Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia

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dc.contributor.authorWandeler, Gillesen_ZA
dc.contributor.authorMusukuma, Kaloen_ZA
dc.contributor.authorZürcher, Samuelen_ZA
dc.contributor.authorVinikoor, Michael Jen_ZA
dc.contributor.authorLlenas-García, Jaraen_ZA
dc.contributor.authorAly, Mussa Men_ZA
dc.contributor.authorMulenga, Lloyden_ZA
dc.contributor.authorChi, Benjamin Hen_ZA
dc.contributor.authorEhmer, Jochenen_ZA
dc.contributor.authorHobbins, Michael Aen_ZA
dc.contributor.authorBolton-Moore, Carolynen_ZA
dc.contributor.authorHoffmann, Christopher Jen_ZA
dc.contributor.authorEgger, Matthiasen_ZA
dc.contributor.authorIeDEA-Southern Africaen_ZA
dc.date.accessioned2016-04-13T12:36:54Z
dc.date.available2016-04-13T12:36:54Z
dc.date.issued2016en_ZA
dc.description.abstractBACKGROUND: Few data on the virological determinants of hepatitis B virus (HBV) infection are available from southern Africa. METHODS: We enrolled consecutive HIV-infected adult patients initiating antiretroviral therapy (ART) at two urban clinics in Zambia and four rural clinics in Northern Mozambique between May 2013 and August 2014. HBsAg screening was performed using the Determine ® rapid test. Quantitative real-time PCR and HBV sequencing were performed in HBsAg-positive patients. Risk factors for HBV infection were evaluated using Chi-square and Mann-Whitney tests and associations between baseline characteristics and high level HBV replication explored in multivariable logistic regression. RESULTS: Seventy-eight of 1,032 participants in Mozambique (7.6%, 95% confidence interval [CI]: 6.1-9.3) and 90 of 797 in Zambia (11.3%, 95% CI: 9.3-13.4) were HBsAg-positive. HBsAg-positive individuals were less likely to be female compared to HBsAg-negative ones (52.3% vs. 66.1%, p<0.001). Among 156 (92.9%) HBsAg-positive patients with an available measurement, median HBV viral load was 13,645 IU/mL (interquartile range: 192-8,617,488 IU/mL) and 77 (49.4%) had high values (>20,000 UI/mL). HBsAg-positive individuals had higher levels of ALT and AST compared to HBsAg-negative ones (both p<0.001). In multivariable analyses, male sex (adjusted odds ratio: 2.59, 95% CI: 1.22-5.53) and CD4 cell count below 200/μl (2.58, 1.20-5.54) were associated with high HBV DNA. HBV genotypes A1 (58.8%) and E (38.2%) were most prevalent. Four patients had probable resistance to lamivudine and/or entecavir. CONCLUSION: One half of HBsAg-positive patients demonstrated high HBV viremia, supporting the early initiation of tenofovir-containing ART in HIV/HBV-coinfected adults.en_ZA
dc.identifier.apacitationWandeler, G., Musukuma, K., Zürcher, S., Vinikoor, M. J., Llenas-García, J., Aly, M. M., ... (2016). Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia. <i>PLoS One</i>, http://hdl.handle.net/11427/18856en_ZA
dc.identifier.chicagocitationWandeler, Gilles, Kalo Musukuma, Samuel Zürcher, Michael J Vinikoor, Jara Llenas-García, Mussa M Aly, Lloyd Mulenga, et al "Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia." <i>PLoS One</i> (2016) http://hdl.handle.net/11427/18856en_ZA
dc.identifier.citationWandeler, G., Musukuma, K., Zürcher, S., Vinikoor, M. J., Llenas-García, J., Aly, M. M., ... & Bolton-Moore, C. (2016). Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia. PloS one, 11(3), e0152043. doi:10.1371/journal.pone.0152043en_ZA
dc.identifier.ris TY - Journal Article AU - Wandeler, Gilles AU - Musukuma, Kalo AU - Zürcher, Samuel AU - Vinikoor, Michael J AU - Llenas-García, Jara AU - Aly, Mussa M AU - Mulenga, Lloyd AU - Chi, Benjamin H AU - Ehmer, Jochen AU - Hobbins, Michael A AU - Bolton-Moore, Carolyn AU - Hoffmann, Christopher J AU - Egger, Matthias AU - IeDEA-Southern Africa AB - BACKGROUND: Few data on the virological determinants of hepatitis B virus (HBV) infection are available from southern Africa. METHODS: We enrolled consecutive HIV-infected adult patients initiating antiretroviral therapy (ART) at two urban clinics in Zambia and four rural clinics in Northern Mozambique between May 2013 and August 2014. HBsAg screening was performed using the Determine ® rapid test. Quantitative real-time PCR and HBV sequencing were performed in HBsAg-positive patients. Risk factors for HBV infection were evaluated using Chi-square and Mann-Whitney tests and associations between baseline characteristics and high level HBV replication explored in multivariable logistic regression. RESULTS: Seventy-eight of 1,032 participants in Mozambique (7.6%, 95% confidence interval [CI]: 6.1-9.3) and 90 of 797 in Zambia (11.3%, 95% CI: 9.3-13.4) were HBsAg-positive. HBsAg-positive individuals were less likely to be female compared to HBsAg-negative ones (52.3% vs. 66.1%, p<0.001). Among 156 (92.9%) HBsAg-positive patients with an available measurement, median HBV viral load was 13,645 IU/mL (interquartile range: 192-8,617,488 IU/mL) and 77 (49.4%) had high values (>20,000 UI/mL). HBsAg-positive individuals had higher levels of ALT and AST compared to HBsAg-negative ones (both p<0.001). In multivariable analyses, male sex (adjusted odds ratio: 2.59, 95% CI: 1.22-5.53) and CD4 cell count below 200/μl (2.58, 1.20-5.54) were associated with high HBV DNA. HBV genotypes A1 (58.8%) and E (38.2%) were most prevalent. Four patients had probable resistance to lamivudine and/or entecavir. CONCLUSION: One half of HBsAg-positive patients demonstrated high HBV viremia, supporting the early initiation of tenofovir-containing ART in HIV/HBV-coinfected adults. DA - 2016 DB - OpenUCT DO - 10.1371/journal.pone.0152043 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia TI - Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia UR - http://hdl.handle.net/11427/18856 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0152043en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/18856
dc.identifier.vancouvercitationWandeler G, Musukuma K, Zürcher S, Vinikoor MJ, Llenas-García J, Aly MM, et al. Hepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambia. PLoS One. 2016; http://hdl.handle.net/11427/18856.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_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© 2016 Wandeler 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.otherHepatitis B virusen_ZA
dc.subject.otherMozambiqueen_ZA
dc.subject.otherZambiaen_ZA
dc.subject.otherViral loaden_ZA
dc.subject.otherAntimicrobial resistanceen_ZA
dc.subject.otherAfricaen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherPolymerase chain reactionen_ZA
dc.titleHepatitis B infection, viral load and resistance in HIV-infected patients in Mozambique and Zambiaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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