefore, determined HDV prevalence among PWH in Botswana. METHODS This was a retrospective cross-sectional study utilizing archived plasma samples from PWH with results for HBV markers such as hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) and hepatitis B e antigen (HBeAg). Samples were categorized according to their HBsAg status and screened for anti-HDV antibodies. Total nucleic acid was extracted from samples with a single positive anti-HDV result, and HDV ribonucleic acid (RNA) load was quantified using the Altona Diagnostic RealStar® HDV RT-PCR kit. Statistical analysis was performed using STATA version 14.0 where p-values < 0.05 were considered statistically significant. RESULTS The study cohort (n = 478) included both HBsAg positive (44 %) and negative (56 %) participants, with a median age of 42 [IQR; 41-43]. Anti-HDV prevalence of (15/211) [7.1 %, 95 % CI: 4.4 - 11.4] was recorded among HBsAg positive participants, all of whom were IgM anti-HBc negative, while 5/6 participants were HBeAg negative. HDV RNA load was detected in 11/12 (92 %) anti-HDV-positive participants. No HDV prevalence was recorded among participants who were HBsAg negative, therefore, the overall HDV prevalence was (15/478) [3.1 %, 95 % CI: 1.9 - 5.1]. HIV viral load suppression was statistically insignificant, irrespective of HDV status. CONCLUSIONS We report high HDV prevalence among HBsAg-positive PWH in Botswana. Most HDV-positive participants had active HDV infection, therefore, we recommend HDV screening in this cohort to guide their clinical care.
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Affiliation(s)
- Kabo Baruti
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Bonolo B Phinius
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Basetsana Phakedi
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Gorata Mpebe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Wonderful Choga
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Lynnette Bhebhe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Graceful Mulenga
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Natasha O Moraka
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Tsholofelo Ratsoma
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Molly Pretorius-Holme
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Joseph Makhema
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Roger Shapiro
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Shahin Lockman
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Sikhulile Moyo
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Mosimanegape Jongman
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Motswedi Anderson
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Simani Gaseitsiwe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States.
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Phinius BB, Anderson M, Mokomane M, Gobe I, Choga WT, Ratsoma T, Phakedi B, Mpebe G, Ditshwanelo D, Musonda R, Makhema J, Moyo S, Gaseitsiwe S. Atypical Hepatitis B Virus Serology Profile-Hepatitis B Surface Antigen-Positive/Hepatitis B Core Antibody-Negative-In Hepatitis B Virus/HIV Coinfected Individuals in Botswana. Viruses 2023; 15:1544. [PMID: 37515230 PMCID: PMC10383918 DOI: 10.3390/v15071544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Hepatitis B core antibodies (anti-HBc) are a marker of hepatitis B virus (HBV) exposure; hence, a normal HBV serology profile is characterized by HBV surface antigen (HBsAg) and anti-HBc positivity. However, atypical HBV serologies occur, and we aimed to determine the prevalence of an atypical profile (HBsAg+/anti-HBc-) in a cohort of people with HIV-1 (PWH) in Botswana. (2) Methods: Plasma samples from an HIV-1 cohort in Botswana (2013-2018) were used. The samples were screened for HBsAg and anti-HBc. Next-generation sequencing was performed using the GridION platform. The Wilcoxon rank-sum test and Chi-squared tests were used for the comparison of continuous and categorical variables, respectively. (3) Results: HBsAg+/anti-HBc- prevalence was 13.7% (95% CI 10.1-18.4) (36/263). HBsAg+/anti-HBc- participants were significantly younger (p < 0.001), female (p = 0.02) and ART-naïve (p = 0.04) and had a detectable HIV viral load (p = 0.02). There was no statistically significant difference in the number of mutations observed in participants with HBsAg+/anti-HBc- vs. those with HBsAg+/anti-HBc+ serology. (4) Conclusions: We report a high HBsAg+/anti-HBc- atypical serology profile prevalence among PWH in Botswana. We caution against HBV-testing algorithms that consider only anti-HBc+ samples for HBsAg testing, as they are likely to underestimate HBV prevalence. Studies to elucidate the mechanisms and implications of this profile are warranted.
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Affiliation(s)
- Bonolo B. Phinius
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana; (M.M.); (I.G.)
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Margaret Mokomane
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana; (M.M.); (I.G.)
| | - Irene Gobe
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana; (M.M.); (I.G.)
| | - Wonderful T. Choga
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana; (M.M.); (I.G.)
| | - Tsholofelo Ratsoma
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Basetsana Phakedi
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Gorata Mpebe
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Doreen Ditshwanelo
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Rosemary Musonda
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana; (M.M.); (I.G.)
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- School of Health Systems and Public Health, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana; (B.B.P.); (M.A.); (W.T.C.); (T.R.); (B.P.); (G.M.); (D.D.); (R.M.); (J.M.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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Phinius BB, Anderson M, Gobe I, Mokomane M, Choga WT, Mutenga SR, Mpebe G, Pretorius-Holme M, Musonda R, Gaolathe T, Mmalane M, Shapiro R, Makhema J, Lockman S, Novitsky V, Essex M, Moyo S, Gaseitsiwe S. High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana. Open Forum Infect Dis 2023; 10:ofac707. [PMID: 36686633 PMCID: PMC9850276 DOI: 10.1093/ofid/ofac707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Background We aimed to determine the prevalence of hepatitis B virus (HBV) infection among people with human immunodeficiency virus (PWH) in rural and periurban communities in Botswana. Methods PWH from a previous population-based study, the Botswana Prevention Combination Project, which enrolled adults in 30 communities across Botswana (2013-2018), were screened for HBV surface antigen (HBsAg) and HBV core antibody (anti-HBc). HBsAg-positive (HBsAg+) samples were further screened for HBV core immunoglobulin M antibodies (anti-HBc immunoglobulin M [IgM]) and HBV e antigen (HBeAg). We quantified HBV viral load on participants who tested positive (n = 148) and negative for HBsAg (n = 381). Results Of 3304 participants tested, 271 (8% [95% confidence interval {CI}, 7%-9%]) were HBsAg+ while 1788 (56% [95% CI, 54%-57%]) of 3218 PWH whom we tested had positive anti-HBc. Approximately 88% of HBsAg+ participants were on antiretroviral therapy (ART), 40% and 56% of whom were receiving lamivudine- and tenofovir-containing ART, respectively. Male sex (relative risk ratio [RRR], 1.8 [95% CI, 1.2-2.7]) and the northern geographic region (RRR, 2.5 [95% CI, 1.4-4.7]) were independent predictors of HBV infection (HBsAg+). Of 381 persons with negative HBsAg who were tested for occult HBV, 126 (33% [95% CI, 29%-38%]) had positive HBV DNA. Eleven participants were highly viremic with high HBV viral load while on a lamivudine- or tenofovir-containing regimen. Ten (91%) of these participants also had positive HBeAg serology, while 4 (36%) had positive anti-HBc IgM serology. Conclusions The prevalence of HBV was high among PWH in Botswana while on ART regimens with activity against HBV.
