Hepatitis B Virus Co-infection Research Articles

A new co-infection model for HBV and HIV with vaccination and asymptomatic transmission using actual data from Taiwan

The co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B virus (HBV) poses a major threat to public health due to their combined negative impacts on health and increased risk of complications. A novel fractional mathematical model of the dynamics of co-infection between HBV and HIV for Taiwan is presented in this paper. Detailed analyses are conducted on the possible impact of HBV vaccination on the dynamics of HBV and HIV co-infection. The next-generation matrix technique is used to calculate the fundamental reproduction number R 0 = max{R 1, R 2}, where R 1 and R 2 are the reproduction numbers for HBV and HIV, respectively. The disease-free and endemic equilibria of the co-infection model are calculated. An extensive investigation is carried out to determine the local and global stability of the disease-free equilibrium point through Rough Hurtwiz criteria and the construction of Lyapunov function, respectively. We demonstrate that when R 1 < 1 < R 2, HBV infection is eradicated, but HIV remains prevalent. If R 2 < 1 < R 1, the opposite outcome occurs. The real data from 2000-2023 for Taiwan is used to fit the model. The fitting results show how effectively our model handles the data. In addition, numerical simulations are run for different scenarios to observe how the vaccine and fractional parameters changed the model state variables, as well as how the solutions behaved and how quickly they reached the model’s equilibrium points. According to the model’s numerical analysis, greater vaccination efforts against HBV have a positive effect on the propagation of co-infection.

Prevalence of HBV Co-infections with HCV and HIV among Blood Donors in Ado-Ekiti, Ekiti State, Nigeria

Blood is a life-saving resource. Despite the significance of blood transfusion in saving a millions life in emergencies and medical treatment, the safety of blood transfusion faced challenges of transmitting life threatening transfusion transmissible infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). The study was carried out to determine the sero-prevalence of HBV, HCV, HIV and co-infections among blood donors in Ado-Ekiti, Nigeria. A total of five hundred (500) prospective blood donors age ranged from 18 to 60 years attending Ekiti State University Teaching Hospital between May to November, 2019 were recruited for the study. Prospective study was based on questionnaires administered to generate socio-demographics and a 5ml venous blood samples were obtained from each blood donors and the plasma was used for determination of hepatitis B surface antigen (HBsAg) and anti-HCV using immunoassay rapid test kit (RTK) Diaspot, Belgium and HIV-1 and HIV-2 Determine Alere Medical ,Japan and further tested with enzyme linked immunosorbent assay (ELISA) Biorad Monolisa, France). The prevalence of HBV, HCV and HIV were 4.8%, 1.2% and 1.8% respectively, while co-infections with HBV/ HIV and HBV/HCV were 0.2% and 0.2% respectively and there was no case of triple infections among the blood donors. The incidence rate was high in HBV followed by HIV and HCV. The use of RTK and ELISA for screening of blood donor for HBsAg, anti HCV and HIV in terms of their sensitively and specificity showed that ELISA is more sensitive than RTK while RTK is more specific than ELISA. From the retrospective study age and gender distribution was not statistically significant (P &gt; 0.05). A significance difference was observed between married blood donors and HIV infection (P &lt; 0.05) and also blood donors with history of blood transfusion showed statistical significant to HBV and HCV (P &lt; 0.05). The prevalence of HBV, HCV and HIV infections among blood donors were found to be statistically associated with smoking, alcohol consumption, surgical operation, multiple sex partners and tattooing (P &lt; 0.05). This study shows that the prevalence of HBV infection in Ado-Ekiti, Ekiti State ,Nigeria was higher than HCV and HIV, hence there is need to increase public awareness of the socio-cultural practices that contribute to the transmission of infection.

Seroprevalence and co-infection of HBV, HCV, and HIV among patients visiting selected hospitals in Anyigba, Kogi State

