2223. HBV infection in untreated HIV-infected adults in Maputo, Mozambique
Session: Poster Abstract Session: HIV and HBV
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • HBV Poster IDWeek 2017 final [Autosaved].pdf (466.4 kB)
  • Background:

    Patients coinfected with HIV and HBV are at higher risk of developing chronic HBV infection, cirrhosis and hepatocellular carcinoma. In Mozambique, where the HIV prevalence is among the highest in the world, the epidemiology of HBV and the profile of HBV resistance to 3TC in HIV-infected patients is barely known.

    Methods:

    A cross-sectional study was conducted between May and November 2012 at two health centers in Maputo, Mozambique, to consecutively enroll ART-naïve HIV-infected adults (AN-HIV). All participants were tested for hepatitis B surface antigen (HBsAg). CD4+T cells count and plasma HBV DNA, HBV genotyping and profile of HBV resistance mutations to 3TC were measured in all coinfected patients.

    Results:

    A total of 518 AN-HIV were enrolled. The median age was 33 years old and 66.8% were women. The median CD4+ T cells count was 361 cells/mm3 and 47 (9.1%) were coinfected with HBV (HBsAg+). Out of 46 coinfected patients, 24 (55.2%) had HBV DNA ≥ 20 - < 20 000 and 12 (26.1%) had HBV-DNA ≥20 000. APRI > 2.0 was reported in 4.3% of coinfected and FIB4 > 3.25 was reported in 4.4%. ALT and AST were within normal ranges in all HBsAg+patients. Genotype A was identified in 25/27 (92.6%) and genotype E in 2/27 (7.4%) of patients. No patient had 3TC-resistance mutation.

    Conclusion:

    Data from this study showed that HBV infection was prevalent among ART naïve HIV infected adults in Mozambique. The most frequent genotype of HBV was genotype A and no 3TC-resistance was detected. Overall, our data suggests that integration of screening of HBV into HIV care and treatment activities is needed to improve the health conditions of HIV/HBV coinfected patients.

    Table 1. Comparison of laboratory characteristics between coinfected and mono-infected patients

    Characterístics

    HIV +

    (n=471)

    HIV+/HBsAg +

    (n=47)

    p

    WHO Clinical Stage

    Stage I (%)

    210 (45.5)

    22 (46.8)

    Stage II (%)

    138 (29.9)

    14 (29.8)

    Stage III (%)

    109 (23.6)

    10 (21.3)

    Stage IV (%)

    4 (0.9)

    1 (2.1)

    0.848

    Median platelets count (IQR)

    226 (177 – 269)

    212 (176 – 286)

    0.278

    Median CD4+T – cell count, cells/mm3 (IQR)

    363 (204 – 508)

    327 (131 – 462)

    0.203

    Median ALT, IU (IQR)

    21.4 (16.0 – 30.1)

    26.2 (18.0 – 35.0)

    0.054

    Median AST (IQR)

    28.8 (22.1 – 38.1)

    29.4 (26.0 – 39.8)

    0.244

    HBV DNA, IU/mL

    Median (IQR)

    1484 (244 – 727,292)

    < 20 (%)

    10 (21,7)

    ≥ 20 - < 20 000 (%)

    24 (52,2)

    ≥20 000 (%)

    12 (26,1)

    APRI

    <=2.0

     

    45 (95.7)

    >2.0

    2 (4.3)

    FIB-4

    < =3.25

    44 (95.6)

    >3.25

    2 (4.4)

    Lucia Chambal, MsC, MD1, Eduardo Samo Gudo, PhD, MD2, Awa Carimo, MsC, MD3, Rita Corte Real, MD4, Nedio Mabunda, MsC2, Cremildo Maueia, MsC2, Ana Flora Zicai, BSc2, Adolfo Vubil, MsC2, Nilesh Bhatt, PhD, MD2 and Francisco Antunes, PhD, MD5, (1)Internal Medicine, Maputo Central Hospital, maputo, Mozambique, (2)Instituto Nacional de Saude - Ministério da Saude, Maputo, Mozambique, (3)Hospital Central de Maputo, Maputo, Mozambique, (4)Laboratório de Biologia Molecular – Centro Hospitalar de Lisboa Central, Lisboa, Portugal, (5)Universidade de Lisboa, Lisboa, Portugal

    Disclosures:

    L. Chambal, None

    E. Samo Gudo, None

    A. Carimo, None

    R. Corte Real, None

    N. Mabunda, None

    C. Maueia, None

    A. F. Zicai, None

    A. Vubil, None

    N. Bhatt, None

    F. Antunes, None

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