Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients
Identifieur interne : 000072 ( Pmc/Checkpoint ); précédent : 000071; suivant : 000073Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients
Auteurs : Timothy N. A. Archampong [Ghana] ; Margaret Lartey [Ghana] ; Kwamena W. Sagoe [Ghana] ; Adjoa Obo-Akwa [Ghana] ; Ernest Kenu [Ghana] ; Fizza S. Gillani [États-Unis] ; Hongmei Yang [États-Unis] ; Isaac Boamah [Ghana] ; Timothy Flanigan [États-Unis] ; Awewura Kwara [États-Unis]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2016.
Abstract
The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.
Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.
Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.
Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.
Url:
DOI: 10.1186/s12879-016-1342-4
PubMed: 26759172
PubMed Central: 4710995
Affiliations:
- Ghana, États-Unis
- Rhode Island, Région du Grand Accra, État de New York
- Accra, Legon (Ghana)
- Université du Ghana
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Archampong</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation></author><author><name sortKey="Sagoe, Kwamena W" sort="Sagoe, Kwamena W" uniqKey="Sagoe K" first="Kwamena W." last="Sagoe">Kwamena W. 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Gillani</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Yang, Hongmei" sort="Yang, Hongmei" uniqKey="Yang H" first="Hongmei" last="Yang">Hongmei Yang</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY USA</nlm:aff><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Boamah, Isaac" sort="Boamah, Isaac" uniqKey="Boamah I" first="Isaac" last="Boamah">Isaac Boamah</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26759172</idno><idno type="pmc">4710995</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710995</idno><idno type="RBID">PMC:4710995</idno><idno type="doi">10.1186/s12879-016-1342-4</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000086</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000086</idno><idno type="wicri:Area/Pmc/Curation">000085</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000085</idno><idno type="wicri:Area/Pmc/Checkpoint">000072</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000072</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients</title><author><name sortKey="Archampong, Timothy N A" sort="Archampong, Timothy N A" uniqKey="Archampong T" first="Timothy N. A." last="Archampong">Timothy N. A. Archampong</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation></author><author><name sortKey="Sagoe, Kwamena W" sort="Sagoe, Kwamena W" uniqKey="Sagoe K" first="Kwamena W." last="Sagoe">Kwamena W. Sagoe</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Obo Akwa, Adjoa" sort="Obo Akwa, Adjoa" uniqKey="Obo Akwa A" first="Adjoa" last="Obo-Akwa">Adjoa Obo-Akwa</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Yang, Hongmei" sort="Yang, Hongmei" uniqKey="Yang H" first="Hongmei" last="Yang">Hongmei Yang</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY USA</nlm:aff><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Boamah, Isaac" sort="Boamah, Isaac" uniqKey="Boamah I" first="Isaac" last="Boamah">Isaac Boamah</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.</p></sec><sec><title>Methods</title><p id="Par2">Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.</p></sec><sec><title>Results</title><p id="Par3">Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.</p></sec><sec><title>Conclusions</title><p id="Par4">Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Puoti, M" uniqKey="Puoti M">M Puoti</name></author><author><name sortKey="Airoldi, M" uniqKey="Airoldi M">M Airoldi</name></author><author><name sortKey="Bruno, R" uniqKey="Bruno R">R Bruno</name></author><author><name sortKey="Zanini, B" uniqKey="Zanini B">B Zanini</name></author><author><name sortKey="Spinetti, A" uniqKey="Spinetti A">A Spinetti</name></author><author><name sortKey="Pezzoli, C" uniqKey="Pezzoli C">C Pezzoli</name></author><author><name sortKey="Patroni, A" uniqKey="Patroni A">A Patroni</name></author><author><name sortKey="Castelli, F" uniqKey="Castelli F">F Castelli</name></author><author><name sortKey="Sacchi, P" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id><journal-title-group><journal-title>BMC Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">1471-2334</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26759172</article-id><article-id pub-id-type="pmc">4710995</article-id><article-id pub-id-type="publisher-id">1342</article-id><article-id pub-id-type="doi">10.1186/s12879-016-1342-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Archampong</surname><given-names>Timothy N. A.</given-names></name><address><phone>00233-203039841</phone><email>tnaa@doctors.net.uk</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Lartey</surname><given-names>Margaret</given-names></name><address><email>malart38@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Sagoe</surname><given-names>Kwamena W.