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Affiliation(s)
- Bonolo B Phinius
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana,Gaborone, Botswana
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana,Gaborone, Botswana
| | - Irene Gobe
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana,Gaborone, Botswana
| | - Margaret Mokomane
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana,Gaborone, Botswana
| | | | - Sharon R Mutenga
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Applied Biological Sciences and Biotechnology, Faculty of Science and Technology, Midlands State University, Gweru, Zimbabwe
| | - Gorata Mpebe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Biological Sciences, Faculty of Sciences, University of Botswana,Gaborone, Botswana
| | - Molly Pretorius-Holme
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rosemary Musonda
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Mompati Mmalane
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Roger Shapiro
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Vlad Novitsky
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Kimpiatu JPM, Mbendi CN, Tshimpi AWY, Nkodila AN, Lepira FB, Mbendi SN, Mbutiwi F, Makulo JRR, Situakibanza HNT, Longo-Mbenza B. Factors Associated with Liver Enzyme Abnormalities in HIV-HBV and/or HCV Co-infected Patients in Kinshasa, Democratic Republic of the Congo: Multicenter Cross-sectional Study. Rambam Maimonides Med J 2022; 13:RMMJ.10474. [PMID: 35701157 PMCID: PMC9345768 DOI: 10.5041/rmmj.10474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Liver enzyme abnormalities (LEA) are extremely common and sometimes severe in individuals infected with human immunodeficiency virus (HIV), but data for this disorder are lacking in the developing countries. The objective of this study was to identify factors associated with LEA in HIV-hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infected patients in Kinshasa, Democratic Republic of the Congo. METHODS This cross-sectional analytical study included 180 people living with HIV (PLWHIV) mono-infected or co-infected with HBV/HCV between November 10, 2013 and January 10, 2014 in Kinshasa. Sociodemographic, clinical, biological, serological, and immunological data were analyzed. Levels of serum glutamate oxaloacetate transferase (SGOT) and serum glutamate pyruvate transaminase (SGPT) were determined. Antibody levels were determined using enzyme-linked immunosorbent assay (ELISA). RESULTS The mean age of patients was 44.2±11.0 years; female sex was predominant (76.7%). Co-infection, mainly with HBV, but also HCV, was found in 43 (23.9%) patients. Elevated liver enzymes were found in 77 (42.8%) of the patients. No difference was found in the rate of liver enzyme abnormalities between patients with HIV mono-infection or HIV co-infection (46.7% versus 30.2%, respectively; P=0.08). Factors associated with LEA were age ≥50 years (adjusted odds ratio [OR] 2.7; 95% CI 1.4-5.5), duration of HIV infection >3 years (adjusted OR 2.7; 95% CI 1.4-5.5), and CD4 T cells count ≤303 cells/mm3 (adjusted OR 2.2; 95% CI 1.1-4.5). CONCLUSIONS Liver enzyme abnormalities are frequent in patients co-infected with HIV-HBV/HCV as well as in HIV patients without co-infection. Diagnosis is determined based on age, immunodeficiency, and length of illness.
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Affiliation(s)
| | - Charles N’lombi Mbendi
- Department of Gastroenterology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Aliocha Natuhoyila Nkodila
- Department of Family Medicine and Primary Health Care, Protestant University in Congo, Kinshasa, Democratic Republic of the Congo
- To whom correspondence should be addressed. E-mail:
| | - François Bompeka Lepira
- Department of Nephrology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Sebastien Nsukini Mbendi
- Department of Gastroenterology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Fiston Mbutiwi
- Department of Nephrology, University of Kikwit, Kikwit, Democratic Republic of the Congo
| | | | | | - Benjamin Longo-Mbenza
- Department of Cardiology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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7
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Shaver ZM, Anderson M, Bhebhe L, Baruti K, Chogaa WT, Ngidi J, Mbangiwa T, Taua M, Setlhare DR, Melamu P, Phinius BB, Musonda R, Mine M, Moyo S, Gaseitsiwe S. Decreased hepatitis B virus vaccine response among HIV-positive infants compared with HIV-negative infants in Botswana. AIDS 2022; 36:755-762. [PMID: 35113045 PMCID: PMC7614825 DOI: 10.1097/qad.0000000000003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We sought to determine vaccine antibody titres and the prevalence of hepatitis B surface antigen (HBsAg) in both HIV-positive and HIV-negative infants born to HIV-positive mothers in Botswana. DESIGN This was a retrospective cross-sectional study using 449 archived dried blood spot samples from both HIV-positive and HIV-negative infants collected between 2016 and 2018. METHODS We screened dried blood spot samples for HBsAg and determined hepatitis B surface antibody titres. We determined hepatitis B virus (HBV) genotypes by amplifying 415 base-pairs of the surface region. RESULTS HIV-positive infants mounted a significantly lower immune response to the HBV vaccine (P < 0.001). Furthermore, a lower proportion of HIV-positive infants had protective hepatitis B surface antibody titres (74.5%) than HIV-negative infants (89.2%) (P < 0.001). HIV-positive infants were older and 50.9% of them had completed vaccination (P = 0.018). Of the 449 infant samples tested, three (0.67%) were positive for HBsAg. Of the three HBsAg-positive infants, two had protective titres (>10 mIU/ml). Two of the three HBV-positive infants were infected with genotype D3 and had no drug-resistance or escape mutations. CONCLUSION Vaccine response was lower among HIV-positive infants compared with HIV-negative infants. HBV infections were observed in both HIV-positive and HIV-negative infants in Botswana. Studies to investigate additional preventive strategies to reduce HBV mother-to-child transmission are recommended.
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Affiliation(s)
| | | | | | - Kabo Baruti
- Botswana Harvard AIDS Institute Partnership, Gaborone
- University of Botswana, Department of Biological Sciences, Gabarone, Botswana
| | - Wonderful T. Chogaa
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Julia Ngidi
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | | | - Modiri Taua
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Ditiro R. Setlhare
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Pinkie Melamu
- Botswana Harvard AIDS Institute Partnership, Gaborone
| | | | | | - Madisa Mine
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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8
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Olagbenro M, Anderson M, Gaseitsiwe S, Powell EA, Gededzha MP, Selabe SG, Blackard JT. In silico analysis of mutations associated with occult hepatitis B virus (HBV) infection in South Africa. Arch Virol 2021; 166:3075-3084. [PMID: 34468889 DOI: 10.1007/s00705-021-05196-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 06/09/2021] [Indexed: 01/02/2023]
Abstract
Occult hepatitis B virus (OBI) infection is defined by the presence of viral DNA in the liver and/or serum in absence of hepatitis B surface antigen (HBsAg). While multiple studies have identified mutations that are associated with OBI, only a small portion of these mutations have been functionally characterized in vitro. Using complementary in silico approaches, the effects of OBI-associated amino acid mutations on HBV protein function in HBV/HIV-positive ART-naïve South Africans were evaluated. Two OBI-associated mutations in the PreS1 region, one in the PreS2 region, and seven in the surface region of subgenotype A1 sequences were identified as deleterious. In subgenotype A2 sequences, 11 OBI-associated mutations in the PreS1 region, seven in the PreS2 region, and 31 in the surface region were identified as deleterious. In the polymerase region, 14 OBI-associated mutations in subgenotype A1 and 71 OBI-associated mutations in subgenotype A2 were identified as deleterious. This study utilized in silico approaches to characterize the likely impact of OBI-associated mutations on viral function, thereby identifying and prioritizing candidates and reducing the significant cost associated with functional studies that are essential for mechanistic studies of the OBI phenotype.
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Affiliation(s)
- Matthew Olagbenro
- Division of Digestive Diseases, University of Cincinnati College of Medicine, ML 0595, Albert Sabin Way, Cincinnati, OH, 45267-0595, USA
| | | | | | - Eleanor A Powell
- Division of Digestive Diseases, University of Cincinnati College of Medicine, ML 0595, Albert Sabin Way, Cincinnati, OH, 45267-0595, USA.,Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Maemu P Gededzha
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa.,HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, Pretoria, South Africa
| | - Selokela G Selabe
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, Pretoria, South Africa
| | - Jason T Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, ML 0595, Albert Sabin Way, Cincinnati, OH, 45267-0595, USA. .,HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, Pretoria, South Africa.
