Journal Article

High Rates of Occult Hepatitis B Virus Infection in HIV-Positive Individuals Initiating Antiretroviral Therapy in Botswana

Kathleen Ryan, Motswedi Anderson, Ivayla Gyurova, Lilliam Ambroggio, Sikhulile Moyo, Teresa Sebunya, Joseph Makhema, Richard Marlink, Max Essex, Rosemary Musonda, Simani Gaseitsiwe and Jason T Blackard

in Open Forum Infectious Diseases

Volume 4, issue 4 ISSN: n/a
Published online September 2017 | e-ISSN: 2328-8957 | DOI: http://dx.doi.org/10.1093/ofid/ofx195
High Rates of Occult Hepatitis B Virus Infection in HIV-Positive Individuals Initiating Antiretroviral Therapy in Botswana

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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.

Keywords: Africa; Botswana; HBV; hepatitis B virus; HIV; HIV/HBV; occult; tenofovir

Journal Article.  4276 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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