https://www.ncbi.nlm.nih.gov/pubmed/29846357 Hepatitis B

Pediatr Infect Dis J. 2018 Jan 15. doi: 10.1097/INF.0000000000001901. [Epub ahead of print]
Seroprevalence of Hepatitis B among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy in the TREAT Asia Pediatric HIV Observational Database.

Aurpibul L1, Kariminia A1, Vibol U1, Fong MS1, Le ON1, Hansudewechakul R1, Bunupuradah T1, Kurniati N1, Chokephaibulkit K1, Kumarasamy N1, Wati DK1, Yusoff NKN1, Razali KAM1, Nallusamy RA1, Sohn AH1, Lumbiganon P1; TREAT Asia Pediatric HIV Observational Database (TApHOD) of IeDEA Asia-Pacific.

Abstract

BACKGROUND:

Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation, which can progress to liver fibrosis/cirrhosis and hepatocellular carcinoma. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database.

METHODS:
A multi-site cross-sectional study was conducted in HIV-infected patients currently aged <25 years receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), and/or HBV surface antibody (anti-HBs), and/or HBV core antibody (anti-HBc) tested during 2012-2013. HBV coinfection was defined as having either a positive HBsAg test, or being anti-HBc positive and anti-HBs negative, reflective of past HBV infection. HBV seroprotection was defined as having a positive anti-HBs test.

RESULTS:
A total of 3,380 patients from six countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia, India) were included. The current median (interquartile range; IQR) age was 11.2 (7.8-15.1) years. Of the 2,755 (81.5%) patients with HBsAg testing, 130 (4.7%) were positive. Of 1,558 (46%) with anti-HBc testing, 77 (4.9%) were positive. Thirteen of 1,037 patients with all three tests were anti-HBc positive and HBsAg and anti-HBs negative. One child was positive for anti-HBc and negative for anti-HBs, but did not have HBsAg tested. The prevalence of HBV coinfection was 144/2,759 (5.2%) [95% confidence interval 4.4-6.1]. Of 1,093 (32%) patients with anti-HBs testing, 257 (23.5; CI 21.0-26.0) had positive tests representing HBV seroprotection.

CONCLUSIONS:
The estimated prevalence of HBV coinfection in this cohort of Asian HIV-infected children and adolescents on ART was 5.2%. The majority of children and adolescents tested in this cohort (76.5%) did not have protective HBV antibody. The finding supports HBV screening of HIV-infected children and adolescents to guide revaccination, the use of ART with anti-HBV activity, and future monitoring.