ABSTRACT Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) remain a public health challenge globally. This study determined the prevalence and coinfection of HBV, HCV, and HIV among patients visiting Maria Goretti Hospital, Grimard Catholic Hospital, and Good News Hospital Anyigba, Kogi State. In a cross-sectional study, sera samples collected from 400 consenting patients were screened for HBV, HCV, and HIV using commercial immunodiagnostic test kits. Of the 400 subjects, 12 (3.0%), 4 (1.0%), and 16 (4.0%) were infected with HBV, HCV, and HIV, respectively. One participant was co-infected with HCV and HIV, while none was simultaneously infected with HBV and HIV. Participants aged 11–20 years had higher hepatitis B-surface antigenemia, while ages 21–30 years and 31–40 years had higher prevalence of HCV and HIV, respectively. Contrary to HBV and HCV positivity, HIV seropositivity was significantly predicted by the ages of exposure (p = 0.002). Males and females were equally infected with HBV (3.0% each), while more males than females were infected with HCV (1.5%) and HIV (4.6%). However, the difference between the occurrence of viral infections and patients’ sex was not significant (p > 0.05). The single participants were more predisposed to HBV while the married subjects had more HCV and HIV mono-infection. However, neither the occurrence of HBV nor HCV or HIV was significantly predicted by the marital status of the individuals (p > 0.05). Subjects with no formal education had a higher positivity rate of HCV and HIV compared to other levels of education, while the tertiary level of education had higher exposure to HBsAg. Occupationally, students were more predisposed to HBV and HCV, while the unemployed participants were more predisposed to HIV. However, neither education nor the occupation of participants was significantly related to any of the viral infections (p > 0.05). Lack of knowledge of disease prevention significantly influenced the occurrence of HBV (p = 0.02), HCV (p = 0.04), and HIV (p = 0.04). Conclusively, the status of HBV, HCV, and HIV infection is low compared with findings of previous epidemiological studies in the area. However, the continuous circulation of the three viral infections and the high disease occurrence in the poorly informed participants suggest the need for increased public health education about infection control and prevention strategies in the area.

Prospective study of hepatitis B and D epidemiology and risk factors in Romania: A 10-year update.

The global burden of hepatitis D virus (HDV) infection represents a major medical challenge and a public health crisis worldwide. However, there is a lack of accurate data on the epidemiology and risk factors for HDV. Hepatitis B virus (HBV) and HDV coinfection causes the most severe form of viral hepatitis, leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection, including the need for liver transplantation and death. To investigate the epidemiology, natural history, risk factors and clinical management of HBV and HDV coinfection in Romanian patients. This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in Romania. All consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were enrolled. Patients with acute hepatitis or incomplete data were excluded. Of the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period, 963 met the inclusion criteria. Testing for anti-HDV antibodies and HDV RNA was performed for all participants. Demographic and risk factor data were collected by investigators using medical charts and patient questionnaires. All data were stored in an anonymized online database during the study. The prevalence of HBV was 3.8%; among these patients, the prevalence of HBV/HDV coinfection was 33.1%. The median age of the study population was 54.0 years, and it consisted of 55.1% men. A higher prevalence of HBV/HDV coinfection was observed in patients 50-69 years old. Patients with HBV/HDV coinfection were significantly older than those with HBV monoinfection (P = 0.03). Multivariate multiple regression analysis identified female gender (P = 0.0006), imprisonment (P < 0.0001), older age at diagnosis (P = 0.01) and sexual contact with persons with known viral hepatitis (P = 0.0003) as significant risk factors for HDV. This study shows that HDV infection among those with HBV remains endemic in Romania and updates our understanding of HDV epidemiology and associated risk factors. It emphasizes the need for systematic screening for HDV infection and collaborative initiatives for controlling and preventing HBV and HDV infection.

Seroprevalence of Hepatitis B and C Viruses and Their Associated Factors Among Military Personnel at Military Camps in Central Gondar, Ethiopia: A Cross-Sectional Study.

Globally, viral hepatitis is a leading cause of death and is highly prevalent in Ethiopia. Military personnel are more vulnerable to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and there are no data on such populations in the study area. Therefore, this study aimed to determine the seroprevalence of HBV and HCV infections and their associated factors among military personnel in military camps in Central Gondar, Ethiopia. This institutional-based cross-sectional study was conducted with 277 military personnel from April to August 2022 at military camps in Central Gondar, Ethiopia. A systematic random sampling technique was used to select the study participants. Sociodemographic and other relevant data were collected using a structured questionnaire. Five milliliters of venous blood were collected using a vacutainer tube and tested for hepatitis B surface antigens and anti-hepatitis C virus antibodies using an enzyme-linked immunosorbent assay. Data were analyzed using STATA version 14 software and logistic regression models were used to determine the association between HBV/HCV infection and risk factors. Out of 277 participants, the overall seroprevalence of HBV and HCV infections was 19 (6.9%) and 9 (3.3%), respectively. The rate of HBV and HCV co-infection was 2 (0.7%). Having multiple sexual partners (p = 0.048), frequent alcohol use (p = 0.034), hospitalization (p = 0.014), and history of receiving injections from traditional practitioners (p = 0.040) were significant predictors of HBV infection. In contrast, a history of blood transfusion (p = 0.048) and sexually transmitted infections (p = 0.039) were significant risk factors for HCV infection. An intermediate prevalence of HBV and HCV infections was observed among the military personnel. Continuous screening, adherence to healthcare service guidelines, and strengthening of vaccination are crucial for preventing HBV and HCV infections.

