Transition to the 2024 World Health Organization Hepatitis B Guidelines and the Implications for the Antiretroviral Therapy Uptake in Northwestern Tanzania: A Cross-Sectional Study

Background The newly released 2024 World Health Organization (WHO) guideline for hepatitis B management aims at increasing the number of chronic hepatitis B infected (CHBI) individuals into antiretroviral therapy (AVT) uptake. The AVT eligibility and uptake implications of these new guidelines have not widely been conceptualized in Tanzania creating a gap in appropriate free AVT scaling-up effort by the Ministry of Health. To fill up this gap, we evaluated this information and compared similar information with the old 2015 WHO guidelines among CHBI individuals attending Bugando Medical Center, Mwanza, Tanzania. Methods A retrospective cross-sectional study involving 299 hepatitis B individuals was conducted between August 2024 and December 2024 at BMC. About 297 of 299 participants were eligible for AVT eligibility and uptake based on the new 2024 WHO hepatitis B guidelines while only 269 among the 299 participants were eligible for AVT eligibility and uptake based the old 205 WHO hepatitis B guidelines. Socio-demographic and other data required for AVT eligibility analysis and AVT uptake status were extracted from the BMC medical records database and entered directly into a well-designed study Excel database. The Aspartate-Platelet Ratio Index was calculated according to its formula. HBV-DNA levels of the target not detected; <20 IU/mL and >1.7 × 108 IU/mL were treated as 0, 20, and 1.7 × 108 IU/mL, respectively. Statistical analysis was done using STATA version 15. Results The 297 participants analyzed under the new 2024 WHO HBV guidelines had a median age of 40 [34-50] years old and majority, 81.8 (218/297) were male. AVT eligibility was 76.8% (228/297) and uptake was 32.9% (75/228) which was significantly higher compared to that obtained by the old guidelines, p-<0.005. The 269 participants analyzed under the old 2015 WHO HBV guidelines had a median age of 40 [33-49] years old and majority, 81 (218/269) were male. AVT eligibility was 54.3% (146/269) and uptake was 38.4% (56/146). Both of the AVT uptake were significantly lower than the WHO AVT expectation of 80%, p<0.005. Conclusion The new WHO guidelines have significantly increased the AVT eligibility, prompting Tanzania to devise some efforts to increase therapy uptake accordingly.