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9
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Souda S, Mwita JC, Cainelli F, Mannathoko NB, Anderson M, Moyo S. Seroprevalence and risk factors of hepatitis B, C and D virus infection amongst patients with features of hepatitis in a referral hospital in Botswana: A cross-sectional study. S Afr J Infect Dis 2021. [DOI: 10.4102/sajid.v36i1.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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10
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Phinius BB, Anderson M, Bhebhe L, Baruti K, Manowe G, Choga WT, Mupfumi L, Mbangiwa T, Mudanga M, Moyo S, Marlink R, Blackard JT, Gaseitsiwe S. Increased Prevalence of Liver Fibrosis and HIV Viremia among Patients with HIV, HBV, and Tuberculosis in Botswana. Pathogens 2020; 9:E950. [PMID: 33202597 PMCID: PMC7696587 DOI: 10.3390/pathogens9110950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022] Open
Abstract
People with concomitant human immunodeficiency virus (HIV) and tuberculosis (TB) have an increased risk of hepatotoxic reactions due to antiretroviral therapy (ART) and anti-TB therapy (ATT). Concomitant hepatitis B virus (HBV) in these patients may lead to poorer health outcomes. To assess liver enzyme levels and immune response in adults with HIV, HBV, and TB, data from 300 antiretroviral-naïve people living with HIV (PLWHIV) were analyzed. The prevalence of HIV/HBV (cHIV/HBV) and HIV/TB (cHIV/TB) was 28% (95% CI: 23.0-33.4) and 10% (95% CI: 6.8-14.0), respectively. HIV/HBV/TB (cHIV/HBV/TB) prevalence was 5.3% (95% CI: 3.1-8.5). There was a statistically significant difference between the groups of participants in HIV viral load (p = 0.004), hemoglobin levels (p = 0.025), and body mass index (p = 0.011). A larger proportion of cHIV/HBV/TB participants (37.5%) had an aspartate aminotransferase to platelet ratio index (APRI) score ≥0.5 (p = 0.013), a lower cutoff for significant liver fibrosis. Immunological non-responders (CD4+ T-cell count <20% gain and HIV viral load <400 copies/mL at 6 months) were observed in all groups except those with cHIV/TB. Our findings support the need to screen for infections that could cause excessive liver damage prior to ATT or ART initiation, such as HBV.
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Affiliation(s)
- Bonolo B. Phinius
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
| | - Motswedi Anderson
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
| | - Lynnette Bhebhe
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
| | - Kabo Baruti
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone 0000, Botswana
| | - Godiraone Manowe
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
| | - Wonderful T. Choga
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Lucy Mupfumi
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
| | - Tshepiso Mbangiwa
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Mbatshi Mudanga
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Statistics, Faculty of Sciences, University of Botswana, Gaborone 0000, Botswana
| | - Sikhulile Moyo
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Richard Marlink
- Rutgers Global Health Institute, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Jason T. Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA;
| | - Simani Gaseitsiwe
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone 0000, Botswana; (B.B.P.); (M.A.); (L.B.); (K.B.); (G.M.); (W.T.C.); (L.M.); (T.M.); (M.M.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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11
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Baruti K, Lentz K, Anderson M, Ajibola G, Phinius BB, Choga WT, Mbangiwa T, Powis KM, Sebunya T, Blackard JT, Lockman S, Moyo S, Shapiro R, Gaseitsiwe S. Hepatitis B virus prevalence and vaccine antibody titers in children HIV exposed but uninfected in Botswana. PLoS One 2020; 15:e0237252. [PMID: 32764801 PMCID: PMC7413399 DOI: 10.1371/journal.pone.0237252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023] Open
Abstract
Background Botswana introduced the HBV vaccine at birth for all newborns in 2000. To the best of our knowledge, since the introduction of HBV vaccination, there have been limited data for vaccine response to HBV and its impact on early childhood HBV infections among children HIV exposed but uninfected in Botswana. Aims To determine the prevalence of hepatitis B surface antigen (HBsAg) and HBV vaccine response in 18 months old children HIV exposed but uninfected in Botswana. Methods Stored plasma samples from 304 children at 18 months of age and 287 mothers from delivery were tested for HBsAg. Mothers with positive HBsAg had HBV DNA level tested, and their HBV genotypes were determined by amplifying a 415-base pair (bp) region of the surface gene. Plasma samples from children exposed to HIV were tested for hepatitis B surface antibody (anti-HBs) titers. Results No children (0 of 304) were positive for HBsAg at 18 months while 5 (1.74%) of 287 HIV-positive mothers were HBsAg positive. Four of the HBsAg positive mothers were infected with genotype A1, while 1 was infected with genotype E. The median anti-HBs titer in children was 174 mIU/mL [QR: 70, 457]. Three (1.1%) of 269 children had an inadequate vaccine response (<10 mIU/mL), while 266 (98.9%) of 269 had protective immunity. However, when using the ≥100mIU/mL threshold, only 170 (63.2%) of 269 children had complete protection. Conclusion No HBsAg positivity was identified in a cohort of children HIV exposed but uninfected. The absence of HBsAg positives was associated with good HBV vaccine responses and low maternal HBsAg prevalence in Botswana.
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Affiliation(s)
- Kabo Baruti
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Kayla Lentz
- Harvard College, Cambridge, Massachusetts, United States of America
| | | | | | | | - Wonderful T. Choga
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tshepiso Mbangiwa
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kathleen M. Powis
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Theresa Sebunya
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Jason T. Blackard
- University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Roger Shapiro
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail: ,
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Platt L, French CE, McGowan CR, Sabin K, Gower E, Trickey A, McDonald B, Ong J, Stone J, Easterbrook P, Vickerman P. Prevalence and burden of HBV co-infection among people living with HIV: A global systematic review and meta-analysis. J Viral Hepat 2020; 27:294-315. [PMID: 31603999 PMCID: PMC7383613 DOI: 10.1111/jvh.13217] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV.
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Affiliation(s)
- Lucy Platt
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Clare E. French
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Catherine R. McGowan
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
- Humanitarian Public Health Technical UnitSave the Children UKLondonUK
| | | | - Erin Gower
- Centre for Disease Control and PreventionAtlantaUSA
| | - Adam Trickey
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Bethan McDonald
- Oxford School of Public HealthNuffield Department of Population HealthUniversity of OxfordOxfordUK
- Oxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxfordUK
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jason Ong
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jack Stone
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | | | - Peter Vickerman
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Phinius BB, Anderson M, Bokete R, Mbangiwa T, Choga WT, Baruti K, Makhema J, Musonda R, Blackard JT, Essex M, Moyo S, Marlink R, Gaseitsiwe S. Incidence of hepatitis B virus infection among human immunodeficiency virus-infected treatment naïve adults in Botswana. Medicine (Baltimore) 2020; 99:e19341. [PMID: 32118769 PMCID: PMC7478615 DOI: 10.1097/md.0000000000019341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection is highest in sub-Saharan Africa and results in accelerated clinical outcomes compared with HBV or HIV mono-infection. HBV clearance rates are higher in healthy adults; however, in sub-Saharan Africa, there are limited data on clearance of incident HBV in HIV-infected adults. Therefore, we sought to estimate HBV incidence and HBV surface antigen (HBsAg) clearance in HIV-infected adults in Botswana.This was a retrospective longitudinal study of 442 HIV-1C infected treatment naïve patients enrolled in a previous Botswana Harvard AIDS Institute Partnership study. Archived plasma samples from 435 HIV-infected treatment naïve participants were screened for HBsAg and HBV core antibody (anti-HBc). HBsAg was evaluated annually over a 4-year period, and HBV deoxyribonucleic acid (DNA) levels of HBsAg-positive chronic and incident patients were quantified.Baseline median CD4+ T-cell count was 458 cells/μL [Q1, Q3: 373, 593], and median HIV viral load was 4.15 copies/mL [Q1, Q3: 3.46, 4.64]. Twenty two HBV incident cases occurred, representing an incidence of 3.6/100 person-years [95% CI: 2.2-5.6]. All incident HBV cases with a follow-up sample available for screening (13/22) cleared HBsAg. Detectable HBV viral loads among chronic and incident cases ranged between 5.15 × 10 to 1.4 × 10 IU/L and 1.80 × 10 to 1.7 × 10 IU/mL, respectively.We report high HBV incidence associated with elevated HBV DNA levels despite high CD4+ T-cell counts in HIV-infected patients in Botswana. These incidence cases represent a potential source of HBV transmission in the population. Scaling-up of HIV treatment strategies utilizing antiretroviral therapy regimens with anti-HBV activity coupled with screening for HBV infections in households of the HBsAg-positive cases is recommended.
