n South African Medical Journal - Hepatitis B infection in HIV-1-infected patients receiving highly active antiretroviral therapy in Lomé, Togo : prevalence and molecular consequences : research

Volume 106, Issue 6
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



No data are available on HIV/hepatitis B virus (HBV) or hepatitis C virus coinfection in Togo, and patients are not routinelytested for HBV infection.

To determine the prevalence of HBV and the risk of HBV drug resistance during antiretroviral treatment in HIV-coinfected patients in Togo.
This cross-sectional study was carried out in Lomé, Togo, from January 2010 to December 2011 among HIV-infected patients who had been on antiretroviral therapy (ART) for at least 6 months.
In total, 1 212 patients (74.9% female) living with HIV/AIDS and treated with ART were included in the study. The seroprevalence of hepatitis B surface antigen (HBsAg) was 9.7% (117/1 212; 95% confidence interval (CI) 8.04 - 11.45). Of these 117 HBsAg-positive patients, 16 (13.7%) were hepatitis B e-antigen (HBeAg)-positive, and 115 (98.3%) were on lamivudine. The HBV DNA load was <10 IU/mL in 33/117 patients overall (38%), and in 87.5% of 16 HBeAg-positive patients (p<0.0001). In multivariate analysis, factors associated with HBV DNA load >10 IU/mL were HBeAg positivity (adjusted odds ratio (aOR) 6.4; =0.001) and a higher level of education (aOR 6.5;=0.026). The prevalence of HBV resistance to lamivudine was 13.0% (15/115; 95% CI 7.0 - 19.0). The detected resistance mutations werertL180M (14/15 patients) and rtM204V/I (15/15).
The seroprevalence of HBV among ART-treated HIV-infected patients in Togo was 9.7%. The prevalence of HBV lamivudine resistance mutations after 2 years of ART was 13.0%. These results suggest that HBV screening before ART initiation can be based on HBsAg testing.

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