T P Goverwa-Sibanda1,2, C Mupanguri3, C Timire3,4,5, A D Harries6,7, S Ngwenya2, E Chikwati1, C Mapfuma4, F Mushambi8, H Tweya6,9, M Ndlovu2,4. 1. AIDS Healthcare Foundation, Zimbabwe, Harare. 2. Mpilo Hospital, Ministry of Health and Child Care, Bulawayo, Zimbabwe. 3. National AIDS/TB Programme, Ministry of Health and Child Care, Harare, Zimbabwe. 4. National University of Science and Technology, Bulawayo, Zimbabwe. 5. International Union Against Tuberculosis and Lung Disease (The Union) Zimbabwe, Harare, Zimbabwe. 6. The Union, Paris, France. 7. London School of Hygiene & Tropical Medicine, London, UK. 8. Parirenyatwa Group of Hospitals, Ministry of Health and Child Care, Harare, Zimbabwe. 9. The Lighthouse Clinic, Lilongwe, Malawi.
Abstract
SETTING: There is little information about the diagnosis and treatment of hepatitis B virus (HBV) infection in people living with HIV (PLHIV) in Zimbabwe despite recommendations that tenofovir (TDF) + lamivudine (3TC) is the most effective nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone of antiretroviral therapy (ART) in those with dual infection. OBJECTIVE: To determine 1) numbers screened for hepatitis B surface antigen (HBsAg); 2) numbers diagnosed HBsAg-positive along with baseline characteristics; and 3) NRTI backbones used among PLHIV initiating first-line ART at Mpilo Opportunistic Infections Clinic, Bulawayo, Zimbabwe, between October 2017 and April 2019. DESIGN: This was a cross-sectional study using routinely collected data. RESULTS: Of the 422 PLHIV initiating first-line ART (median age 34 years, IQR 25-43), 361 (85%) were screened for HBV, with 10% being HBsAg-positive. HBsAg positivity was significantly associated with anaemia (adjusted prevalence ratio [aPR] 2.3, 95%CI 1.1-4.7) and elevated ala-nine transaminase levels (aPR 2.9, 95%CI 1.5-5.8). Of 38 PLHIV who were diagnosed HBsAg-positive, 30 (79%) were started on ART based on tenofovir (TDF) and lamivudine (3TC), seven were given abacavir (ABC) + 3TC-based ART and one was given zido vudine (ZDV) + 3TC-based ART. CONCLUSION: In PLHIV, HBV screening worked well, the prevalence of HIV-HBV co-infection was high and most patients received appropriate treatment for both conditions. Recommendations to improve screening, diagnosis and treatment of HIV-HBV co-infection are discussed.
SETTING: There is little information about the diagnosis and treatment of hepatitis B virus (HBV) infection in people living with HIV (PLHIV) in Zimbabwe despite recommendations that tenofovir (TDF) + lamivudine (3TC) is the most effective nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone of antiretroviral therapy (ART) in those with dual infection. OBJECTIVE: To determine 1) numbers screened for hepatitis B surface antigen (HBsAg); 2) numbers diagnosed HBsAg-positive along with baseline characteristics; and 3) NRTI backbones used among PLHIV initiating first-line ART at Mpilo Opportunistic Infections Clinic, Bulawayo, Zimbabwe, between October 2017 and April 2019. DESIGN: This was a cross-sectional study using routinely collected data. RESULTS: Of the 422 PLHIV initiating first-line ART (median age 34 years, IQR 25-43), 361 (85%) were screened for HBV, with 10% being HBsAg-positive. HBsAg positivity was significantly associated with anaemia (adjusted prevalence ratio [aPR] 2.3, 95%CI 1.1-4.7) and elevated ala-nine transaminase levels (aPR 2.9, 95%CI 1.5-5.8). Of 38 PLHIV who were diagnosed HBsAg-positive, 30 (79%) were started on ART based on tenofovir (TDF) and lamivudine (3TC), seven were given abacavir (ABC) + 3TC-based ART and one was given zido vudine (ZDV) + 3TC-based ART. CONCLUSION: In PLHIV, HBV screening worked well, the prevalence of HIV-HBV co-infection was high and most patients received appropriate treatment for both conditions. Recommendations to improve screening, diagnosis and treatment of HIV-HBV co-infection are discussed.
Authors: Tasilo Kamenya; Damian Jeremia Damian; James Samwel Ngocho; Rune Nathaniel Philemon; Michael Johnson Mahande; Sia Emmanueli Msuya Journal: Pan Afr Med J Date: 2017-11-28
Authors: Lucy Platt; Clare E French; Catherine R McGowan; Keith Sabin; Erin Gower; Adam Trickey; Bethan McDonald; Jason Ong; Jack Stone; Philippa Easterbrook; Peter Vickerman Journal: J Viral Hepat Date: 2019-12-22 Impact factor: 3.728