Rates of hepatitis B among people living with HIV more than double estimated rates across general population globally, study finds

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More than 8% of people living with HIV worldwide also live with hepatitis B virus, a disease that increases death rates and accelerates liver damage among them, a study reported in Clinical Infectious Diseases found. About a quarter of those living with both infections have active replication of the hepatis B virus, that is likely to be transmitted.

The findings, showing an estimated 3.1 million people living with HIV (8.5% of the approximately 36.9 million people living with HIV in 2017) from an analysis of reports from around the world on regional rates of HBV among people living with HIV, as well as on rates of the diseases among specific populations, represent more than double the overall estimate of global HBV prevalence, of 3.5%. HIV and HBV are both blood-borne viruses that can be transmitted sexually, from mother to child and by exposure to blood carrying the virus. Having

The authors examined studies produced between 1990 and 2017 from regions around the world, and found gaps, with the fewest studies in some of the most regions with highest prevalences and among populations with the greatest risks of infection. The latter includes people who are incarcerated, people who earn income through sex work, people who inject drugs, and men who have sex with men, who are at high risks of infection and face the most barriers to services. The regions with the highest rates of co-infection of the two viruses were sub-Saharan Africa, home to nearly three quarters of all co-infected people, as well as Asia and the South Pacific. Together the three regions of Eastern and Southern Africa, Western and Central Africa and Asia and the South Pacific account for 90 percent of all co-infections. Places with the weakest services to prevent mother to child transmission of HBV had the highest rates of co-infection. The more limited a countries resources overall, including weak health systems, education and income levels, the higher the rates of co-infection, the authors found.

The finding indicates needs for both resources and strategies to test all people with HIV for HPV, vaccinate all people with HIV with negative HBV test results, andprovide appropriate treatment for both viruses, including with tenofovir, which can help reduce transmissions of HBV, write the authors, led by Dr. Jean Joel Bigna of the University of Yaoundé in Cameroon.

Their study is accompanied in Clinical Infectious Diseases by a commentary Hepatitis B infection in people living with HIV – a global challenge needing more research.

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