Carimo Awa Abdul, Gudo Eduardo Samo, Maueia Cremildo, Mabunda Nédio, Chambal Lúcia, Vubil Adolfo, Flora Ana, Antunes Francisco, Bhatt Nilesh
Internal Medicine Department, Maputo Central Hospital, Maputo, Mozambique.
Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
PLoS One. 2018 Jan 10;13(1):e0190775. doi: 10.1371/journal.pone.0190775. eCollection 2018.
The prevalence of hepatitis B virus (HBV) infection and human immunodeficiency virus (HIV) infection in Mozambique is one of the highest in the world, though in spite of this the prevalence of occult hepatitis B infection (OBI) is unknown.
This study was conducted with the aim to investigate the prevalence of OBI and frequency of isolated hepatitis B core antibody (anti-HBc alone) among antiretroviral (ART) naïve HIV-positive patients in Mozambique.
A cross-sectional study was conducted in two health facilities within Maputo city. All ART-naive HIV seropositive patients attending outpatient clinics between June and October 2012 were consecutively enrolled. Blood samples were drawn from each participant and used for serological measurement of HBV surface antigen (HBsAg), antibodies against HBV surface antigen (anti-HBs) and antibodies against core antigen (anti-HBc) using ELISA. Quantification of HBV DNA was performed by real time PCR. A questionnaire was used to obtain demographics and clinical data.
Of the 518 ART-naive HIV-positive subjects enrolled in the study, 90.9% (471/518) were HBsAg negative. Among HBsAg negative, 45.2% (213/471) had isolated anti-HBc antibodies, and the frequency of OBI among patients with anti-HBc alone was 8.3% (17/206). OBI was not correlated either with CD4+ T cells count or transaminases levels. A total of 11.8% of patients with OBI presented elevated HBV DNA level. Frequency of individuals with APRI score > 2 and FIB-4 score > 3.25 was higher in patients with OBI as compared not exposed, immune and anti-HBc alone patients.
Our data demonstrate for the first time that OBI is prevalent among HIV patients in Mozambique, and will be missed using the commonly available serological assays that measures HBsAg.
莫桑比克的乙型肝炎病毒（HBV）感染率和人类免疫缺陷病毒（HIV）感染率位居世界前列，但隐匿性乙型肝炎感染（OBI）的流行情况尚不清楚。
本研究旨在调查莫桑比克未接受抗逆转录病毒治疗（ART）的HIV阳性患者中OBI的流行率及单独乙型肝炎核心抗体（仅抗-HBc）的出现频率。
在马普托市的两家医疗机构开展了一项横断面研究。连续纳入了2012年6月至10月期间在门诊就诊的所有未接受ART治疗的HIV血清学阳性患者。采集每位参与者的血样，采用酶联免疫吸附测定法（ELISA）进行HBV表面抗原（HBsAg）、抗HBV表面抗原抗体（抗-HBs）和抗核心抗原抗体（抗-HBc）的血清学检测。采用实时聚合酶链反应（PCR）对HBV DNA进行定量分析。通过问卷调查获取人口统计学和临床数据。
在本研究纳入的518例未接受ART治疗的HIV阳性受试者中，90.9%（471/518）的患者HBsAg呈阴性。在HBsAg阴性的患者中，45.2%（213/471）仅有抗-HBc抗体，在仅抗-HBc的患者中OBI的出现频率为8.3%（17/206）。OBI与CD4+T细胞计数或转氨酶水平均无相关性。共有11.8%的OBI患者HBV DNA水平升高。与未感染、免疫和仅抗-HBc的患者相比，OBI患者中天门冬氨酸氨基转移酶与血小板比值指数（APRI）评分>2和FIB-4评分>3.25的个体比例更高。
我们的数据首次表明，OBI在莫桑比克的HIV患者中普遍存在，使用常用的检测HBsAg的血清学检测方法会漏诊。
