Epidemiology of Hepatitis B Virus Co-infection Among People Living with HIV in Four Countries in Sub-Saharan Africa

  1. Josphat Kosgei
  2. Walter Jaoko
  3. Julius Oyugi
  4. Natalie Burns
  5. Jonah Maswai
  6. John Owuoth
  7. Valentine Sing’oei
  8. Emmanuel Bahemana
  9. Abdulwasiu B. Tiamiyu
  10. Hannah Kibuuka
  11. Leigh Anne Eller
  12. Julie A. Ake
  13. Neha Shah
  14. Trevor A. Crowell
  15. the African Cohort Study (AFRICOS) Study Group
Read the full article See related articles

Discuss this preprint

Start a discussion What are Sciety discussions?

Listed in

This article is not in any list yet, why not save it to one of your lists.
Log in to save this article

Abstract

Background

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share transmission routes and are associated with morbidity in sub-Saharan Africa. Understanding the prevalence and demographic predictors of HBV co-infection among people living with HIV (PLWH) can inform integrated screening and treatment strategies.

Methods

We analyzed enrollment data from the African Cohort Study (AFRICOS), a prospective study of participants aged ≥15 years with and without HIV across 12 clinical sites in Kenya, Uganda, Tanzania, and Nigeria. HBV was diagnosed via hepatitis B surface antigen (Bio-Rad, Hercules, CA). Descriptive statistics summarized HBV prevalence by HIV status and demographic characteristics. Relative risk (RR) of HBV among PLWH compared to people without HIV was calculated. Among PLWH, multivariable logistic regression identified odds ratios (ORs) and 95% confidence intervals (CIs) for factors independently associated with HBV co-infection.

Results

Among 4,221 participants with valid HBV results, 3,433 were PLWH. HBV prevalence was 4.7% among PLWH and 4.3% among people without HIV (RR: 1.09; 95% CI: 0.76-1.56). Among PLWH, HBV prevalence was highest in Nigeria and lowest in Kenya (11.1% vs. 2.6%, p<0.001), higher among males than females (6.8% vs. 3.8%, p<0.001, and highest in participants aged ≥40 years and lowest in participants aged 15–19 years (5.8% vs. 0.2%, p<0.001). In multivariable analysis, male sex (OR: 2.28 [95%CI: 1.63-3.18]), Nigeria residence (OR: 5.19 [95%CI: 3.35-8.04]), and age ≥40 (OR: 2.90 [95%CI: 1.69-4.99]) were independently associated with HBV co-infection.

Conclusion

Routine HBV screening and targeted interventions are needed within HIV programs, especially for older males and in high-prevalence settings like Nigeria.

Article activity feed

  1. Version published to 10.1101/2025.11.16.25340356 on medRxiv