Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM)
Abstract Background Hepatitis B is a major concern in Africa, especially in HIV-infected patients. Unfortunately, access to hepatitis B virus (HBV) testing and adequate treatment remains a challenge in the continent. We investigated HBV testing, treatment, and virologic suppression in HIV-infected p...
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doaj-4385afd61a86477696ec7fe9d9bd81c92021-01-17T12:08:33ZengBMCBMC Infectious Diseases1471-23342020-01-0120111010.1186/s12879-020-4784-7Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM)Florian Liégeois0Sylvie Boyer1Sabrina Eymard-Duvernay2Patrizia Carrieri3Charles Kouanfack4Jenny Domyeum5Gwenaëlle Maradan6Jacques Ducos7Eitel Mpoudi-Ngolé8Bruno Spire9Eric Delaporte10Christopher Kuaban11Laurent Vidal12Christian Laurent13for the EVOLCAM study groupInstitut de Recherche pour le Développemen, Inserm, Univ Montpellier, TransVIHMIInserm, IRD, Univ Aix-Marseille, SESSTIMInstitut de Recherche pour le Développemen, Inserm, Univ Montpellier, TransVIHMIInserm, IRD, Univ Aix-Marseille, SESSTIMCentral HospitalCREMERInserm, IRD, Univ Aix-Marseille, SESSTIMLaboratory of Viral Hepatitis, Inserm, University HospitalCREMERInserm, IRD, Univ Aix-Marseille, SESSTIMInstitut de Recherche pour le Développemen, Inserm, Univ Montpellier, TransVIHMIFaculty of Medicine and Biomedical Sciences, University of Yaoundé IInserm, IRD, Univ Aix-Marseille, SESSTIMInstitut de Recherche pour le Développemen, Inserm, Univ Montpellier, TransVIHMIAbstract Background Hepatitis B is a major concern in Africa, especially in HIV-infected patients. Unfortunately, access to hepatitis B virus (HBV) testing and adequate treatment remains a challenge in the continent. We investigated HBV testing, treatment, and virologic suppression in HIV-infected patients followed up as part of Cameroon’s national antiretroviral programme. Methods A cross-sectional survey was performed in adult patients receiving antiretroviral therapy (ART) in 19 hospitals in the Centre and Littoral regions in Cameroon. The proportions of patients tested for hepatitis B surface antigen (HBsAg) prior to the study were compared among all study hospitals using the Chi-square test. The association of individual and hospital-related characteristics with HBV testing and virologic suppression was assessed using multilevel logistic regression models. Results Of 1706 patients (women 74%, median age 42 years, median time on ART 3.9 years), 302 (17.7%) had been tested for HBsAg prior to the study. The proportion of HBV-tested patients ranged from 0.8 to 72.5% according to the individual hospital (p < 0.001). HBV testing was lower in women (adjusted odds ratio [aOR] 0.64, 95% confidence interval [CI] 0.46–0.89, p = 0.010) and higher in patients who initiated ART in 2010 or later (aOR 1.66, 95% CI 1.23–2.27, p < 0.001). Of 159 HBsAg-positive patients at the time of the study (9.3%), only 97 (61.0%) received Tenofovir + Lamivudine (or Emtricitabine). Of 157 coinfected patients, 114 (72.6%) had a HBV viral load < 10 IU/mL. HBV suppression was higher in patients with a HIV viral load < 300 copies/mL (aOR 3.46, 95% CI 1.48–8.09, p = 0.004) and lower in patients with increased ALT level (aOR 0.86 per 10 IU/mL increase, 95% CI 0.75–0.97, p = 0.019). Conclusions A substantial proportion of HIV/HBV coinfected patients were at higher risk of liver disease progression. Improving the management of HBV infection in the routine healthcare setting in Africa is urgently required in order to achieve the 2030 elimination targets. Micro-elimination of HBV infection in people living with HIV could be an easier and cost-effective component than more widely scaling up HBV policies.https://doi.org/10.1186/s12879-020-4784-7AfricaHBVHIVTestingTreatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florian Liégeois Sylvie Boyer Sabrina Eymard-Duvernay Patrizia Carrieri Charles Kouanfack Jenny Domyeum Gwenaëlle Maradan Jacques Ducos Eitel Mpoudi-Ngolé Bruno Spire Eric Delaporte Christopher Kuaban Laurent Vidal Christian Laurent for the EVOLCAM study group |
