Anderson, MotswediPhinius, Bonolo B.Phakedi, BasetsanaMudanga, MbatshiBhebhe, LynnetteTlhabano, Girlie N.Motshosi, PatienceRatsoma, TsholofeloBaruti, KaboMpebe, GorataChoga, Wonderful T.Marlink, RichardGlebe, DieterBlackard, Jason T.Moyo, SikhulileKramvis, AnnaGaseitsiwe, Simani2024-12-042024-12-042024-05Anderson, M., Phinius, B.B., Phakedi, B.K., Mudanga, M., Bhebhe, L.N., Tlhabano, G.N., Motshosi, P., Ratsoma, T., Baruti, K., Mpebe, G., Choga, W.T., Marlink, R., Glebe, D., Blackard, J.T., Moyo, S., Kramvis, A. & Gaseitsiwe, S. (2024) Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana. Frontiers in Microbiology 15:1342862. doi: 10.3389/fmicb.2024.1342862.1664-302X (online)10.3389/fmicb.2024.1342862http://hdl.handle.net/2263/99740DATA AVAILABITY STATEMENT: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.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.en© 2024 Anderson, Phinius, Phakedi, Mudanga, Bhebhe, Tlhabano, Motshosi, Ratsoma, Baruti, Mpebe, Choga, Marlink, Glebe, Blackard, Moyo, Kramvis and Gaseitsiwe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).IncidenceHIV/HBVHepatitis B surface antigen (HBsAg) negativeSDG-03: Good health and well-beingSDG-10: Reduced inequalitiesHepatitis B virus (HBV)Occult hepatitis B (OBI)Human immunodeficiency virus (HIV)People living with HIV (PLHIV)Article