HIV-HBV Co-infections in Central India: Prevalence, Clearance Rates, and Long-term Outcomes from a Decade of Experience at a Tertiary Care Center

Abstract

AbstractTwo of the most infamous viruses, the Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) have similar transmission routes. Consequently, some individuals might get co-infected with both viruses resulting in increased deaths and prolonged disease. Even among healthy (Non-immunocompromised) persons, chances of getting persistent HBV infection are 5-10%, however among persons harboring HIV, HBV the persistence rates might escalate up to 15 %. Such increased suffering might occur despite the longevity provided by starting highly active anti-retroviral therapy (HAART), which is the current standard treatment.Our pioneering study, in our region aims to assess the prevalence of HIV-HBV co-infection, clearance rates of HBV, demographic characteristics of affected individuals, and long-term outcomes. By shedding light on these aspects, we hope to gain valuable insights into the impact of such co-infections and pave the way for better management and care of individuals facing this dual challenge.We studied 1808 persons enrolled for HIV treatment from amongst 170,019 persons screened. Higher co-infection of HIV-HBV was observed in males as compared to females, with the age group of 31-40 years being most affected. The most common route of infection, was heterosexual contact accounting for 86% of cases, accounting for majority co-infections. Over the years, we noticed a decline in the number of HIV-HBV co-infected cases, with the nadir occurring in 2015. Seroprevalence of co-infections was 2.37%, but despite this observed low sero-prevalence HBV clearance was relatively poor among the co-infected, as only 4 (9.3%) able to clear the infection after initiation of HAART. Our study highlights that chances of HBV clearance among the co-infected are worse than that observed among otherwise heathy populations thus also highlighting the urgent need for universal HBV vaccination in all HIV-affected persons, underscoring the importance of providing special attention to them.