spellingShingle |
Florian Liégeois Sylvie Boyer Sabrina Eymard-Duvernay Patrizia Carrieri Charles Kouanfack Jenny Domyeum Gwenaëlle Maradan Jacques Ducos Eitel Mpoudi-Ngolé Bruno Spire Eric Delaporte Christopher Kuaban Laurent Vidal Christian Laurent for the EVOLCAM study group Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) BMC Infectious Diseases Africa HBV HIV Testing Treatment |
author_facet |
Florian Liégeois Sylvie Boyer Sabrina Eymard-Duvernay Patrizia Carrieri Charles Kouanfack Jenny Domyeum Gwenaëlle Maradan Jacques Ducos Eitel Mpoudi-Ngolé Bruno Spire Eric Delaporte Christopher Kuaban Laurent Vidal Christian Laurent for the EVOLCAM study group |
author_sort |
Florian Liégeois |
title |
Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) |
title_short |
Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) |
title_full |
Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) |
title_fullStr |
Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) |
title_full_unstemmed |
Hepatitis B testing, treatment, and virologic suppression in HIV-infected patients in Cameroon (ANRS 12288 EVOLCAM) |
title_sort |
hepatitis b testing, treatment, and virologic suppression in hiv-infected patients in cameroon (anrs 12288 evolcam) |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-01-01 |
description |
Abstract Background Hepatitis B is a major concern in Africa, especially in HIV-infected patients. Unfortunately, access to hepatitis B virus (HBV) testing and adequate treatment remains a challenge in the continent. We investigated HBV testing, treatment, and virologic suppression in HIV-infected patients followed up as part of Cameroon’s national antiretroviral programme. Methods A cross-sectional survey was performed in adult patients receiving antiretroviral therapy (ART) in 19 hospitals in the Centre and Littoral regions in Cameroon. The proportions of patients tested for hepatitis B surface antigen (HBsAg) prior to the study were compared among all study hospitals using the Chi-square test. The association of individual and hospital-related characteristics with HBV testing and virologic suppression was assessed using multilevel logistic regression models. Results Of 1706 patients (women 74%, median age 42 years, median time on ART 3.9 years), 302 (17.7%) had been tested for HBsAg prior to the study. The proportion of HBV-tested patients ranged from 0.8 to 72.5% according to the individual hospital (p < 0.001). HBV testing was lower in women (adjusted odds ratio [aOR] 0.64, 95% confidence interval [CI] 0.46–0.89, p = 0.010) and higher in patients who initiated ART in 2010 or later (aOR 1.66, 95% CI 1.23–2.27, p < 0.001). Of 159 HBsAg-positive patients at the time of the study (9.3%), only 97 (61.0%) received Tenofovir + Lamivudine (or Emtricitabine). Of 157 coinfected patients, 114 (72.6%) had a HBV viral load < 10 IU/mL. HBV suppression was higher in patients with a HIV viral load < 300 copies/mL (aOR 3.46, 95% CI 1.48–8.09, p = 0.004) and lower in patients with increased ALT level (aOR 0.86 per 10 IU/mL increase, 95% CI 0.75–0.97, p = 0.019). Conclusions A substantial proportion of HIV/HBV coinfected patients were at higher risk of liver disease progression. Improving the management of HBV infection in the routine healthcare setting in Africa is urgently required in order to achieve the 2030 elimination targets. Micro-elimination of HBV infection in people living with HIV could be an easier and cost-effective component than more widely scaling up HBV policies. |
topic |
Africa HBV HIV Testing Treatment |
url |
https://doi.org/10.1186/s12879-020-4784-7 |
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