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Affiliation(s)
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership
- University of Botswana, Gaborone, Botswana
| | | | - Tshepiso Mbangiwa
- Botswana Harvard AIDS Institute Partnership
- Division of Immunology, Department of Pathology, University of Cape Town, South Africa
| | - Wonderful Tatenda Choga
- Botswana Harvard AIDS Institute Partnership
- Division of Immunology, Department of Pathology, University of Cape Town, South Africa
| | - Kabo Baruti
- Botswana Harvard AIDS Institute Partnership
- University of Botswana, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership
- Harvard T.H. Chan School of Public Health AIDS Initiative, Boston, Massachusetts
| | - Rosemary Musonda
- Botswana Harvard AIDS Institute Partnership
- Harvard T.H. Chan School of Public Health AIDS Initiative, Boston, Massachusetts
| | | | - Max Essex
- Botswana Harvard AIDS Institute Partnership
- Harvard T.H. Chan School of Public Health AIDS Initiative, Boston, Massachusetts
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership
- Harvard T.H. Chan School of Public Health AIDS Initiative, Boston, Massachusetts
| | - Richard Marlink
- Botswana Harvard AIDS Institute Partnership
- Rutgers University, New Jersey, USA
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership
- Harvard T.H. Chan School of Public Health AIDS Initiative, Boston, Massachusetts
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Bhebhe L, Anderson M, Souda S, Choga WT, Zumbika E, Shaver ZM, Mbangiwa T, Phinius BB, Banda CC, Melamu P, Musonda RM, Essex M, Blackard JT, Moyo S, Gaseitsiwe S. Molecular characterization of hepatitis C virus in liver disease patients in Botswana: a retrospective cross-sectional study. BMC Infect Dis 2019; 19:875. [PMID: 31640596 PMCID: PMC6805647 DOI: 10.1186/s12879-019-4514-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/26/2019] [Indexed: 12/11/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is a major cause of chronic liver disease globally. Direct acting antivirals (DAAs) have proven effective in curing HCV. However, the current standard of care (SOC) in Botswana remains PEGylated interferon-α (IFN-α) with ribavirin. Several mutations have been reported to confer resistance to interferon-based treatments. Therefore, there is a need to determine HCV genotypes in Botswana, as these data will guide new treatment guidelines and understanding of HCV epidemiology in Botswana. Methods This was a retrospective cross-sectional pilot study utilizing plasma obtained from 55 participants from Princess Marina Hospital in Gaborone, Botswana. The partial core region of HCV was amplified, and genotypes were determined using phylogenetic analysis. Results Four genotype 5a and two genotype 4v sequences were identified. Two significant mutations – K10Q and R70Q – were observed in genotype 5a sequences and have been associated with increased risk of hepatocellular carcinoma (HCC), while R70Q confers resistance to interferon-based treatments. Conclusion Genotypes 5a and 4v are circulating in Botswana. The presence of mutations in genotype 5 suggests that some patients may not respond to IFN-based regimens. The information obtained in this study, in addition to the World health organization (WHO) recommendations, can be utilized by policy makers to implement DAAs as the new SOC for HCV treatment in Botswana.
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Affiliation(s)
- Lynnette Bhebhe
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Applied Biology and Biochemistry, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana
| | - Sajini Souda
- Department of Pathology, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Wonderful T Choga
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Applied Biology and Biochemistry, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Edward Zumbika
- Department of Applied Biology and Biochemistry, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Zachary M Shaver
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana
| | - Tshepiso Mbangiwa
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Bonolo B Phinius
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana
| | - Chabeni C Banda
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana
| | - Pinkie Melamu
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana
| | - Rosemary M Musonda
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jason T Blackard
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Research Laboratory, Gaborone, Botswana. .,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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15
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Goa A, Dana T, Bitew S, Arba A. Seroprevalence and associated factors of hepatitis B virus infection among HIV-positive adults attending an antiretroviral treatment clinic at Wolaita Sodo University Referral Hospital. Hepat Med 2019; 11:137-147. [PMID: 31565003 PMCID: PMC6735655 DOI: 10.2147/hmer.s206870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/19/2019] [Indexed: 12/19/2022] Open
Abstract
Background Hepatitis B virus infection (HBV) constitutes major public health problems in sub-Saharan Africa from different infections occuring in HIV positive patients. Ethiopia is a part of sub-Saharan Africa with 1.5% adult HIV prevalence, and also belongs to the intermediate to high HBV prevalence category. Hence, this study aimed to measure the seroprevalence and associated factors of HBV infection among HIV-positive adults attending an antiretroviral treatment (ART) clinic at Wolaita Sodo University Referral Hospital. Methods An institution-based cross-sectional study was conducted from October 15 to December 10, 2017 using a systematic random sampling technique. After getting informed written consent, data were collected by a structured and interviewer-administered questionnaire. Venous blood was collected and centrifuged to separate serum. Hepatitis B surface antigen (HBsAg) was detected from serum using an advanced quality one-step rapid test kit. Data were entered into EpiData version 3.01 and exported to SPSS version 20. Summary statistics, bivariate analysis, and multivariate analyses were performed. The variables having significant association of P<0.05 in the multivariate logistic regression were taken as independent factors. OR and 95% CI were used to measure the strength of the association. Results A total of 442 study participants, 187 males and 255 females, were included in this study. Overall prevalence of HBsAg was 37 (8.4%). Family history of HBV (adjusted OR=8.83, 95% CI=2.56–30.49), multiple sexual partners (adjusted OR=7.08, 95% CI=2.29–21.9), and CD4 count <200 cells/μL (adjusted OR=15.34, 95% CI=4.77–49.3) were found to be significantly associated with HBsAg positivity. Conclusion The prevalence of HBsAg in this study was high. Family history of HBV, multiple sexual partners, and CD4 count <200 cells/μL were independently associated with HBsAg positivity. Therefore, screening for HBV is recommended before initiation of ART in HIV patients and providing appropriate treatment for co-infection. Furthermore, accurate information on risk factors for HBV transmission should be provided. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: http://www.youtube.com/watch?v=Z05OsXCUwHY
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Affiliation(s)
- Abraham Goa
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Tadele Dana
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Shimelash Bitew
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Aseb Arba
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
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16
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Hashiani AA, Sadeghi F, Ayubi E, Rezaeian S, Moradi Y, Mansori K, Gholamaliei B, Mohammadbeigi A, Khazaei S. Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta-Analysis. Malays J Med Sci 2019; 26:37-48. [PMID: 31303849 PMCID: PMC6613465 DOI: 10.21315/mjms2019.26.3.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 07/03/2018] [Indexed: 12/27/2022] Open
Abstract
Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models. Overall, 916 relevant papers were recognised and 14 articles were included in the meta-analysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5–2.1), 16.3% (95%CI: 1.1–31.6), 0.5% (95%CI: 0–1.4) and 0.5% (95%CI: 0.2–0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010–2016 as compared to that of the years 2003–2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers.