</given-names></name><address><email>kwcsagoe@chs.edu.gh</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Obo-Akwa</surname><given-names>Adjoa</given-names></name><address><email>saintadjoa@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kenu</surname><given-names>Ernest</given-names></name><address><email>ernest_kenu@yahoo.com</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Gillani</surname><given-names>Fizza S.</given-names></name><address><email>FGillani@lifespan.org</email></address><xref ref-type="aff" rid="Aff4">4</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Yang</surname><given-names>Hongmei</given-names></name><address><email>Hongmei_Yang@urmc.rochester.edu</email></address><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Boamah</surname><given-names>Isaac</given-names></name><address><email>ikebosa@yahoo.com</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Flanigan</surname><given-names>Timothy</given-names></name><address><email>TFlanigan@lifespan.org</email></address><xref ref-type="aff" rid="Aff4">4</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Kwara</surname><given-names>Awewura</given-names></name><address><email>Akwara@lifespan.org</email></address><xref ref-type="aff" rid="Aff4">4</xref><xref ref-type="aff" rid="Aff5">5</xref></contrib><aff id="Aff1"><label>1</label>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</aff><aff id="Aff2"><label>2</label>Korle-Bu Teaching Hospital, Accra, Ghana</aff><aff id="Aff3"><label>3</label>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</aff><aff id="Aff4"><label>4</label>Warren Alpert Medical School of Brown University, Providence, RI USA</aff><aff id="Aff5"><label>5</label>The Miriam Hospital, Providence, RI USA</aff><aff id="Aff6"><label>6</label>Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY USA</aff></contrib-group><pub-date pub-type="epub"><day>13</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>13</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>16</volume><elocation-id>14</elocation-id><history><date date-type="received"><day>21</day><month>7</month><year>2015</year></date><date date-type="accepted"><day>9</day><month>1</month><year>2016</year></date></history><permissions><copyright-statement>© Archampong et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p id="Par1">The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.</p></sec><sec><title>Methods</title><p id="Par2">Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.</p></sec><sec><title>Results</title><p id="Par3">Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.</p></sec><sec><title>Conclusions</title><p id="Par4">Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>ART</kwd><kwd>HIV and HBV co-infection</kwd><kwd>Viremia</kwd><kwd>Sub-Saharan Africa</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100006418</institution-id><institution>Brown University (US)</institution></institution-wrap></funding-source><award-id>P30AI042853</award-id><principal-award-recipient><name><surname>Archampong</surname><given-names>Timothy N. A.</given-names></name></principal-award-recipient></award-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100000200</institution-id><institution>United States Agency for International Development (US)</institution></institution-wrap></funding-source><award-id>AEG-A-00-05-00007</award-id><principal-award-recipient><name><surname>Archampong</surname><given-names>Timothy N. A.</given-names></name></principal-award-recipient></award-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100006418</institution-id><institution>Brown University (US)</institution></institution-wrap></funding-source><award-id>D43TW000237</award-id><principal-award-recipient><name><surname>Kwara</surname><given-names>Awewura</given-names></name></principal-award-recipient></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Rhode Island</li><li>Région du Grand Accra</li><li>État de New York</li></region><settlement><li>Accra</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li></orgName></list><tree><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Archampong, Timothy N A" sort="Archampong, Timothy N A" uniqKey="Archampong T" first="Timothy N. A." last="Archampong">Timothy N. A. Archampong</name></region><name sortKey="Archampong, Timothy N A" sort="Archampong, Timothy N A" uniqKey="Archampong T" first="Timothy N. A." last="Archampong">Timothy N. A. Archampong</name><name sortKey="Boamah, Isaac" sort="Boamah, Isaac" uniqKey="Boamah I" first="Isaac" last="Boamah">Isaac Boamah</name><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><name sortKey="Obo Akwa, Adjoa" sort="Obo Akwa, Adjoa" uniqKey="Obo Akwa A" first="Adjoa" last="Obo-Akwa">Adjoa Obo-Akwa</name><name sortKey="Sagoe, Kwamena W" sort="Sagoe, Kwamena W" uniqKey="Sagoe K" first="Kwamena W." last="Sagoe">Kwamena W. Sagoe</name></country><country name="États-Unis"><region name="Rhode Island"><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name></region><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><name sortKey="Yang, Hongmei" sort="Yang, Hongmei" uniqKey="Yang H" first="Hongmei" last="Yang">Hongmei Yang</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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