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- Title
Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients.
- Authors
Archampong, Timothy N. A.; Lartey, Margaret; Sagoe, Kwamena W.; Obo-Akwa, Adjoa; Kenu, Ernest; Gillani, Fizza S.; Hongmei Yang; Boamah, Isaac; Flanigan, Timothy; Kwara, Awewura; Yang, Hongmei
- Abstract
<bold>Background: </bold>The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.<bold>Methods: </bold>Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.<bold>Results: </bold>Of 3108 HIV-infected patients screened, 257 (8.3%) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7%) were ART-experienced and 83 (35.3%) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1% of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95% CI 4.6-21.9) and elevated ALT (OR 3.7, 95% CI 1.8-7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0-12.1) and male sex (OR 2.1, 95% CI 1.0-4.2) were associated with Hepatitis B viremia.<bold>Conclusions: </bold>Majority of ART-naïve (89%) and 42% of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.
- Subjects
GHANA; HEPATITIS B; VIREMIA; ANTIRETROVIRAL agents; MIXED infections; HIV-positive persons; GHANAIANS; CROSS-sectional method; HEALTH; HIV infection epidemiology; ANTIVIRAL agents; CLINICAL trials; COMPARATIVE studies; HEPATITIS viruses; HIV; HIV infections; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; VIRAL load; EVALUATION research; LAMIVUDINE; ANTI-HIV agents; PHYSIOLOGY
- Publication
BMC Infectious Diseases, 2016, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-016-1342-4