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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Hepatitis B viral replication markers and hepatic fibrosis in untreated chronic hepatitis B virus infection with and without HIV coinfection in Zambia
AIDS, Volume 37, No. 13, Year 2023
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Description
Background:To inform novel therapies, a more nuanced understanding of HIV's impact on hepatitis B virus (HBV) natural history is needed, particularly in high burden countries.Methods:In Lusaka, Zambia, we compared prospectively recruited adults (18+ years) with chronic HBV infection, with and without HIV. We excluded those with prior antiviral treatment experience or HBV diagnosis due to clinical suspicion (rather than routine testing). We assessed HBV DNA levels, hepatitis B e antigen (HBeAg), CD4+ (if HIV coinfection), and liver disease (transient elastography, serum alanine aminotransferase). In multivariable analyses, we evaluated the association of HIV overall and by level of CD4+ count on these markers.Results:Among 713 adults analyzed, median age was 33 years, 63% were male, and 433 had HBV/HIV coinfection. Median CD4+ count was 200 cells/μl. HBV DNA was greater than 2000 IU/ml for 311 (51.0%) and 227 (32.5%) were HBeAg-positive. 15.5% had advanced fibrosis or cirrhosis. HIV coinfection was associated with five-fold increased HBV DNA levels [adjusted geometric mean ratio, 5.78; 95% confidence interval (CI), 2.29-14.62] and two times the odds of HBeAg-positivity (adjusted odds ratio, 2.54; 95% CI, 1.59-4.08). These associations were significant only at CD4+ counts 100-350 and <100 cells/μl. HIV was not associated with markers of fibrosis or ALT.Discussion:HIV's impact on HBV natural history likely depends on the degree and duration of immune suppression. There is strong rationale to monitor HBV DNA in people with HBV/HIV coinfection and immune suppression. A better understanding is needed of mechanisms of increased liver-related mortality in people with HBV/HIV coinfection. © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Authors & Co-Authors
Muula, Guy K.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Bosomprah, Samuel
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Ghana, Accra
University of Ghana
Sinkala, Edford
Zambia, Lusaka
University of Zambia
Zambia, Lusaka
Zambian Ministry of Health
Nsokolo, Bright
Zambia, Lusaka
Levy Mwanawasa Medical University
Musonda, Taonga L.
Zambia, Lusaka
University of Zambia
Hamusonde, Kalongo
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Switzerland, Bern
University Hospital Bern
Bhattacharya, Debika
United States, Los Angeles
University of California, Los Angeles
Lauer, Georg M.
United States, Boston
Massachusetts General Hospital
Chung, Raymond T.
United States, Boston
Massachusetts General Hospital
Mulenga, Lloyd Berdad
Zambia, Lusaka
Zambian Ministry of Health
Wandeler, Gilles
Switzerland, Bern
University Hospital Bern
Switzerland, Bern
University of Bern
Vinikoor, Michael J.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Zambia, Lusaka
University of Zambia
United States, Birmingham
The University of Alabama at Birmingham
Statistics
Authors: 12
Affiliations: 10
Identifiers
Doi:
10.1097/QAD.0000000000003659
ISSN:
02699370
Research Areas
Genetics And Genomics
Infectious Diseases
Study Design
Case-Control Study
Study Locations
Zambia
Participants Gender
Male