Hepatitis B Infection, Viral Load and Resistance in HIV-Infected Patients in Mozambique and Zambia
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Wandeler, Gilles, et al. Hepatitis B Infection, Viral Load and Resistance In Hiv-infected Patients In Mozambique and Zambia. 2016. https://doi.org/10.17615/re7n-c761APA
Wandeler, G., Musukuma, K., Zürcher, S., Vinikoor, M., Llenas García, J., Aly, M., Mulenga, L., Chi, B., Ehmer, J., Hobbins, M., Bolton Moore, C., Hoffmann, C., & Egger, M. (2016). Hepatitis B Infection, Viral Load and Resistance in HIV-Infected Patients in Mozambique and Zambia. https://doi.org/10.17615/re7n-c761Chicago
Wandeler, Gilles, Kalo Musukuma, Samuel Zürcher, Michael J Vinikoor, Jara Llenas García, Mussa M Aly, Lloyd Mulenga et al. 2016. Hepatitis B Infection, Viral Load and Resistance In Hiv-Infected Patients In Mozambique and Zambia. https://doi.org/10.17615/re7n-c761- Creator
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Wandeler, Gilles
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
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Musukuma, Kalo
- Other Affiliation: SolidarMed
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Zürcher, Samuel
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
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Vinikoor, Michael J.
- Other Affiliation: SolidarMed
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Llenas-García, Jara
- Other Affiliation: SolidarMed
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Aly, Mussa M.
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
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Mulenga, Lloyd
- Other Affiliation: SolidarMed
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Chi, Benjamin H.
- Other Affiliation: SolidarMed
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Ehmer, Jochen
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
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Hobbins, Michael A.
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
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Bolton-Moore, Carolyn
- Other Affiliation: SolidarMed
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Hoffmann, Christopher J.
- Other Affiliation: SolidarMed
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Egger, Matthias
- Other Affiliation: Johns Hopkins University School of Medicine; United States of America
- Abstract
- BackgroundFew data on the virological determinants of hepatitis B virus (HBV) infection are available from southern Africa.MethodsWe 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.ResultsSeventy-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.ConclusionOne half of HBsAg-positive patients demonstrated high HBV viremia, supporting the early initiation of tenofovir-containing ART in HIV/HBV-coinfected adults.
- Date of publication
- 2016
- Keyword
- DOI
- Identifier
- PMCID: PMC4816321
- Publisher DOI: https://doi.org/10.1371/journal.pone.0152043
- PMID: 27032097
- Onescience id: e366c726fdec0ee8ad4ab6f284721d012e04a87f
- Resource type
- Article
- Rights statement
- In Copyright
- Journal title
- PloS One
- Journal volume
- 11
- Journal issue
- 3
- Page start
- e0152043
- Language
- English
- ISSN
- 1932-6203
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