Co-infections of malaria and hepatitis B among pregnant women in Igbo-Eze North LGA of Enugu State, Nigeria

Acute hepatitis B virus (HBV) and malaria infections pose serious health risks to the general population and may worsen victims' physical and financial well-being. The objective of this study was to determine the frequency of HBV and malaria co-infections during LGA among expectant mothers. This study used a cross-sectional, prospective design. Blood samples were collected from both pregnant and non-pregnant women for parasitological and serological examinations in the study area. This was performed to compare the severity of infections between pregnant and non- pregnant women, as pregnant women are more susceptible to infections. The study included 50 women who attended antenatal care at the time of this project and 10 non-pregnant women who came to the hospitals for check-ups. Samples of people aged 18 to 52 years were collected. Age groups of 18-28 and 40-50 years had the greatest 30(50%) and lowest 8(13%) populations of women screened for malaria and hepatitis B co-infection, respectively. The 1st and 3rd trimesters were followed by the 2nd trimester, which had the highest prevalence. Only the second trimester had a 2% prevalence rate of hepatitis B. Farmers were the group most likely to contract malaria (92%). The percentage of government employees who had malaria and hepatitis B was the highest 20%), followed by traders (5%). Ogrute, the seat of the Local Government had a high rate of malaria infection despite having several medical facilities and less farming activities. Olido (25%), followed by Ogrute (14 point 3%), had the highest rate of co-infection with hepatitis B and malaria. The PCV ranges of 25–27(100%) and 28–30(100%) had the highest prevalence of malaria. This study shows how persistent malaria and hepatitis B are also associated with decreased packed cell volume (PCV) in pregnant women.

Seroprevalence and risk factors of HBV, HCV and HIV among hemodialysis patients: a multicenter cross-sectional study from Damascus Syria

ObjectiveThe aim of this study is to determine the prevalence rates of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among hemodialysis (HD) patients as well as to identify associated risk factors.MethodologyA multicenter cross-sectional study involved patients who had been on HD for at least three months. The study was conducted at five HD centers in Damascus, Syria from August 2019 to September 2021. HBsAg, HCV-Ab and HIV (antibody/antigen) seropositivity were identified using the third generation ELISA technique. Patients’ information was extracted from their records and by face-to-face interview. Multiple logistic regression models were applied to identify risk factors associated with HBV or HCV seropositivity. The significance level was set at 5%.ResultsA total of 637 patients were included in the study with a mean age (SD) of 50.5 (15.6) years and 56.7% of them were men. The dialytic age ranged from one to thirty years with a mean (SD) of 6.10 (5.6) years. The prevalence of positive hepatitis B surface antigen, anti-HCV, co-infection of HBV and HCV, and anti-HIV (antibody/antigen) were 3.2%, 22.1%, 0.7%, and 0%, respectively. After controlling for co-variables, hepatitis B vaccine was the only predictor of seropositivity of HBV (OR: 0.15, 95% CI: 0.057–0.393, P < 0.001), as it significantly protected against contracting HBV. On the other hand, the dialytic age (OR: 1.42, 95% CI: 1.12–1.94, P = 0.032) and the dialysis center were significant factors affecting the prevalence of HCV.ConclusionsThe prevalence of HCV and HBV infections among HD patients in Damascus, Syria has decreased remarkably compared with the results from 2001. Nevertheless, it is still considered relatively high. Thus, there is an urgent need to strengthen the prevention and control measures for viral infection transmission in HD centers in Damascus.

Characteristics of Hepatitis B Virus, Hepatitis C Virus, and Syphilis Coinfection in People With HIV/AIDS Contracted Through Different Sources: Retrospective Study.

The burden of hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis coinfections remains disproportionately high among people living with HIV/AIDS. Hubei province is located in central China, where there are distinct regional characteristics of the distribution of people living with HIV/AIDS acquired via diverse transmission routes and the AIDS epidemic itself. We aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission. From January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men. Among 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission. In people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.

