January 06, 2020
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Study suggests ‘high burden’ of global hepatitis B infection among PLWH

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A systematic review and meta-analysis published in Clinical Infectious Diseases suggests a high burden of hepatitis B infection among people living with HIV, with discrepancies that vary by region, level of development and the area’s HIV prevalence.

“HIV and HBV infections remain major public health concerns. ... There were 36.9 million people living with HIV (PLWH) worldwide in 2017 [and] 257 million people living with HBV infection. . . ,” Steve Leumi, MSc, of the University of Yaoundé’s Biotechnology Centre, and colleagues wrote. “Accurate data on the burden of HBV infection in PLWH are important for health care planning and resources allocations and to implement efficient strategies.”

To assess the prevalence and burden of HBV infection among PLWH at global, regional and national levels, Leumi and colleagues examined PubMed, Excerpta Medica Database, Web of Science and Global Index Medicus to find studies published between Jan. 1, 1990 and Dec. 31, 2017. The researchers required that HBV infection had to be diagnosed via serological assays.

The study included 358 studies with a total of 834,544 PLWH from 87 countries.

The pooled prevalence of HBV infections was 8.4% (95% CI, 7.9-8.8), although prevalence differed according to UNAIDS regions.

HBV prevalence was 12.4% in the West and Central Africa region, 9.9% in Middle East and North Africa, 9.8% in Asia and the Pacific, 7.4% in Eastern and Southern Africa, 6% in Western and Central Europe and North America and 5.1% in Latin America and the Caribbean. The incidence of HBV decreased from 10.4% in developing countries to 6.6% in very highly developed countries but increased from 7.3% in countries with HIV prevalence of 1% or less to 9.7% in countries with HIV prevalence of higher than 1% (P < .0001).

There were approximately 3,136,500 cases of HBV globally in PLWH; 73.8% of estimated regional cases were from sub-Saharan African and 17.1% were from Asia and the Pacific.

“This study suggests a high burden of HBV infection and infectivity in PLWH, with disparities according to regions, level of development and country HIV prevalence,” the authors concluded. “To curb the global burden of HBV infection, innovative and community-based strategies are needed in PLWH, including education, vaccine, HBV testing and initiation of appropriate treatment like [antiretroviral therapy] containing [tenofovir]. Specific strategies are needed in sub-Saharan Africa and Asia and the Pacific regions, especially in developing countries and countries with high HIV prevalence.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.