博茨瓦纳农村及城市周边社区艾滋病毒感染者中乙肝病毒感染的高流行率
High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana.
作者信息
Phinius Bonolo B, Anderson Motswedi, Gobe Irene, Mokomane Margaret, Choga Wonderful T, Mutenga Sharon R, Mpebe Gorata, Pretorius-Holme Molly, Musonda Rosemary, Gaolathe Tendani, Mmalane Mompati, Shapiro Roger, Makhema Joseph, Lockman Shahin, Novitsky Vlad, Essex Max, Moyo Sikhulile, Gaseitsiwe Simani
机构信息
Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.
出版信息
Open Forum Infect Dis. 2023 Jan 6;10(1):ofac707. doi: 10.1093/ofid/ofac707. eCollection 2023 Jan.
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.
背景
我们旨在确定博茨瓦纳农村和城市周边社区的人类免疫缺陷病毒感染者（PWH）中乙型肝炎病毒（HBV）感染的流行情况。
方法
对先前一项基于人群的研究——博茨瓦纳预防联合项目中的PWH进行筛查，该项目于2013年至2018年在博茨瓦纳的30个社区招募成年人，检测其HBV表面抗原（HBsAg）和HBV核心抗体（抗-HBc）。对HBsAg阳性（HBsAg）样本进一步检测HBV核心免疫球蛋白M抗体（抗-HBc免疫球蛋白M [IgM]）和HBV e抗原（HBeAg）。我们对HBsAg检测呈阳性（n = 148）和阴性（n = 381）的参与者的HBV病毒载量进行了定量分析。
结果
在3304名接受检测的参与者中，271人（8% [95%置信区间{CI}，7%-9%]）HBsAg呈阳性，而在我们检测的3218名PWH中，1788人（56% [95% CI，54%-57%]）抗-HBc呈阳性。约88%的HBsAg阳性参与者正在接受抗逆转录病毒治疗（ART），其中分别有40%和56%的人接受含拉米夫定和替诺福韦的ART治疗。男性（相对风险比[RRR]，1.8 [95% CI，1.2 - 2.7]）和北部地理区域（RRR，2.5 [95% CI，1.4 - 4.7]）是HBV感染（HBsAg）的独立预测因素。在381名HBsAg阴性且接受隐匿性HBV检测的人中，126人（33% [95% CI，29%-38%]）HBV DNA呈阳性。11名参与者在接受含拉米夫定或替诺福韦的治疗方案时病毒血症水平较高且HBV病毒载量较高。其中10人（91%）HBeAg血清学检测也呈阳性，4人（36%）抗-HBc IgM血清学检测呈阳性。
结论
在博茨瓦纳接受对HBV有活性的ART治疗方案的PWH中，HBV感染率较高。
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