Severity and Mortality in Covid-19 With Hepatitis B Co-Infection A Systematic Review and Meta-Analysis

This systematic review and meta-analysis investigate the severity and mortality in COVID-19 patients coinfected with Hepatitis B Virus (HBV). Utilizing established databases and adhering to PRISMA guidelines, 15 studies were included after a rigorous selection and data extraction process, with quality assessed using the Newcastle–Ottawa Scale (NOS). Statistical analysis was conducted using Review Manager (RevMan) software. The findings indicate a significantly higher risk of severe clinical outcomes and mortality in COVID-19 patients with HBV co-infection compared to those without HBV. Among patients with both HBV and COVID-19, 30.2% developed severe clinical outcomes, compared to 19.5% in COVID-19 patients without HBV. Mortality rates were also higher in the co-infected group (4.9%) compared to those with only COVID-19 (3.4%). The study notes considerable heterogeneity among the included studies, as indicated by high I2 values. These results align with previous findings on the impact of chronic liver diseases on COVID-19 outcomes but contrast with some studies suggesting a potential protective effect of HBV. The analysis also considers the complexities of managing COVID-19 in HBV patients, particularly the risks associated with corticosteroid therapy and HBV reactivation, while acknowledging limitations such as variability in methodologies and potential publication biases. The study underscores the heightened severity and mortality risks for COVID-19 patients with HBV co-infection, emphasizing the need for tailored management strategies and further research into the mechanisms and optimal treatment protocols for this patient population.

Hepatitis B virus coinfection in patients treated for chronic hepatitis C: clinical characteristics, risk of reactivation with long-term follow-up, and effectiveness of antiviral therapy.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) share a similar transmission route, which increases coinfection odds and worsens clinical outcomes. Our aim was to investigate coinfected patients undergoing HCV treatment with direct-acting antivirals (DAAs) to understand their characteristics, risk of HBV reactivation, and effectiveness of the therapy. Our study comprehensively analyzed 1118 patients with chronic HCV infection, divided into 3 subgroups based on their HBV status. We documented that 0.7% of the analyzed population was positive for hepatitis B virus surface antigen (HBsAg), while 14.3% had evidence of a past HBV infection. The patients without HBV coinfection were less burdened with comorbidities, and were mostly treatment-naive, while the individuals suffering from coinfection were younger and more likely to have a history of a previous therapy. Infection with HCV genotype 3 was more common among the HBsAg-positive patients than in the other studied groups. Response to DAA therapy was comparable between the groups, and most patients completed the course of treatment as planned. Only 3 cases of HBV reactivation were observed, all of which achieved sustained virologic response after DAA therapy. Two were women on immunosuppressants with antihepatitis B core positive antibodies, and the third patient was an HBsAgpositive man. These patients remained in long-term follow-up. Neither the presence of HBV markers nor HBV reactivation during DAA treatment reduced effectiveness of the therapy. Our findings are important for future recommendations and guidelines on managing HBV/HCV coinfection.

Seroepidemiology of Asymptomatic Plasmodium falciparum CoInfections with Hepatitis B And C Virus among Blood Donors in Modakeke Area Office, Ile Ife, Osun State, Nigeria

