Low rates of active hepatitis B and C infections among adults and children living with HIV and taking antiretroviral therapy: A multicenter screening study in Lesotho

Abstract

Lesotho presents the second highest adult human immunodeficiency virus (HIV) prevalence globally. Among people living with HIV, data on hepatitis B virus (HBV) or hepatitis C virus (HCV) co‐infection are limited. We report HBV and HCV co‐infection data from a multicentre cross‐sectional study among adult and pediatric patients taking antiretroviral therapy (ART) in ten health facilities in Lesotho. Among 1,318 adults screened (68% female, median age 44 years), 262 (20%) had immunologically controlled HBV infection, 99 (7.6%) tested anti‐HBs positive and anti‐HBc negative, indicating vaccination, and 57 (4.3%) had chronic HBV infection. Among the patients with chronic HBV infection, 15 tested HBeAg positive and eight had detectable HBV viremia (median 2,477,400 copies/mL; IQR 205‐34,400,000) with a mean aspartate aminotransferase‐to‐platelet ratio index of 0.48 (SD 0.40). Prevalence of HCV co‐infection was 1.7% (22/1318), and only one patient had detectable HCV viremia. Among 162 pediatric patients screened, three (1.9%) had chronic HBV infection, whereby two also tested HBeAg positive, and one had detectable HBV viral load (210 copies/mL). Six of 162 (3.7%) had anti‐HCV antibodies, all with undetectable HCV viral loads. Overall prevalence of chronic HBV/HIV and HCV/HIV co‐infection among adults and children was relatively low, comparable to earlier reports from the same region. But prevalence of immunologically controlled HBV infection among adults was high. Of those patients with chronic HBV infection, a minority had detectable HBV DNA.