Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Jan 15;20(1):49.
doi: 10.1186/s12879-020-4784-7.

Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM)

Florian Liégeois  1   2   3 , Sylvie Boyer  4 , Sabrina Eymard-Duvernay  1 , Patrizia Carrieri  4 , Charles Kouanfack  5   6 , Jenny Domyeum  2 , Gwenaëlle Maradan  4 , Jacques Ducos  7 , Eitel Mpoudi-Ngolé  2 , Bruno Spire  4 , Eric Delaporte  1 , Christopher Kuaban  8 , Laurent Vidal  4 , Christian Laurent  9 ; EVOLCAM study group
Collaborators, Affiliations
Multicenter Study

Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM)

Florian Liégeois et al. BMC Infect Dis. .

Abstract

Background: Hepatitis B is a major concern in Africa, especially in HIV-infected patients. Unfortunately, access to hepatitis B virus (HBV) testing and adequate treatment remains a challenge in the continent. We investigated HBV testing, treatment, and virologic suppression in HIV-infected patients followed up as part of Cameroon's national antiretroviral programme.

Methods: A cross-sectional survey was performed in adult patients receiving antiretroviral therapy (ART) in 19 hospitals in the Centre and Littoral regions in Cameroon. The proportions of patients tested for hepatitis B surface antigen (HBsAg) prior to the study were compared among all study hospitals using the Chi-square test. The association of individual and hospital-related characteristics with HBV testing and virologic suppression was assessed using multilevel logistic regression models.

Results: Of 1706 patients (women 74%, median age 42 years, median time on ART 3.9 years), 302 (17.7%) had been tested for HBsAg prior to the study. The proportion of HBV-tested patients ranged from 0.8 to 72.5% according to the individual hospital (p < 0.001). HBV testing was lower in women (adjusted odds ratio [aOR] 0.64, 95% confidence interval [CI] 0.46-0.89, p = 0.010) and higher in patients who initiated ART in 2010 or later (aOR 1.66, 95% CI 1.23-2.27, p < 0.001). Of 159 HBsAg-positive patients at the time of the study (9.3%), only 97 (61.0%) received Tenofovir + Lamivudine (or Emtricitabine). Of 157 coinfected patients, 114 (72.6%) had a HBV viral load < 10 IU/mL. HBV suppression was higher in patients with a HIV viral load < 300 copies/mL (aOR 3.46, 95% CI 1.48-8.09, p = 0.004) and lower in patients with increased ALT level (aOR 0.86 per 10 IU/mL increase, 95% CI 0.75-0.97, p = 0.019).

Conclusions: A substantial proportion of HIV/HBV coinfected patients were at higher risk of liver disease progression. Improving the management of HBV infection in the routine healthcare setting in Africa is urgently required in order to achieve the 2030 elimination targets. Micro-elimination of HBV infection in people living with HIV could be an easier and cost-effective component than more widely scaling up HBV policies.

Keywords: Africa; HBV; HIV; Testing; Treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Proportion of patients tested for HBsAg prior to the study, by hospital
See this image and copyright information in PMC

References

    1. World Health Organization. Global health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. 2016 [September 2, 2019]; Available from: https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/.
    1. Spearman CW, Afihene M, Ally R, Apica B, Awuku Y, Cunha L, et al. Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets. Lancet Gastroenterol Hepatol. 2017;2:900–909. doi: 10.1016/S2468-1253(17)30295-9. - DOI - PubMed
    1. World Health Organization. Global hepatitis report. 2017 [July 9, 2019]; Available from: http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/.
    1. Leumi S, Bigna JJ, Amougou MA, Ngouo A, Nyaga UF, Noubiap JJ. Global burden of hepatitis B infection in people living with HIV: a systematic review and meta-analysis. Clin Infect Dis. 2019. - PubMed
    1. World Health Organization. Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach. 2010 revision. 2010 [July 9, 2019]; Available from: http://www.who.int/hiv/pub/arv/adult2010/en/. - PubMed

Publication types

Substances

Grants and funding