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Affiliation(s)
- Amir Almasi Hashiani
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran and Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Farzin Sadeghi
- Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Erfan Ayubi
- Department of Community Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahab Rezaeian
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yousef Moradi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Kamyar Mansori
- Department of Epidemiology and Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Behzad Gholamaliei
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abolfazl Mohammadbeigi
- Research Center of Gastroenterology and Hepatology, Qom University of Medical Sciences, Qom, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Molecular Characterization of Near Full-Length Genomes of Hepatitis B Virus Isolated from Predominantly HIV Infected Individuals in Botswana. Genes (Basel) 2018; 9:genes9090453. [PMID: 30205537 PMCID: PMC6162474 DOI: 10.3390/genes9090453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/27/2018] [Accepted: 09/03/2018] [Indexed: 12/13/2022] Open
Abstract
The World Health Organization plans to eliminate hepatitis B and C Infections by 2030. Therefore, there is a need to study and understand hepatitis B virus (HBV) epidemiology and viral evolution further, including evaluating occult (HBsAg-negative) HBV infection (OBI), given that such infections are frequently undiagnosed and rarely treated. We aimed to molecularly characterize HBV genomes from 108 individuals co-infected with human immunodeficiency virus (HIV) and chronic hepatitis B (CHB) or OBI identified from previous HIV studies conducted in Botswana from 2009 to 2012. Full-length (3.2 kb) and nearly full-length (~3 kb) genomes were amplified by nested polymerase chain reaction (PCR). Sequences from OBI participants were compared to sequences from CHB participants and GenBank references to identify OBI-unique mutations. HBV genomes from 50 (25 CHB and 25 OBI) individuals were successfully genotyped. Among OBI participants, subgenotype A1 was identified in 12 (48%), D3 in 12 (48%), and E in 1 (4%). A similar genotype distribution was observed in CHB participants. Whole HBV genome sequences from Botswana, representing OBI and CHB, were compared for the first time. There were 43 OBI-unique mutations, of which 26 were novel. Future studies using larger sample sizes and functional analysis of OBI-unique mutations are warranted.
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18
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Anderson M, Choga WT, Moyo S, Bell TG, Mbangiwa T, Phinius BB, Bhebhe L, Sebunya TK, Makhema J, Marlink R, Kramvis A, Essex M, Musonda RM, Blackard JT, Gaseitsiwe S. In Silico Analysis of Hepatitis B Virus Occult Associated Mutations in Botswana Using a Novel Algorithm. Genes (Basel) 2018; 9:genes9090420. [PMID: 30134551 PMCID: PMC6162659 DOI: 10.3390/genes9090420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/16/2018] [Indexed: 02/06/2023] Open
Abstract
Occult hepatitis B infections (OBI) represent a reservoir of undiagnosed and untreated hepatitis B virus (HBV), hence the need to identify mutations that lead to this phenotype. Functionally characterizing these mutations by in vitro studies is time-consuming and expensive. To bridge this gap, in silico approaches, which predict the effect of amino acid (aa) variants on HBV protein function, are necessary. We developed an algorithm for determining the relevance of OBI-associated mutations using in silico approaches. A 3 kb fragment of subgenotypes A1 and D3 from 24 chronic HBV-infected (CHB) and 24 OBI participants was analyzed. To develop and validate the algorithm, the effects of 68 previously characterized occult-associated mutations were determined using three computational tools: PolyPhen2, SNAP2, and PROVEAN. The percentage of deleterious mutations (with impact on protein function) predicted were 52 (76.5%) by PolyPhen2, 55 (80.9%) by SNAP2, and 65 (95.6%) by PROVEAN. At least two tools correctly predicted 59 (86.8%) mutations as deleterious. To identify OBI-associated mutations exclusive to Botswana, study sequences were compared to CHB sequences from GenBank. Of the 43 OBI-associated mutations identified, 26 (60.5%) were predicted by at least two tools to have an impact on protein function. To our knowledge, this is the first study to use in silico approaches to determine the impact of OBI-associated mutations, thereby identifying potential candidates for functional analysis to facilitate mechanistic studies of the OBI phenotype.
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Affiliation(s)
- Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Faculty of Science, Department of Biological Sciences, University of Botswana, Gaborone, Botswana.
| | | | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Trevor Graham Bell
- Hepatitis Virus Diversity Research Unit (HVDRU), Faculty of Health Sciences, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2050, South Africa.
| | - Tshepiso Mbangiwa
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Faculty of Allied Health Sciences, University of Botswana, Gaborone, Botswana.
| | - Bonolo B Phinius
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
| | - Lynette Bhebhe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
| | - Theresa K Sebunya
- Faculty of Science, Department of Biological Sciences, University of Botswana, Gaborone, Botswana.
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Richard Marlink
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Rutgers Global Health Institute, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08854, USA.
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit (HVDRU), Faculty of Health Sciences, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2050, South Africa.
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | | | - Jason T Blackard
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
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Moturi E, Tevi-Benissan C, Hagan JE, Shendale S, Mayenga D, Murokora D, Patel M, Hennessey K, Mihigo R. Implementing a Birth Dose of Hepatitis B Vaccine in Africa: Findings from Assessments in 5 Countries. JOURNAL OF IMMUNOLOGICAL SCIENCES 2018; Suppl:31-40. [PMID: 30931434 PMCID: PMC6436721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Few African countries have introduced a birth dose of hepatitis B vaccine (HepB-BD) despite a World Health Organization (WHO) recommendation. HepB-BD given within 24 hours of birth, followed by at least two subsequent doses, is 90% effective in preventing perinatal transmission of hepatitis B virus. This article describes findings from assessments conducted to document the knowledge, attitudes, and practices surrounding HepB-BD implementation among healthcare workers in five African countries. METHODS Between August 2015 and November 2016, a series of knowledge, attitude and practices assessments were conducted in a convenience sample of public and private health facilities in Botswana, the Gambia, Namibia, Nigeria, and São Tomé and Príncipe (STP). Data were collected from immunization and maternity staff through interviewer-administered questionnaires focusing on HepB-BD vaccination knowledge, practices and barriers, including those related to home births. HepB-BD coverage was calculated for each visited facility. RESULTS A total of 78 health facilities were visited: STP 5 (6%), Nigeria 23 (29%), Gambia 9 (12%), Botswana 16 (21%), and Namibia 25 (32%). Facilities in the Gambia attained high total coverage of 84% (range: 60-100%) but low timely estimates 7% (16-28%) with the median days to receiving HepB-BD of 11 days (IQR: 6-16 days). Nigeria had low total (23% [range: 12-40%]), and timely (13% [range: 2-21%]) HepB-BD estimates. Facilities in Botswana had high total (94% [range: 80-100%]), and timely (74% [range: 57-88%]) HepB-BD coverage. Coverage rates were not calculated for STP because the maternal Hepatitis B virus (HBV) status was not recorded in the delivery registers. The study in Namibia did not include a coverage assessment component. Barriers to timely HepB-BD included absence of standard operating procedures delineating staff responsible for HepB-BD, not integrating HepB-BD into essential newborn packages, administering HepB-BD at the point of maternal discharge from facilities, lack of daily vaccination services, sub-optimal staff knowledge about HepB-BD contraindications and age-limits, lack of outreach programs to reach babies born outside facilities, and reporting tools that did not allow for recording the timeliness of HepB-BD doses. DISCUSSION These assessments demonstrate how staff perceptions and lack of outreach programs to reach babies born outside health facilities with essential services are barriers for implementing timely delivery of HepB-BD vaccine. Addressing these challenges may accelerate HepB-BD implementation in Africa.
