Presence of occult HBV, but near absence of active HBV and HCV infections in people infected with HIV in rural South Africa

Roos Emilie Barth (1) , Quirine Huijgen (2) , Hugo A Tempelman (3) , Tania Mudrikova (1) , Annemarie Mj Wensing (4) , Andy I.M. Hoepelman (1)

1 Internal Medicine and Infectious Diseases
2 Faculty of Medicine
3 Ndlovu Medical Centre
4 Virology and Microbiology

Human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses are endemic in Sub-Saharan Africa, but data regarding the prevalence of hepatitis co-infections in HIV-positive individuals residing there are limited. The aim of the study was to determine the prevalence of HBV, HCV and occult HBV (presence of HBV-DNA in the absence of HBsAg) in a rural, South African cohort. The results were compared to various ethnic groups in a Dutch cohort of people infected with HIV. Antiretroviral-naïve individuals with HIV from both a rural South African clinic (n=258), and a Dutch University hospital (n=782), were included. Both serological (HBV and HCV) and molecular (occult HBV) assays were performed. Logistic regression analysis was used to define independent predictors of a hepatitis co-infection. HBV and HCV prevalence rates in the South African cohort were exceptionally low (0.4%, 1/242 and 0.8%, 2/242 respectively), compared to those observed in Caucasians (HBV 4.4%, HCV 10.9%) and African immigrants (HBV 8.9%, HCV 4.8%). Conversely, occult HBV was observed in a considerable proportion (10%, 6/60) of South African patients who were anti-HBc-positive but HBsAg-negative. Occult infections were less frequent in Caucasians and Africans in the Dutch cohort (3.2% and 1.4% respectively). Independent predictors for occult HBV were not identified, but a trend towards more occult HBV at lower CD4 counts was observed. Local HBV/HCV prevalence data are needed to optimise vaccination and antiretroviral treatment strategies. Occult HBV in patients with HIV may be missed regularly when molecular analyses are not available.

Mots clés: Medicine

Roos Emilie Barth, Quirine Huijgen, Hugo A Tempelman, Tania Mudrikova, Annemarie Mj Wensing, et al.. Presence of occult HBV, but near absence of active HBV and HCV infections in people infected with HIV in rural South Africa. Journal of Medical Virology, 2011, 83 (6), pp.929. ⟨10.1002/jmv.22026⟩. ⟨hal-00633212⟩