Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial

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dc.contributor.authorIve, Prudenceen_ZA
dc.contributor.authorMacLeod, Williamen_ZA
dc.contributor.authorMkumla, Nompumeleloen_ZA
dc.contributor.authorOrrell, Catherineen_ZA
dc.contributor.authorJentsch, Uteen_ZA
dc.contributor.authorWallis, Carole Len_ZA
dc.contributor.authorStevens, Wendyen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.contributor.authorSanne, Ianen_ZA
dc.contributor.authorBhattacharya, Debikaen_ZA
dc.date.accessioned2015-11-23T12:28:26Z
dc.date.available2015-11-23T12:28:26Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: Hepatitis B virus (HBV) infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA 'Safeguard the household study' in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART) initiation. METHODS: 812 participants from two South African townships Soweto and Masiphumelele were enrolled in a randomized trial of ART (CIPRA-SA). Participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and HBV DNA. FIB-4 scores were calculated at baseline. RESULTS: Forty-eight (5.9%) were HBsAg positive, of whom 28 (58.3%) were HBeAg positive. Of those with HBV, 29.8% had an HBV DNA<2000 IU/ml and ALT<40 IU/ml ; 83.0% had a FIB-4 score <1.45, consistent with absent or minimal liver disease. HBV prevalence was 8.5% in Masiphumelele compared to 3.8% in Soweto (relative risk 2.3; 95% CI: 1.3-4.0). More participants in Masiphumelele had HBeAg-negative disease (58% vs. 12%, p = 0.002) and HBV DNA levels ≤2000 IU/ml, (43% vs. 6% p<0.007). CONCLUSION: One third of HIV/HBV co-infected subjects had low HBV DNA levels and ALT while the majority had indicators of only mild liver disease. There were substantial regional differences in HBsAg and HbeAg prevalence in HIV/HBV co-infection between two regions in South Africa. This study highlights the absence of severe liver disease and the marked regional differences in HIV/HBV co-infection in South Africa and will inform treatment decisions in these populations.en_ZA
dc.identifier.apacitationIve, P., MacLeod, W., Mkumla, N., Orrell, C., Jentsch, U., Wallis, C. L., ... Bhattacharya, D. (2013). Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial. <i>PLoS One</i>, http://hdl.handle.net/11427/15287en_ZA
dc.identifier.chicagocitationIve, Prudence, William MacLeod, Nompumelelo Mkumla, Catherine Orrell, Ute Jentsch, Carole L Wallis, Wendy Stevens, Robin Wood, Ian Sanne, and Debika Bhattacharya "Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15287en_ZA
dc.identifier.citationIve, P., MacLeod, W., Mkumla, N., Orrell, C., Jentsch, U., Wallis, C. L., ... & Bhattacharya, D. (2013). Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial. PloS one, 8(12), e74900. doi:10.1371/journal.pone.0074900en_ZA
dc.identifier.ris TY - Journal Article AU - Ive, Prudence AU - MacLeod, William AU - Mkumla, Nompumelelo AU - Orrell, Catherine AU - Jentsch, Ute AU - Wallis, Carole L AU - Stevens, Wendy AU - Wood, Robin AU - Sanne, Ian AU - Bhattacharya, Debika AB - BACKGROUND: Hepatitis B virus (HBV) infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA 'Safeguard the household study' in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART) initiation. METHODS: 812 participants from two South African townships Soweto and Masiphumelele were enrolled in a randomized trial of ART (CIPRA-SA). Participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and HBV DNA. FIB-4 scores were calculated at baseline. RESULTS: Forty-eight (5.9%) were HBsAg positive, of whom 28 (58.3%) were HBeAg positive. Of those with HBV, 29.8% had an HBV DNA<2000 IU/ml and ALT<40 IU/ml ; 83.0% had a FIB-4 score <1.45, consistent with absent or minimal liver disease. HBV prevalence was 8.5% in Masiphumelele compared to 3.8% in Soweto (relative risk 2.3; 95% CI: 1.3-4.0). More participants in Masiphumelele had HBeAg-negative disease (58% vs. 12%, p = 0.002) and HBV DNA levels ≤2000 IU/ml, (43% vs. 6% p<0.007). CONCLUSION: One third of HIV/HBV co-infected subjects had low HBV DNA levels and ALT while the majority had indicators of only mild liver disease. There were substantial regional differences in HBsAg and HbeAg prevalence in HIV/HBV co-infection between two regions in South Africa. This study highlights the absence of severe liver disease and the marked regional differences in HIV/HBV co-infection in South Africa and will inform treatment decisions in these populations. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0074900 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial TI - Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial UR - http://hdl.handle.net/11427/15287 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15287
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0074900
dc.identifier.vancouvercitationIve P, MacLeod W, Mkumla N, Orrell C, Jentsch U, Wallis CL, et al. Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial. PLoS One. 2013; http://hdl.handle.net/11427/15287.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Ive et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHepatitis B virusen_ZA
dc.subject.otherCo-infectionsen_ZA
dc.subject.otherViral loaden_ZA
dc.subject.otherLiver diseasesen_ZA
dc.subject.otherLiver fibrosisen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherHepatitis Ben_ZA
dc.titleLow prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trialen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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