Despite the remarkable achievements in the reduction of malaria mortality, the disease had remained the most common cause of morbidity and mortality. Infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) might associate with increased mortality rate as the infections may predisposes to the development of serious liver diseases such as liver cirrhosis, liver failure and hepatocellular carcinoma (HCC). The aim of the present study was to determine the Asymptomatic Plasmodium falciparum co-infections with hepatitis B and C viruses among blood donors in Modakeke Area Office, Ile Ife, Osun State, Nigeria. The study was conducted in Modakeke Area Office, Ile Ife, Osun State. The study was conducted in Modakeke health facility, Ile Ife, Osun State. Five (5) ml of venous blood was obtained from each of 400 blood donors into plain bottles and labeled accordingly. Thick and thin films of the donor’s blood samples were made on slides dried for five minutes at 37°C then stained using Giemsa stain. The slides were then examined microscopically for presence and densities of malaria parasites. Species identification and determination of the Hematological parameters were also conducted on the slides. Sera were separated from the remaining aliquots of the blood and screened for hepatitis-B and C surface antigens (HBsAg and anti-HCV). The overall mean parasitaemia of malarious blood donors was 786.20µl/blood while that of blood donors with hepatitis virus infection was 53 representing 13.3% of the total donor examined. Donors infected with HBV, HCV and co-infection of HBV and HCV had viraemia of 25 (6.3%), 21 (5.3%) and 7(1.8%) respectively. Among the age groups, high prevalence of Hepatitis viral infection rate of 57.9% was recorded among aged group 18-26 years. The infection rate of 15.8%, 13.6% and 10.5% of HBV, HCV was recorded from age group 18-26years respectively. The highest co-infection rate of HBV and HCV of 18.8% was recorded from age group 54-62years, while high mean malaria parasitaemia of 1,882.78 (µl of blood) was also recorded among donors aged 18-26 years. High hepatitis viral infection rate of 22.2% with 16.7% of HCV were recorded among females, while 6.3% of HBV and 1.9% of co-infection was observed among males and the mean malaria parasitaemia of 2,382.80 µl of blood was observed among females. High prevalence of Hepatitis infection rate of 17.1%, 8.6% of HCV, (6.3%) of HBV and 2.3% of co-infection were recorded among single donors. The mean malaria parasitaemia of 786.89 (µl of blood) was observed among married donors, there was significant difference between marital status and hepatitis infection (p= 0.0043) and between HCV (p=0.009). High prevalence of hepatitis viraemia of 21.4% and co-infection 5.6% was recorded among artisans, while 14.6% HBV infection rate was recorded among civil servants and 14.3% of HCV was recorded among donors who are farmers. The mean malaria parasitaemia of 1,150.15 µl/blood was recorded among donors who are traders. Donors that have acquired primary education have high prevalence of hepatitis infection rate of 38.5%, with 15.4% of HBV and (23.1%) co-infection (HBVand HCV). HCV (6.7%) was high among donors with secondary education; high mean malaria parasitaemia of 2,096.84 µl of blood was recorded among donors with primary education. Blood B+ve had high hepatitis viral infection rate of 21.7%, HCV 13.0% and co-infection of 5.8% while 7.8% of HBV was recorded among O+ve donors. The mean malaria parasitaemia of 1,378.50 (µl of blood) was recorded among B-ve donors. The total mean PCV in the study was 42.63, White blood cell count was 5,281.25, lymphocytes count was 42.88, eosinophils was 1.53 and neutrophil count was 55.72. The total percentage of elevated AST was 5.0%, ALT was 6.0% and ALB was 10.5%. There was significant difference between malaria and ALT (p=0.000) also, there was significant difference between HCV and ALB (p=0.000). There was significant difference between HBV and AST (p=0.001), ALT (p=0.028) and ALB (p=0.028).The hepatitis viral infection had significant difference with ALB (p=0.000). The logistic regression shows that there was an association between hepatitis viral infection and aged group 27-35years (p=0.022), female (p=0.006), trading (p=0.001), tertiary (p=0.003) A+ve (p=0.018) and B+ve (p=0.001). In conclusion, Although, the prevalence of malaria was low, while that of hepatitis viral infection was high in the local government area, critical screening of blood donors is of prime importance because they serve as an asymptomatic reservoirs and a potential source of transmission of these infections. The strengthening of creating awareness on the general public regarding Malaria, HBV and HCV transmission and prevention should be embarked on.

390. Corticosteroid Treatment in Severe Patients with SARS-CoV-2 and Chronic HBV Co-infection: A Retrospective Multicenter Study

Abstract Background The impact of corticosteroids on patients with severe coronavirus disease 2019 (COVID-19)/chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate the association of corticosteroids with these patients. Methods This retrospective multicenter study screened 5447 confirmed COVID-19 patients hospitalized between Jan 1, 2021, to December 1, 2022, in three centers in India, where the prevalence of chronic HBV infection is moderate to high. Severe patients who had chronic HBV and acute SARS-CoV-2 infection were potentially eligible. The diagnosis of chronic HBV infection was based on positive testing for hepatitis B surface antigen (HBsAg) or HBV DNA during hospitalization and a medical history of chronic HBV infection. Severe patients (meeting one of the following criteria: respiratory rate &amp;gt; 30 breaths/min; severe respiratory distress; or SpO2 ≤ 93% on room air; or oxygen index &amp;lt; 300 mmHg) with COVID-19/HBV co-infection were identified. The bias of confounding variables on corticosteroid effects was minimized using a multivariable logistic regression model and inverse probability of treatment weighting (IPTW) based on the propensity score. Results The prevalence of HBV co-infection in COVID-19 patients was 4.1%. There were 105 patients with severe COVID-19/HBV co-infections (median age 62 years, 57.1% male). Fifty-five patients received corticosteroid treatment and 50 patients did not. In the multivariable analysis, corticosteroid therapy (OR, 6.32, 95% CI 1.17-34.24, P = 0.033) was identified as an independent risk factor for 28-day mortality. With IPTW analysis, corticosteroid treatment was associated with delayed SARS-CoV-2 viral RNA clearance (OR, 2.95, 95% CI 1.63-5.32, P &amp;lt; 0.001), increased risk of 28-day and in-hospital mortality (OR, 4.90, 95% CI 1.68-14.28, P = 0.004; OR, 5.64, 95% CI 1.95-16.30, P = 0.001, respectively), and acute liver injury (OR, 4.50, 95% CI 2.57-7.85, P &amp;lt; 0.001). Methylprednisolone dose per day and cumulative dose in non-survivors were significantly higher than in survivors. Conclusion In patients with severe COVID-19/HBV co-infection, corticosteroid treatment may be associated with an increased risk of 28-day and in-hospital mortality. Disclosures All Authors: No reported disclosures

Interaction between hepatitis B, hepatitis C and smoking in the development of hepatocellular carcinoma: a systematic review and meta-analysis.