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Affiliation(s)
- Edna Moturi
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Carole Tevi-Benissan
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - José E. Hagan
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephanie Shendale
- World Health Organization, Expanded Programme on Immunization, Geneva, Switzerland
| | - David Mayenga
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Daniel Murokora
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Minal Patel
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen Hennessey
- World Health Organization, Expanded Programme on Immunization, Geneva, Switzerland
| | - Richard Mihigo
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Mbangiwa T, Kasvosve I, Anderson M, Thami PK, Choga WT, Needleman A, Phinius BB, Moyo S, Leteane M, Leidner J, Blackard JT, Mayondi G, Kammerer B, Musonda RM, Essex M, Lockman S, Gaseitsiwe S. Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana. Genes (Basel) 2018; 9:genes9050259. [PMID: 29772814 PMCID: PMC5977199 DOI: 10.3390/genes9050259] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/20/2022] Open
Abstract
The hepatitis B virus (HBV) is a global problem; however, the burden of HBV infection in pregnant women in Botswana is unknown. We sought to determine the prevalence of chronic and occult HBV infection in human immunodeficiency virus (HIV)-infected and -uninfected pregnant women in Botswana. Samples from 752 pregnant women were tested for hepatitis B surface antigen (HBsAg), and HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) and HBV DNA load. Samples that were HBsAg negative were screened for occult HBV infection by determining the HBV DNA load. HBV genotypes were determined based on a 415-base-pair fragment of the surface gene. Among the 752 women tested during pregnancy or early postpartum, 16 (2.1%) (95% confidence interval (CI): 2.0–2.2) were HBsAg-positive. The prevalence of chronic HBV infection was higher (3.1%) among HIV-infected (95% CI: 3.0–3.2) compared with HIV-uninfected women (1.1%) (95% CI: 1.07–1.1, p = 0.057). Among the 622 HBsAg-negative women, the prevalence of occult HBV infection was 6.6% (95% CI: 6.5–6.7). Three of thirteen HBsAg-positive participants were HBeAg-positive, and all were HIV-negative. Of the 11 maternal samples successfully genotyped, five (45.5%) were genotype D3, five (45.5%) were genotype A1, and one was genotype E (9%). Low and similar proportions of HIV-infected and -uninfected pregnant women in Botswana had occult or chronic HBV infection. We identified a subset of HIV-negative pregnant women who had high HBV DNA levels and were HBeAg-positive, and thus likely to transmit HBV to their infants.
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Affiliation(s)
- Tshepiso Mbangiwa
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone 0022, Botswana.
| | - Ishmael Kasvosve
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone 0022, Botswana.
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana.
| | - Prisca K Thami
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana.
| | - Wonderful T Choga
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
| | | | - Bonolo B Phinius
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Melvin Leteane
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana.
| | - Jean Leidner
- Goodtables Data Consulting, Norman, OK 73019, USA.
| | - Jason T Blackard
- University of Cincinnati College of Medicine, Cincinnati, OH 45627, USA.
| | - Gloria Mayondi
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
| | - Betsy Kammerer
- Department of Psychiatry, Boston Children's Hospital, Boston, MA 02115, USA.
- Brigham and Women's Hospital, Boston, MA 02115, USA.
| | | | - Max Essex
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
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21
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Ryan K, Anderson M, Gyurova I, Ambroggio L, Moyo S, Sebunya T, Makhema J, Marlink R, Essex M, Musonda R, Gaseitsiwe S, Blackard JT. High Rates of Occult Hepatitis B Virus Infection in HIV-Positive Individuals Initiating Antiretroviral Therapy in Botswana. Open Forum Infect Dis 2017; 4:ofx195. [PMID: 29062862 PMCID: PMC5641381 DOI: 10.1093/ofid/ofx195] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/12/2017] [Indexed: 12/16/2022] Open
Abstract
Background Hepatitis B surface antigen (HBsAg)–negative but hepatitis B virus (HBV) DNA-positive infection—known as occult hepatitis B infection (OBI)—occurs in 1% to >15% of HIV-positive individuals in the United States and South Africa, respectively. However, there are no data on OBI from Botswana, a country known to be hyperendemic for chronic HBV infection and to have a significant HIV burden. Methods Two hundred seventy-two adults enrolled in an HIV treatment study of tenofovir/emtricitabine as the nucleoside backbone who were previously determined to be HBsAg negative were tested for HBV DNA at baseline and 1 year after initiation of highly active antiretroviral therapy (HAART). Results HBV DNA was detected in 72 of 272 (26.5%). Six individuals (8.3%) had HBV DNA levels greater than 200 IU/mL, and the highest viral load was 3280 IU/mL. Of 65 participants with OBI evaluated at 12 months after initiating HAART, only 1 (1.5%) had detectable HBV DNA. Conclusions Occult HBV infection is quite common in HIV-infected patients in Botswana, although its impact on the course of HIV disease progression is unknown. The suppression of occult HBV DNA levels by tenofovir/emtricitabine suggests an effective therapeutic option, although the long-term suppressive abilities remain unstudied.
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Affiliation(s)
- Kathleen Ryan
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Biological Sciences, University of Botswana, Gaborone, Botswana
| | - Ivayla Gyurova
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Teresa Sebunya
- Department of Biological Sciences, University of Botswana, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Richard Marlink
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Rosemary Musonda
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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22
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Mandiwana A, Tshitenge S. Prevalence of human immunodeficiency virus — hepatitis B virus co-infection amongst adult patients in Mahalapye, Ngami, Serowe, Botswana: a descriptive cross-sectional study. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2016.1272230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Stephane Tshitenge
- Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
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23
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Anderson M, Gaseitsiwe S, Moyo S, Thami KP, Mohammed T, Setlhare D, Sebunya TK, Powell EA, Makhema J, Blackard JT, Marlink R, Essex M, Musonda RM. Slow CD4 + T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana. Open Forum Infect Dis 2016; 3:ofw140. [PMID: 27800524 PMCID: PMC5084712 DOI: 10.1093/ofid/ofw140] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 06/21/2016] [Indexed: 12/21/2022] Open
Abstract
Background. Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection has emerged as an important cause of morbidity and mortality. We determined the response to Truvada-based first-line combination antiretroviral therapy (cART) in HIV/HBV-coinfected verus HIV-monoinfected patients in Botswana. Methods. Hepatitis B virus surface antigen (HBsAg), HBV e antigen (HBeAg), and HBV deoxyribonucleic acid (DNA) load were determined from baseline and follow-up visits in a longitudinal cART cohort of Truvada-based regimen. We assessed predictors of HBV serostatus and viral suppression (undetectable HBV DNA) using logistic regression techniques. Results. Of 300 participants, 28 were HBsAg positive, giving an HIV/HBV prevalence of 9.3% (95% confidence interval [CI], 6.3-13.2), and 5 of these, 17.9% (95% CI, 6.1-36.9), were HBeAg positive. There was a reduced CD4+ T-cell gain in HIV/HBV-coinfected compared with HIV-monoinfected patients. Hepatitis B virus surface antigen and HBeAg loss was 38% and 60%, respectively, at 24 months post-cART initiation. The HBV DNA suppression rates increased with time on cART from 54% to 75% in 6 and 24 months, respectively. Conclusions. Human immunodeficiency virus/HBV coinfection negatively affected immunologic recovery compared with HIV-1C monoinfection. Hepatitis B virus screening before cART initiation could help improve HBV/HIV treatment outcomes and help determine treatment options when there is a need to switch regimens.
