Hepatitis B infection in HIV-1-infected patients receiving highly active antiretroviral therapy in Lomé, Togo: Prevalence and molecular consequences
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 Lomé, 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 >10 IU/mL in 33/117 patients overall (38%), and in 87.5% of 16 HBeAg-positive patients (p<0.0001). In multivariate analysis, factors associated with HBV DNA load >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.
Akouda Patassi, Service Maladies Infectieuses et Pneumologie CHU Sylvanus Olympio, Lomé, Togo
Sihem Benaboud, Unité de Recherche clinique, GFH Cochin, Paris, France
Dadja Essoya Landoh, Division de l’épidémiologie, Ministère de la santé du Togo, Lomé, Togo
M Salou, Laboratoire de Biologie Moléculaire, BIOLIM, Université de Lomé, Togo
Anoumou Claver Dagnra, Laboratoire de Biologie Moléculaire, BIOLIM, Université de Lomé, Togo
Bayaki Saka, Service de dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Togo
Anne Krivine, Laboratoire de Virologie Pr Rozenberg Pöle Biologie Pharmacie Pathologie, Hôpital Cochin, Paris, France
Jean-François Meritet, Laboratoire de Virologie Pr Rozenberg Pöle Biologie Pharmacie Pathologie, Hôpital Cochin, Paris, France
Palokinam Pitché, Service de dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Togo; Conseil National de Lutte contre les IST/VIH/Sida, Lomé, Togo
Dominique Salmon-Ceron, Unité de Pathologie infectieuse, Groupe hospitalier Cochin, Paris, France
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Date published: 2016-05-10
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