Hepatitis B virus clinical and virologic characteristics in an HIV perinatal transmission study in sub-Saharan Africa
Year: 2023
Type: article
Abstract: OBJECTIVES: To describe the clinical and virologic characteristics of HIV-HBV coinfection, including the predictors of high maternal HBV viral load in pregnant women with HIV in sub-Saharan Africa (SSA). METHODS: HPTN 046 was a HIV perinatal transmission clinical trial evaluating infant nevirapine vs. placebo. Women-infant pairs ( n = 2016) were enrolled in SSA from 2007 to 2010; 1579 (78%) received antiretrovirals (ARV). Maternal delivery samples were retrospectively tested for hepatitis B surface antigen (HBsAg), and if positive, were tested for hepatitis B e antigen (HBeAg) and HBV viral load (VL). High HBV VL was defined as ≥10 6 IU/ml. RESULTS: Overall, 4.4% (88/2016) had HBV co-infection, with geographic variability ranging from 2.4% to 8.7% ( P < 0.0001); 25% (22/88) were HBeAg positive with prevalence in countries ranging from 10.5% to 39%. Fifty-two percentage (40/77) of those with HBV received ARV, the majority (97%) received 3TC as the only HBV active agent. HBeAg positivity was associated with high maternal HBV VL, odds ratio (OR) 37.0, 95% confidence interval (CI) 5.4-252.4. Of those with high HBV VL, 40% (4/10) were receiving HBV active drugs (HBV-ARV). HBV drug resistance occurred in 7.5% (3/40) receiving HBV-ARV. CONCLUSIONS: In SSA, HBV co-infection is common in pregnant women with HIV. HBsAg and HBeAg prevalence vary widely by country in this clinical trial cohort. HBeAg is a surrogate for high HBV viral load. HBV drug resistance occurred in 7.5% receiving HBV-ARV with lamivudine as the only HBV active agent. These findings reinforce the importance of HBsAg screening and early treatment with two active agents for HBV.
Source: AIDS
Institutions: Johns Hopkins University, University of California, Los Angeles, Fred Hutch Cancer Center, University of Zimbabwe, University of Miami, MUJHU Research Collaboration, Muhimbili University of Health and Allied Sciences, Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Stanford University
Language: English
Topic: Hepatitis B Virus Studies
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Gilead Sciences, Regeneron Pharmaceuticals, ACT Government, International Maternal Pediatric Adolescent AIDS Clinical Trials Network, National Institutes of Health, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: HIV PREVENTION TRIALS NETWORK LEADERSHIP GROUP, G1929754733, Impact of HIV PMTCT Interventions on HIV/HBV Co-infected Women and Their Infants, G4378046842, International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Group, Lamivudine and its Impact on Perinatal HBV Transmission in HIV/HBV Coinfection, SDMC: HIV Prevention Trials Network, KwaZulu-Natal Clinical Trials Unit, G95499620
OpenAlex ID: W4387798613