Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study
Introduction Globally, more than 254 million people are living with hepatitis B virus (HBV), and 7.4% of the people living with HIV (PLHIV) are coinfected with HBV. More than 70% of them reside in Africa. We aimed to describe the characteristics of newly diagnosed antiretroviral treatment (ART)-naïv...
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BMJ Publishing Group
2025-08-01
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| Series: | BMJ Public Health |
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| author | Esperanca Sevene Orvalho Augusto Corssino Tchavana Charlotta Nilsson Elias Manjate Lucia Mabalane Chambal Vanda dos Muchangos Júlia Muando |
| author_facet | Esperanca Sevene Orvalho Augusto Corssino Tchavana Charlotta Nilsson Elias Manjate Lucia Mabalane Chambal Vanda dos Muchangos Júlia Muando |
| author_sort | Esperanca Sevene |
| collection | DOAJ |
| description | Introduction Globally, more than 254 million people are living with hepatitis B virus (HBV), and 7.4% of the people living with HIV (PLHIV) are coinfected with HBV. More than 70% of them reside in Africa. We aimed to describe the characteristics of newly diagnosed antiretroviral treatment (ART)-naïve HIV/HBV co-infected and HIV monoinfected patients.Methods This cross-sectional study included newly HIV-diagnosed ART-naïve patients recruited at Mavalane Health Centre located in a periurban area of Maputo City. Between May 2021 and November 2022, all patients over 18 years old were enrolled and screened for hepatitis B surface antigen (HBsAg). Data on socio-demographic and clinical characteristics, haematology, liver and kidney function tests, CD4+T cell counts, serological markers of hepatitis B (IgM Core hepatitis B antibody, hepatitis B e antigen, and hepatitis B e antibody), HIV and HBV viral loads were assessed using standard procedures.Results A total of 1106 participants were included. The age of the participants ranged from 18 years to 71 years with a median of 34.0 (IQR: 28.0–42.0) years, 513 (46.4%) were men and HBsAg was reactive in 81 participants, yielding a co-infection rate of 7.3%. Being male (OR, 1.72; 95% CI, 1.06 to 2.83) or a sex worker (OR, 3.69; 95% CI, 1.10 to 10.58) was associated with the co-infection. The median Aspartate Aminotransferase-Platelet Ratio Index (APRI) of the HIV/HBV co-infected was 0.5 (IQR 0.3–1.1), with 40/81 (49.4%) presenting with an APRI>0.5. Overall, 67/81 (80.2%) of the co-infected people were HBeAg-negative. The median APRI was 0.5 (IQR, 0.3–1.1) for the HBeAg-negative and 0.7 (IQR 0.3–1.4) for the HBeAg-positive subjects. The median HBV-DNA was 258.0 IU (IQR, 10.0–4974.5) for the HBeAg-negative and 746 287.0 IU (IQR 2720.0–49 899 213.0) for the HBeAg-positive subjects. Two (3.0%) HBeAg-negative and one (7.1%) HBeAg-positive subjects presented with hepatocellular carcinoma.Conclusion These data confirm the high prevalence of HIV/HBV co-infection in Mozambique and bring new data related to HBeAg status, reinforcing the need to test all PLHIV for HBV and to integrate the management and monitoring of hepatitis B and liver disease-specific tests in public ART programmes to predict and reduce the occurrence of HBV complications and mortality. |
| format | Article |
| id | doaj-art-27f3aba9082f4dc19a377a9c6fd4acb6 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-27f3aba9082f4dc19a377a9c6fd4acb62025-08-20T03:38:39ZengBMJ Publishing GroupBMJ Public Health2753-42942025-08-013210.1136/bmjph-2024-001563Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional studyEsperanca Sevene0Orvalho Augusto1Corssino Tchavana2Charlotta Nilsson3Elias Manjate4Lucia Mabalane Chambal5Vanda dos Muchangos6Júlia Muando7Department of Physiological Sciences, Clinical Pharmacology, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, MozambiqueDepartment of Global Health, University of Washington, Seattle, Washington, USACentro de Investigação em Saúde de Manhiça, Manhiça, MozambiqueDivision of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden1Universidade Eduardo Mondlane Faculdade de Medicina, MozambiqueFaculty of Medicine, Eduardo Mondlane University, Maputo, MozambiqueDepartment of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Maputo City, MozambiqueNational Institute of Health, Maputo, MozambiqueIntroduction Globally, more than 254 million people are living with hepatitis B virus (HBV), and 7.4% of the people living with HIV (PLHIV) are coinfected with HBV. More than 70% of them reside in Africa. We aimed to describe the characteristics of newly diagnosed antiretroviral treatment (ART)-naïve HIV/HBV co-infected and HIV monoinfected patients.Methods This cross-sectional study included newly HIV-diagnosed ART-naïve patients recruited at Mavalane Health Centre located in a periurban area of Maputo City. Between May 2021 and November 2022, all patients over 18 years old were enrolled and screened for hepatitis B surface antigen (HBsAg). Data on socio-demographic and clinical characteristics, haematology, liver and kidney function tests, CD4+T cell counts, serological markers of hepatitis B (IgM Core hepatitis B antibody, hepatitis B e antigen, and hepatitis B e antibody), HIV and HBV viral loads were assessed using standard procedures.Results A total of 1106 participants were included. The age of the participants ranged from 18 years to 71 years with a median of 34.0 (IQR: 28.0–42.0) years, 513 (46.4%) were men and HBsAg was reactive in 81 participants, yielding a co-infection rate of 7.3%. Being male (OR, 1.72; 95% CI, 1.06 to 2.83) or a sex worker (OR, 3.69; 95% CI, 1.10 to 10.58) was associated with the co-infection. The median Aspartate Aminotransferase-Platelet Ratio Index (APRI) of the HIV/HBV co-infected was 0.5 (IQR 0.3–1.1), with 40/81 (49.4%) presenting with an APRI>0.5. Overall, 67/81 (80.2%) of the co-infected people were HBeAg-negative. The median APRI was 0.5 (IQR, 0.3–1.1) for the HBeAg-negative and 0.7 (IQR 0.3–1.4) for the HBeAg-positive subjects. The median HBV-DNA was 258.0 IU (IQR, 10.0–4974.5) for the HBeAg-negative and 746 287.0 IU (IQR 2720.0–49 899 213.0) for the HBeAg-positive subjects. Two (3.0%) HBeAg-negative and one (7.1%) HBeAg-positive subjects presented with hepatocellular carcinoma.Conclusion These data confirm the high prevalence of HIV/HBV co-infection in Mozambique and bring new data related to HBeAg status, reinforcing the need to test all PLHIV for HBV and to integrate the management and monitoring of hepatitis B and liver disease-specific tests in public ART programmes to predict and reduce the occurrence of HBV complications and mortality.https://bmjpublichealth.bmj.com/content/3/2/e001563.full |
| spellingShingle | Esperanca Sevene Orvalho Augusto Corssino Tchavana Charlotta Nilsson Elias Manjate Lucia Mabalane Chambal Vanda dos Muchangos Júlia Muando Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study BMJ Public Health |
| title | Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study |
| title_full | Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study |
| title_fullStr | Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study |
| title_full_unstemmed | Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study |
| title_short | Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study |
| title_sort | epidemiological and clinical profile of hepatitis b infection in art naive people living with hiv in maputo mozambique a cross sectional study |
| url | https://bmjpublichealth.bmj.com/content/3/2/e001563.full |
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