Hepatitis B Infection in HIV-1-Infected Patients Receiving Highly Active Antiretroviral Therapy in Lome; Togo: Prevalence and Molecular Consequences

ABSTRACT

BACKGROUND:No data are available on HIV/hepatitis B virus (HBV) or hepatitis C virus coinfection in Togo; and patients are not routinely tested for HBV infection.OBJECTIVE:To determine the prevalence of HBV and the risk of HBV drug resistance during antiretroviral treatment in HIV-coinfected patients in Togo.METHOD:This cross-sectional study was carried out in Lome; Togo; from January 2010 to December 2011 among HIV-infected patients who had been on antiretroviral therapy (ART) for at least 6 months.RESULTS: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 etgt;10 IU/mL in 33/117 patients overall (38%); and in 87.5% of 16 HBeAg-positive patients (petlt;0.0001). In multivariate analysis; factors associated with HBV DNA load etgt;10 IU/mLwere HBeAg positivity (adjusted odds ratio (aOR) 6.4; p=0.001) and a higher level of education (aOR 6.5; p=0.026). The prevalence of HBV resistance to lamivudine was 13.0% (15/115; 95% CI 7.0 - 19.0). The detected resistance mutations were rtL180M (14/15 patients) and rtM204V/I (15/15).CONCLUSION: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