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. 2022 Jan;29(1):60-68.
doi: 10.1111/jvh.13615. Epub 2021 Oct 5.

Hepatitis B screening practices and viral control among persons living with HIV in urban Senegal

Adrià Ramírez Mena  1   2   3 , Judicaël M Tine  2 , Louise Fortes  2 , Ousseynou Ndiaye  2 , Daye Ka  2 , Ndeye Fatou Ngom  2 , Alban Ramette  4 , Pascal Bittel  4 , Moussa Seydi  2 , Gilles Wandeler  1   2   5 ; for SEN-B
Affiliations

Hepatitis B screening practices and viral control among persons living with HIV in urban Senegal

Adrià Ramírez Mena et al. J Viral Hepat. 2022 Jan.

Abstract

Chronic hepatitis B virus (HBV) infection affects >10% of the general population and is the leading cause of liver cirrhosis and cancer in West Africa. Despite current recommendations, HBV is often not tested for in clinical routine in the region. We included all people living with HIV (PLWH) in care between March and July 2019 at Fann University Hospital in Dakar (Senegal) and proposed hepatitis B surface antigen (HBsAg) test to those never tested. All HBsAg-positive underwent HIV and HBV viral load (VL) and liver stiffness measurement. We evaluated, using logistic regression, potential associations between patient characteristics and (a) HBV testing uptake; (b) HIV/HBV co-infection among individual HBsAg tested. We determined the proportion of co-infected who had HBV DNA >20 IU/ml on ART and sequenced HBV polymerase in those with HBV replication.of 1076 PLWH in care, 689 (64.0%) had never had an HBsAg test prior to our HBV testing intervention. Women and individuals >40 years old were less likely to have been previously tested. After HBV testing intervention,107/884 (12.1%) PLWH were HBsAg-positive. Seven of 58 (12.1%) individuals newly diagnosed with HIV/HBV co-infection had a detectable HBV VL, of whom five were HIV-suppressed. Two patients on ART including 3TC and AZT as backbone showed the presence of the triple resistance mutation 180M/204I/80V. In this Senegalese urban HIV clinic, the majority of patients on ART had never been tested for HBV infection. One in ten co-infected individuals had a detectable HBV VL despite HIV suppression, and 8% were not receiving a TDF-containing regimen.

Keywords: HIV; hepatitis B; resistance; screening; sub-Saharan Africa; testing.

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Conflict of interest statement

The authors have no competing interest to declare.

Figures

FIGURE 1
FIGURE 1
Study flow diagram. Abbreviations: HBsAg, hepatitis B virus antigen; HBV, hepatitis B virus; DNA, deoxyribonucleic acid; HIV, human immunodeficiency virus; RNA, ribonucleic acid
FIGURE 2
FIGURE 2
Liver, renal and virological assessment of HIV/HBV‐co‐infected individuals screened during the study. Abbreviations: ALT, alanine aminotransferase; eGFR, estimated glomerular filtrate rate; CKD‐EPI, chronic kidney disease epidemiology collaboration equation; HBV, hepatitis B virus; DNA, deoxyribonucleic acid; HIV, human immunodeficiency virus; RNA, ribonucleic acid; IU, international units
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