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Affiliation(s)
- Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership; Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | | | - Terence Mohammed
- Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone
| | | | - Theresa K Sebunya
- Department of Biological Sciences , University of Botswana , Gaborone
| | | | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Richard Marlink
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Rosemary M Musonda
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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24
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Molecular characterisation of hepatitis B virus in HIV-1 subtype C infected patients in Botswana. BMC Infect Dis 2015; 15:335. [PMID: 26268355 PMCID: PMC4535680 DOI: 10.1186/s12879-015-1096-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/06/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is a major global health problem especially in sub-Saharan Africa and in East Asia. Ten hepatitis B virus genotypes have been described that differ by geographic distribution, disease progression, and response to treatment. Escape mutations within the surface open reading frame (ORF) affect HBV antigenicity leading to failures in diagnosis, vaccine and hepatitis B immunoglobulin therapy. However, the molecular characteristics of HBV in Botswana, a highly endemic country, are unknown. We describe the molecular characteristics of HBV and prevalence of escape mutants among HIV/HBV coinfected individuals Botswana. METHODS DNA was extracted from archived plasma samples from 81 HIV/HBV co-infected participants from various clinical studies at the Botswana Harvard AIDS Institute Partnership. A 415 base pair (bp) fragment of the polymerase gene was amplified by semi-nested PCR. In a subset of samples, a 2100 bp fragment was amplified. The PCR product was genotyped using Big Dye sequencing chemistry and the sequences were analysed for genotypes and mutations. RESULTS Of the 81 samples included, 70 (86 %) samples were successfully genotyped. Genotype A was found in 56 (80 %) participants, D in 13 (18.6 %), and 1 (1.4 %) was genotype E. Escape mutations previously linked with failure of diagnosis or escaping active vaccination and passive immunoglobulin therapy were detected in 12 (17.1 %) participants at positions 100, 119, 122, 123, 124, 126, 129, 130, 133, 134 and 140 of the S ORF. Genotypes and escape mutations were not significantly associated with aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST platelet ratio index (APRI). CONCLUSION Genotypes A, D and E were found in this cohort of HIV coinfected patients in Botswana, consistent with the findings from the sub-Saharan Africa region. Some escape mutations which have previously been associated with diagnosis failure, escaping vaccine and immunoglobulin therapy were also observed and are important in guiding future policies related to vaccine implementation, therapeutic guidelines, and diagnostic guidelines. They are also important for identifying patients who are at an increased risk of disease progression and to choose optimal therapy. Future research should focus on determining the clinical significance of the different HBV genotypes and mutations found in this population.
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25
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Stabinski L, OʼConnor S, Barnhart M, Kahn RJ, Hamm TE. Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings. J Acquir Immune Defic Syndr 2015; 68 Suppl 3:S274-85. [PMID: 25768867 PMCID: PMC10426262 DOI: 10.1097/qai.0000000000000496] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Screening people living with HIV for hepatitis B virus (HBV) co-infection is recommended in resource-rich settings to optimize HIV antiretroviral therapy (ART) and mitigate HBV-related liver disease. This review examines the need, feasibility, and impact of screening for HBV in resource-limited settings (RLS). METHODS We searched 6 databases to identify peer-reviewed publications between 2007 and 2013 addressing (1) HIV/HBV co-infection frequency in sub-Saharan Africa (SSA); (2) performance of hepatitis B surface antigen (HBsAg) rapid strip assays (RSAs) in RLS; (3) impact of HBV co-infection on morbidity, mortality, or liver disease progression; and/or (4) impact of HBV-suppressive antiretroviral medications as part of ART on at least one of 5 outcomes (mortality, morbidity, HIV transmission, retention in HIV care, or quality of life). We rated the quality of individual articles and summarized the body of evidence and expected impact of each intervention per outcome addressed. RESULTS Of 3940 identified studies, 85 were included in the review: 55 addressed HIV/HBV co-infection frequency; 6 described HBsAg RSA performance; and 24 addressed the impact of HIV/HBV co-infection and ART. HIV/HBV frequency in sub-Saharan Africa varied from 0% to >28.4%. RSA performance in RLS showed good, although variable, sensitivity and specificity. Quality of studies ranged from strong to weak. Overall quality of evidence for the impact of HIV/HBV co-infection and ART on morbidity and mortality was fair and good to fair, respectively. CONCLUSIONS Combined, the body of evidence reviewed suggests that HBsAg screening among people living with HIV could have substantial impact on preventing morbidity and mortality among HIV/HBV co-infected individuals in RLS.
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Affiliation(s)
- Lara Stabinski
- *United States Department of State, Office of the US Global AIDS Coordinator and Health Diplomacy, Washington, DC; †Division of Viral Hepatitis, National Center for HIV/AIDS, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA; ‡Office of HIV and AIDS, Bureau for Global Health, United States Agency for International Development, Washington, DC; §US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and ‖The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD
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26
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Machiya T, Burnett RJ, Fernandes L, François G, De Schryver A, van Sprundel M, Mphahlele MJ. Hepatitis B vaccination of healthcare workers at the Princess Marina Hospital, Botswana. Int Health 2014; 7:256-61. [PMID: 25424721 DOI: 10.1093/inthealth/ihu084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 09/29/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Batswana (i.e., the people of Botswana) healthcare workers (HCWs) are at high risk for occupational exposure to hepatitis B virus (HBV), thus the Botswana Ministry of Health recommends that HCWs should receive three doses of hepatitis B (HB) vaccine. However, there are no data on HB vaccination uptake by Batswana HCWs. This study investigated knowledge of, and attitudes towards, HB prevention and control, and predictors of HB vaccination uptake in HCWs at the Princess Marina Hospital during 2010. METHODS Self-administered questionnaires were distributed to doctors, nurses and laboratory workers (n=200). Knowledge was measured using 14 questions; attitude was measured using a 5-point Likert scale and 9 statements. Data on vaccination status and demographics were collected. RESULTS Of the respondents, 17.2% (20/116) had good knowledge and 97.4% (113/116) had positive attitudes. At least one dose of HB vaccine had been received by 50.9% (59/116), while 31.0% (36/116) had received all three doses. Profession was the only predictor of HB vaccination uptake, with being a laboratory worker (OR=61.0) or a doctor (OR=51.5) predicting HB vaccination uptake with at least one dose. CONCLUSION This is the first study on HB vaccination of Batswana HCWs, and shows that HB vaccination uptake is suboptimal.
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Affiliation(s)
- Tichaona Machiya
- Department of Public Health, University of Limpopo, Medunsa Campus, Pretoria, South Africa
| | - Rosemary J Burnett
- HIV and Hepatitis Research Unit, Department of Virology, PO Box 173, University of Limpopo/National Health Laboratory Service, Medunsa Campus, Pretoria, 0204, South Africa
| | - Lucy Fernandes
- Department of Public Health, University of Limpopo, Medunsa Campus, Pretoria, South Africa
| | - Guido François
- Department of Epidemiology and Social Medicine, University of Antwerpen, Belgium
| | - Antoon De Schryver
- Department of Epidemiology and Social Medicine, University of Antwerpen, Belgium
| | - Marc van Sprundel
- Department of Epidemiology and Social Medicine, University of Antwerpen, Belgium
| | - M Jeffrey Mphahlele
- HIV and Hepatitis Research Unit, Department of Virology, PO Box 173, University of Limpopo/National Health Laboratory Service, Medunsa Campus, Pretoria, 0204, South Africa
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27
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Oliveira SBD, Merchán-Hamann E, Amorim LDAF. HIV/AIDS coinfection with the hepatitis B and C viruses in Brazil. CAD SAUDE PUBLICA 2014; 30:433-8. [PMID: 24627070 DOI: 10.1590/0102-311x00010413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 08/26/2013] [Indexed: 11/21/2022] Open
Abstract
The aim of this study is to estimate the prevalence of HIV/HBV and HIV/HCV coinfections among AIDS cases reported in Brazil, and to describe the epidemiological profile of these cases. Coinfection was identified through probabilistic record linkage of the data of all patients carrying the HIV virus recorded as AIDS patients and of those patients reported as carriers of hepatitis B or C virus in various databases from the Brazilian Ministry of Health from 1999 to 2010. In this period 370,672 AIDS cases were reported, of which 3,724 were HIV/HBV coinfections. Women are less likely to become coinfected than men and the chance of coinfection increases with age. This study allowed an important evaluation of HBV/HIV and HCV/HIV coinfections in Brazil using information obtained via merging secondary databases from the Ministry of Health, without conducting seroprevalence research. The findings of this study might be important for planning activities of the Brazilian epidemiologic surveillance agencies.
