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Globally, 35 million people are living with HIV (PLHIV) and 257 million have chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, EMBASE and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorised by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 6.1% (IQR 4.0-9.9%) in PLHIV, or 2.6 million HIV-HBsAg co-infections (IQR 1.9-4.2). The greatest burden (69% of cases; 1.9 million) is in Sub-Saharan Africa. Globally there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6-7%), but slightly higher among PWID (11.8% IQR 6. 0-16.9%). Odds of HBsAg infection is 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in Sub-Saharan Africa. Findings highlight the importance of specific targeting PLHIV for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of HIV treatment for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBsAg co-infection and reduce mother-to-child transmission of HBV alongside HIV.
This article was published in the following journal.
Name: Journal of viral hepatitis
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Measure of the burden of disease using the disability-adjusted-life-year (DALY). This time-based measure combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health. The metric was developed to assess the burden of disease consistently across diseases, risk factors and regions.
Increase in the temperature of the atmosphere near the Earth's surface and in the troposphere, which can contribute to changes in global climate patterns.
Termination of all transmission of infection by global extermination of the infectious agent through surveillance and containment (From Porta, A Dictionary of Epidemiology, 5th ed).
The constant presence of diseases or infectious agents within a given geographic area or population group. It may also refer to the usual prevalence of a given disease with such area or group. It includes holoendemic and hyperendemic diseases. A holoendemic disease is one for which a high prevalent level of infection begins early in life and affects most of the child population, leading to a state of equilibrium such that the adult population shows evidence of the disease much less commonly than do children (malaria in many communities is a holoendemic disease). A hyperendemic disease is one that is constantly present at a high incidence and/or prevalence rate and affects all groups equally. (Last, A Dictionary of Epidemiology, 3d ed, p53, 78, 80)
A multi- and interdisciplinary field concerned with improving health and achieving equity in health for all people. It transcends national boundaries, promotes cooperation and collaboration within and beyond health science fields, and combines population-based disease prevention with individually-based patient care.
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AIDS and HIV
AIDS; Acquired Immune Deficiency Syndrome. HIV; Human Immunodeficiency Virus HIV infection causes AIDS. HIV infection also causes the production of anti-HIV antibodies, which forms the test for HIV in patients. People who have the HIV antibodies are ...