This meta-analysis reports the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), smoking and their combined impact on the development of hepatocellular carcinoma (HCC). We conducted a systematic search of PubMed, Web of Science and Scopus databases up to 15 July 2023. Observational studies investigating the association between HBV, HCV and smoking in the development of HCC were included. We assessed between-study heterogeneity using the I2 statistics. The effect sizes were estimated as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. Out of 20794 studies identified in the initial search, 32 observational studies involving 22282 participants met the inclusion criteria. Our meta-analysis showed that the combined impact of HBV and smoking was associated with an OR of 19.81 (95% CI: 14.77, 26.58), HCV and smoking was associated with an OR of 24.86 (95% CI: 12.41, 49.79), and coinfection of HBV and HCV was associated with an OR of 32.58 (95% CI: 20.57, 51.60). Our findings indicate a significant interaction between HBV, HCV and smoking in the development of HCC and highlight the importance of addressing smoking cessation and viral hepatitis prevention and treatment as potential strategies for reducing HCC.

A Tale of Two Viruses: Seroepidemiological and a Cross-Sectional Insights into HIV/HBV Coinfection in Selected Hospitals in Rivers State, Nigeria

Background: Hepatitis B virus (HBV), a circular DNA virus with humans serving as the only reservoir, remains a worldwide public health problem. The similarity in transmission routes for HBV and HIV makes co-infection very common. Thus, this study aimed at unveiling the seroepidemiological patterns of HBV coinfections among HIV-infected individuals in some selected hospitals in Rivers State, Nigeria. Materials and methods: A cross-sectional study was conducted on 350 HIV-infected individuals attending ART clinics at selected hospitals in Rivers State, Nigeria. Sociodemographic data were collected based on interviewer-based questionnaire, and clinical history was obtained from participants' medical records. Serological analysis for HBsAg was done using ELISA method. Results: Of the 350 HIV-infected patients, 9(2.6%) were positive for HBsAg. The majority of HIV/HBV coinfected participants were in age groups &gt;41 (3.7%), females (2.9%), singles (3.0%), tertiary education holders (3.5%), and business owners (1.1%) as shown in Table 1. Furthermore, immunological and virological markers analysis revealed that HBV seropositivity is more common with patients having CD4 count of 350-499 cells/mm3 (6.2%) and viral loads as target not detected (TND) with 5.4%. Conclusion: This study observed an HIV/HBV coinfection rate of 2.6% which has further confirmed the persistence of HIV/HBV co-infection in Rivers State, Nigeria. Ongoing and persistent public health interventions among the study population are thereby advocated.

Analysis of HBV and COVID-19 Coinfection Model with Intervention Strategies.

Coinfection of hepatitis B virus (HBV) and COVID-19 is a common public health problem throughout some nations in the world. In this study, a mathematical model for hepatitis B virus (HBV) and COVID-19 coinfection is constructed to investigate the effect of protection and treatment mechanisms on its spread in the community. Necessary conditions of the proposed model nonnegativity and boundedness of solutions are analyzed. We calculated the model reproduction numbers and carried out the local stabilities of disease-free equilibrium points whenever the associated reproduction number is less than unity. Using the well-known Castillo-Chavez criteria, the disease-free equilibrium points are shown to be globally asymptotically stable whenever the associated reproduction number is less than unity. Sensitivity analysis proved that the most influential parameters are transmission rates. Moreover, we carried out numerical simulation and shown results: some parameters have high spreading effect on the disease transmission, single infections have great impact on the coinfection transmission, and using protections and treatments simultaneously is the most effective strategy to minimize and also to eradicate the HBV and COVID-19 coinfection spreading in the community. It is concluded that to control the transmission of both diseases in a population, efforts must be geared towards preventing incident infection with either or both diseases.

Hepatitis B care cascade among people with HIV/HBV coinfection in the North American AIDS Cohort Collaboration on Research and Design, 2012-2016.

