Low rates of active hepatitis B and C infections among adults and children living with HIV and taking antiretroviral therapy: A multicenter screening study in Lesotho. Issue 12 (25th May 2020)

• Record Type: Journal Article
• Authors: Amstutz, Alain; Nsakala, Bienvenu L.; Cheleboi, Molisana; Lejone, Thabo I.; Hobbins, Michael A.; Battegay, Manuel; Klimkait, Thomas; Labhardt, Niklaus D.
• Is Part Of: Journal of medical virology. Volume 92:Issue 12(2020)
• Page Start: 3857
• Page End: 3861
• Publication Date: 2020-05-25
• Subjects: Africa -- hepatitis B -- hepatitis C -- HIV, coinfection -- Lesotho; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25970
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: Lesotho presents the second‐highest adult human immunodeficiency virus (HIV) prevalence globally. Among people living with HIV, data on hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfection are limited. We report HBV and HCV coinfection data from a multicentre cross‐sectional study among adult and pediatric patients taking antiretroviral therapy in 10 health facilities in Lesotho. Among 1318 adults screened (68% female; median age, 44 years), 262 (20%) had immunologically controlled HBV infection, 99 (7.6%) tested anti‐HBs positive and anti‐HBc negative, indicating vaccination, and 57 (4.3%) had chronic HBV infection. Among the patients with chronic HBV infection, 15 tested hepatitis B envelope antigen (HBeAg) positive and eight had detectable HBV viremia (median, 2 477 400 copies/mL; interquartile range, 205‐34 400 000) with a mean aspartate aminotransferase‐to‐platelet ratio index of 0.48 (SD, 0.40). Prevalence of HCV coinfection was 1.7% (22 of 1318), and only one patient had detectable HCV viremia. Among 162 pediatric patients screened, three (1.9%) had chronic HBV infection, whereby two also tested HBeAg‐positive, and one had detectable HBV viral load (210 copies/mL). Six of 162 (3.7%) had anti‐HCV antibodies, all with undetectable HCV viral loads. Overall prevalence of chronic HBV/HIV and HCV/HIV coinfection among adults and children was relatively low, comparable to earlier reports from the same region. But prevalence of immunologically controlled HBV infection among adults was high. Of those patients with chronic HBV infection, a minority had detectable HBV‐DNA. Highlights: In this multicentre cross‐sectional study from Lesotho, prevalence of chronic HBV/HIV and HCV/HIV co‐infection among adults and children taking ART was relatively low. Those with co‐infection showed low HBV and HCV activity. However, the prevalence of immunologically controlled HBV infection among adults living with HIV was high.