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Affiliation(s)
| | - Edgar Merchán-Hamann
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brasil, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brasil
| | - Leila Denise Alves Ferreira Amorim
- Instituto de Matemática, Universidade Federal da Bahia, Salvador, Brasil, Instituto de Matemática, Universidade Federal da Bahia, Salvador, Brasil
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28
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Hønge BL, Jespersen S, Medina C, da Silva Té D, da Silva ZJ, Lewin SR, Østergaard L, Laursen AL, Krarup H, Erikstrup C, Wejse C. Hepatitis C prevalence among HIV-infected patients in Guinea-Bissau: a descriptive cross-sectional study. Int J Infect Dis 2014; 28:35-40. [PMID: 25223805 DOI: 10.1016/j.ijid.2014.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 04/12/2014] [Accepted: 06/09/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To estimate the prevalence and determine the clinical presentation of risk factors of hepatitis C virus (HCV) among HIV-infected patients in Bissau, Guinea-Bissau. METHODS In this cross-sectional study, we included individuals who had a routine blood analysis performed during the period April 28 to September 30, 2011. Patient samples were tested for HCV antibodies (anti-HCV) with a chemiluminescence test (Architect, Abbott, USA) and INNO-LIA HCV Score (Innogenetics, Belgium). HCV viral load and genotype were analyzed using an in-house real-time PCR method. RESULTS In total, 576 patients were included (417 HIV-1, 104 HIV-2, and 55 HIV-1/2). Ten (1.7%) patients were anti-HCV-positive and eight (1.4%) patients had detectable HCV RNA; all were genotype 2. In a multivariable logistic regression analysis, age >50 years was associated with anti-HCV reactivity (p<0.01). No subjective symptoms or objective signs were more prevalent among patients with detectable HCV RNA compared to patients without detectable HCV RNA. Biochemically, detectable HCV RNA was associated with elevated amylase (83.3% vs. 38.6%, p=0.03), but not with the liver enzymes alanine aminotransferase and aspartate aminotransferase. CONCLUSIONS The prevalence of anti-HCV was low and comparable to similar settings, and genotype analysis confirmed the presence of genotype 2 in West Africa.
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Affiliation(s)
- Bo Langhoff Hønge
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark.
| | - Sanne Jespersen
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark
| | - Candida Medina
- National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau
| | | | - Zacarias José da Silva
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National Public Health Laboratory, Bissau, Guinea-Bissau
| | - Sharon R Lewin
- Department of Infectious Diseases, Alfred Hospital and Monash University, Australia; Centre for Biomedical Research, Burnet Institute, Melbourne, Australia
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark
| | - Alex Lund Laursen
- Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark
| | - Henrik Krarup
- Department of Clinical Biochemistry, Aalborg University Hospital, Denmark
| | | | - Christian Wejse
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark; GloHAU, Centre for Global Health, School of Public Health, Aarhus University, Denmark
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Bessimbaye N, Moussa AM, Mbanga D, Tidjani A, Mahamat SO, Ngawara MN, Ngarnayal G, Fissou HY, Sangare L, Ndoutamia G, Barro N. [Seroprevalence of HBs Ag and of anti-HCV antibodies among HIV infected people in N'Djamena, Chad]. ACTA ACUST UNITED AC 2014; 107:327-31. [PMID: 25158842 DOI: 10.1007/s13149-014-0386-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 07/01/2014] [Indexed: 01/28/2023]
Abstract
This is a prospective study conducted as part of a voluntary testing for HBV, HCV and HIV. The aim of the study is to determine the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people and a control group of HIV negative people. HIV prevalence among newly diagnosed volunteers is 9.1%. The overall seroprevalence of HBs Ag and anti-HCV antibodies is respectively 13.5% and 2.0%. The seroprevalence of HBs Ag and anti-HCVantibodies in the control group (HIV-negative) is respectively 12.2% and 2%. The seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people (old and new) is respectively 16.1% and 1%.This study, the first one conducted in Chad, has allowed us to know the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people.
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Affiliation(s)
- N Bessimbaye
- Centre de prise en charge des PVVIH de N'Djamena, N'Djamena, Tchad
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Matthews PC, Geretti AM, Goulder PJR, Klenerman P. Epidemiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa. J Clin Virol 2014; 61:20-33. [PMID: 24973812 DOI: 10.1016/j.jcv.2014.05.018] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 05/22/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023]
Abstract
Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research.
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Affiliation(s)
- Philippa C Matthews
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK
| | - Philip J R Goulder
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Paediatrics, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Paul Klenerman
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK; NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
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Dziuban EJ, Marton SA, Hughey AB, Mbingo TL, Draper HR, Schutze GE. Seroprevalence of hepatitis B in a cohort of HIV-infected children and adults in Swaziland. Int J STD AIDS 2013; 24:561-5. [DOI: 10.1177/0956462413476274] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Summary Hepatitis B virus (HBV) is an important co-morbidity in the HIV epidemic. A retrospective chart review was performed of HIV-infected patients with no previous antiretroviral history enrolled in a Swaziland clinic from January 2009 to May 2011. The seroprevalence of HBV surface antigen (HBsAg) was calculated and the data were analyzed using Mann-Whitney U and Fisher's exact tests. A total of 1282 patients were included in analysis. Five hundred were children aged <15 years. Overall HBsAg seroprevalence was 3.7% (1.4% of children and 5.1% of adults). Prevalence in under-5s was low (0.4%). Among adult women and men, prevalence was 4.2% and 9.8%, respectively ( P = 0.022). Median alanine aminotransferase level was 19 U/L in the HBsAg-negative adults and 25 U/L in the HBsAg-positive adults ( P = 0.005). Given the number of patients found to be HBsAg-positive, especially among adults, it is important for antiretroviral programmes to consider universal screening and strategically utilize medications that have been found effective in treating both HBV and HIV.
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Affiliation(s)
- E J Dziuban
- Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine Department of Pediatrics, Houston, TX, USA
- Baylor College of Medicine Bristol Myers Squibb Children's Clinical Center of Excellence-Swaziland, Mbabane, Swaziland
| | - S A Marton
- Baylor College of Medicine Department of Pediatrics, Houston, TX, USA
| | - A B Hughey
- Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX, USA
| | - T L Mbingo
- Baylor College of Medicine Children's Foundation, Mbabane, Swaziland
| | - H R Draper
- Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine Department of Pediatrics, Houston, TX, USA
| | - G E Schutze
- Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine Department of Pediatrics, Houston, TX, USA
- Baylor College of Medicine Bristol Myers Squibb Children's Clinical Center of Excellence-Swaziland, Mbabane, Swaziland
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Davis S, Patel P, Sheikh A, Anabwani G, Tolle MA. Adaptation of a general primary care package for HIV-infected adults to an HIV centre setting in Gaborone, Botswana. Trop Med Int Health 2013; 18:328-43. [PMID: 23289364 DOI: 10.1111/tmi.12041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND As life expectancy of HIV-infected patients improves due to antiretroviral treatment (ART) and the importance of associated co-morbidities and chronic diseases increases, preventive care will become increasingly important. Adaptation of existing preventive guidelines to local environments will become a priority for HIV treatment programmes. METHODS Guidance from the World Health Organization, a focused evidenced-based literature review, Botswana national guidelines, Botswana-specific morbidity and mortality data and centre-specific data were used to adapt a published general primary care package for limited-resource areas to our centre's specific setting. RESULTS The preventive care package contains recommendations on tuberculosis prevention, malnutrition, depression, cervical and breast cancer, hepatitis B coinfection, cardiovascular risk factors, external injury prevention, domestic violence screening, tobacco and substance-abuse counselling, contraception and screening and treatment of sexually transmitted infections. CONCLUSION This preventive care package addresses the comprehensive health needs of HIV-infected adults in the FMC in an evidence-based manner. The process of combining clinic-specific prevalence data, national guidelines, regional literature and assessment of public-sector resources to adapt an existing general package could be utilised to develop similar guidelines in other resource-limited locales.
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Affiliation(s)
- Stephanie Davis
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
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Mabayoje V, Muhibi M, Akindele R, Akinleye C, Mabayoje P, Babatunde O. Hepatitis C virus co-infection among people living with HIV/AIDS in a Nigerian Teaching Hospital. HIV & AIDS REVIEW 2013. [DOI: 10.1016/j.hivar.2013.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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