A care cascade is a critical tool for evaluating delivery of care for chronic infections across sequential stages, starting with diagnosis and ending with viral suppression. However, there have been few data describing the hepatitis B virus (HBV) care cascade among people living with HIV infection who have HBV coinfection. We conducted a cross-sectional study among people living with HIV and HBV coinfection receiving care between January 1, 2012 and December 31, 2016 within 13 United States and Canadian clinical cohorts contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). We evaluated each of the steps in this cascade, including: 1) laboratory-confirmed HBV infection, 2) tenofovir-based or entecavir-based HBV therapy prescribed, 3) HBV DNA measured during treatment, and 4) viral suppression achieved via undetectable HBV DNA. Among 3,953 persons with laboratory-confirmed HBV (median age, 50 years; 6.5% female; 43.8% were Black; 7.1% were Hispanic), 3,592 (90.9%; 95% confidence interval, 90.0-91.8%) were prescribed tenofovir-based antiretroviral therapy or entecavir along with their antiretroviral therapy regimen, 2,281 (57.7%; 95% confidence interval, 56.2-59.2%) had HBV DNA measured while on therapy, and 1,624 (41.1%; 95% confidence interval, 39.5-42.6) achieved an undetectable HBV DNA during HBV treatment. Our study identified significant gaps in measurement of HBV DNA and suppression of HBV viremia among people living with HIV and HBV coinfection in the United States and Canada. Periodic evaluation of the HBV care cascade among persons with HIV/HBV will be critical to monitoring success in completion of each step.

Analysis of Hepatitis D Virus in Minor Salivary Gland of Sjögren’s Disease

Hepatitis delta virus (HDV) has been detected in the minor salivary gland (MSG) tissue of Sjögren’s disease (SjD) patients in the absence of a hepatitis B virus (HBV) coinfection. Previous research has shown that HDV antigen (HDAg) expression can trigger an SjD-like phenotype in vivo, demonstrating a potential cause-and-effect relationship. We hypothesize that if HDV plays a role in the development of SjD, then HDV profiles may be correlated with disease manifestations. This retrospective study characterized HDV in a cohort of 48 SjD MSG samples collected between 2014 and 2021. Analyses of HDAg expression, including cell type and subcellular localization, in situ hybridization of HDV RNA, and comparative analyses with associated SjD and viral hepatitis clinical features, were conducted. HDAg was detected in MSG acinar, ductal, myoepithelial, and adipose cells and localized with the nuclei, cytoplasm, and mitochondria. In situ hybridization detected HDV genomic RNA localization in the MSG nuclei. A significant negative correlation was found between HDAg intensity and focal lymphocytic inflammation and in patients with both anti-SSA/Ro-52 and anti-SSA/Ro-60. In analyzing autoimmune disease comorbidities with SjD, it was found that SjD patients diagnosed with autoimmune thyroiditis and/or hypothyroidism were significantly more represented in the high HDAg intensity group compared to the negative and moderate HDAg intensity groups. No significant associations were detected between MSG-localized HDAg and liver enzymes or an evident HBV coinfection. This study has further confirmed that there is a nonhepatic reservoir for chronic HDV persistence in SjD-affected salivary gland tissue in a third independent SjD patient cohort. In addition, this study describes the unique colocalization of HDAg with mitochondria. The detection of HDV antigen and sequence within SjD-affected salivary gland tissue, and in the absence of an evident current or past HBV coinfection, warrants further investigation.

Burden of hepatitis B virus and syphilis co-infections and its impact on HIV treatment outcome in Ethiopia: nationwide community-based study

Background Hepatitis B virus (HBV) and syphilis have been the most common co-infections that hinder treatment outcomes and increase early mortality among people living with human immunodeficiency virus (PLHIV). In this study, we aimed to determine the burden of HBV and syphilis co-infections and its impact on treatment outcomes among PLHIV in Ethiopia. Methods We used data from the Ethiopian Population-based HIV Impact Assessment (EPHIA), which was a household-based national survey in 2017/2018. Human immunodeficiency virus (HIV) testing was done among 19,136 participants using the national testing algorithm and 662 participants (3.50%) were HIV positives who were further tested for viral hepatitis and syphilis co-infections using HBV surface antigen and Chembio DPP syphilis assay, respectively. Viral load, CD4 count and high-sensitivity C-reactive protein (hsCRP) were done to measure HIV treatment outcomes. Descriptive statistics were used to determine the burden of co-infections and a logistic regression model to evaluate the determinants of co-infections using STATA V17.0. Results Overall prevalence of HBV and syphilis co-infection was 5.5% and 2.2%, respectively. HBV and syphilis (double co-infection) was 5.9%. The highest prevalence of HBV co-infection was observed among 10–19 years age group (12.9%) and male participants (7.44%) while the highest syphilis co-infection was among people aged ≥50 years (3.5%) followed by age groups 40–49 (3.3%) and 10–19 years (3.2%). Syphilis co-infection was higher among males (5.2%) compared to females (1.1%). After adjusted regression analysis, HBV co-infected PLHIV had higher odds of virologic failure (AOR (95% confidence interval (CI)) = 6.3 (4.2–14.3)), immunosuppression (CD4 count < 500 cells/mm3) (AOR (95%CI) = 2.1(1.3–4.9)) and inflammation (hsCRP >10 mg/dL) (AOR (95%CI) = 9.2(4.3–14.6)). Immunosuppression was also significantly higher among syphilis co-infected PLHIV (AOR (95%CI) = 3.4 (1.3–5.2)). Conclusions Burden of HBV and syphilis co-infections is high particularly among male and adolescent PLHIV and these co-infections hinder virologic and immunologic outcome in Ethiopia. Hence, the program shall enhance HBV and syphilis testing and treatment.

