Abstract:
AIM: This study aimed to determine the kinetics of occult hepatitis B virus
infections (OBI) among people with HIV (PWH).
METHODS: The study used archived plasma samples from longitudinal HIV natural
history studies. We identified new OBI cases and assessed risk factors for OBI
using Cox proportional hazards regression analysis.
RESULTS: At baseline, 8 of 382 [(2.1%) (95% CI: 1.06–4.1)] samples tested positive
for hepatitis B surface antigen (HBsAg+). Of the 374 HBsAg-negative samples,
76 had sufficient sample volume for HBV DNA screening. OBI positivity (OBI+) at
baseline was reported in 11 of 76 [14.7 95% CI (8.3–24.1)] HBsAg-negative (HBsAg−)
participants. Baseline HBsAg-negative samples with sufficient follow-up samples
(n = 90) were used for analysis of newly identified OBI cases. Participants contributed
129.74 person-years to the study and were followed for a median of 1.02 years
(IQR: 1.00–2.00). Cumulatively, there were 34 newly identified OBI cases from the
90 participants, at the rate of 26.2/100 person-years (95% CI: 18.7–36.7). Newly
identified OBI cases were more common among men than women (61.1% vs. 31.9%)
and among participants with CD4+ T-cell counts ≤450 cells/mL (p-value = 0.02).
Most of the newly identified OBI cases [55.9% (19/34)] were possible reactivations as
they were previously HBV core antibody positive.
CONCLUSION: There was a high rate of newly identified OBI among young PWH in
Botswana, especially in men and in participants with lower CD4+ T-cell counts.
OBI screening in PWH should be considered because of the risk of transmission,
possible reactivation, and risk factors for the development of chronic liver
disease, including hepatocellular carcinoma.