Hepatitis C virus/Hepatitis B virus coinfection: Current prospectives.

In endemic areas, hepatitis C virus (HCV)/hepatitis B virus (HBV) coinfection is common, and patients with coinfection have a higher risk of developing liver disease such as hepatocellular carcinoma, liver fibrosis and cirrhosis. In such cases, HCV predominates, and HBV replication is suppressed by HCV. HCV core proteins and interferons that are activated by HCV are responsible for the suppression of HBV. Immunosuppression is also seen in patients with HCV and HBV coinfections. A decrease in HCV-neutralizing antibody response and circulation of Th1-like Tfh cells is observed in patients with HCV and HBV coinfection. Both viruses interacted in the liver, and treatment of HCV/HBV coinfection is genotype-based and complex due to the interaction of both viruses. In HCV-dominant cases, direct-acting antiviral drugs and peg interferon plus ribavirin are used for the treatment, with continuous monitoring of AST and ALT. HBV-dominant cases are less common and are treated with peg interferon and nucleoside nucleotide analogues with monitoring of AST and ALT. The SVR rate in HCV-HBV coinfection is higher than that in monoinfection when treated with direct-acting antiviral drugs. But there is a risk of reactivation of HBV during and after therapy. The rate of reactivation is lower in patients treated with direct-acting antiviral drugs as compared to those treated with peg interferon plus ribavirin. Biomarkers of HBV such as HBcrAg, HBV DNA and HBVpg RNA are not effective in the prediction of HBV reactivation; only the hepatitis B surface antigen titre can be used as a biomarker for HBV reactivation. HCV can also be reactive, but this is found in very rare cases in which HBV is present and is treated first.

High frequency of Lamivudine and Telbivudine resistance mutations in hepatitis B virus isolates from human immunodeficiency virus co-infected patients on highly active antiretroviral therapy in Bucaramanga, Colombia.

Hepatitis B virus (HBV) antiviral Resistance-Associated Mutations (RAMs) in human immunodeficiency virus (HIV) coinfected patients undergoing highly active antiretroviral therapy (HAART) are complex and incompletely understood. We aimed to determine the prevalence of HBV coinfection, HBV genotypes, and RAMs in a cohort of people living with HIV (PLWH) in the northeastern region of Colombia. This cross-sectional study was carried out between February 2013 and February 2014. Virological, immunological and HAART data were collected from clinical records. In-house nested PCR and Sanger sequencing of the HBV pol gene were used to identify coinfections, genotypes, RAMs and HBV s antigen (HBsAg) escape mutants. Among 275 PLWH, HBV coinfection was confirmed in 32 patients (11.6%), of whom nine (28.2%) were HBsAg positive (active hepatitis B), and 23 (71.8%) were occult hepatitis B infections (OBI). All HBV sequences (n = 23) belonged to the genotype F3. Among HIV/HBV coinfections, 71.9% had CD4+ T cell counts above 200 cells/mm3 and 37.5% had undetectable HIV viral loads. The RAMs rtL80I, rtL180M, and rtM204V, which confer resistance to Lamivudine/Telbivudine and partially resistant to Entecavir, were found in all HBV isolates. An unknown rt236Y mutation to Tenofovir was also identified. Most patients under HAART received first-generation HBV antiviral therapy with a low genetic barrier to resistance. Antiviral Drug-associated Potential Vaccine-escape Mutations (ADAPVEMs) in the S gene were observed in all isolates ranging from 1-20 amino acid substitutions. However, no vaccine escape mutants were detected. In Conclusion, these findings highlight the importance of HBV molecular screening, antiviral resistance monitoring and new guidelines for PLWH to overcome RAMs and prevent HBV-related liver disease.