Étude de la co-infection virus de l’immunodeficience humaine / virus de l’hépatite virale b chez les personnes vivant avec le vih suivies au centre de référence ist/vih/sida chu de sétif

Abstract

Co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV) remains a major public health concern. Our objective was to estimate the prevalence of hepatitis B among people living with HIV (PLHIV), to describe their epidemiological profile, and to identify associed risk factors. A descriptive and analytical cross-sectional study was conducted over a 12-month period, from May 2, 2023 to April 30, 2024, at the STI/HIV/AIDS Reference Center of the University Hospital of Setif. Data collection combined a retrospective and a prospective one-time component, with no longitudinal follow-up. HBV status was assessed using an expanded serological panel including HBsAg, total and IgM anti-HBc, and anti-HBs. HIV/HBV co-infection was defined as active infection, occult infection, or documented past exposure to HBV. Associated factors were analyzed using univariate and multivariate models, with adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI). Patients' knowledge of HIV/HBV transmission and prevention was assessed using a structured questionnaire. Among the 318 PLHIV included in the study, 36 had HIV/HBV co-infection, for an overall prevalence of 11.3% [95% CI: 7.8 , 14.8]. Two patients were HBsAg positive 0.6% [95% CI: 0.0 , 1.5], one case of occult hepatitis B was identified 0.3% [95% CI: 0.0 , 0.9) and 33 patients had cured hepatitis B 10.4% [95% CI: 7.0 , 13.7). In adjusted multivariate analysis, factors independently associated with HIV/HBV co-infection were a history of piercing (PRa = 2.04; 95% CI [1.08 , 3.86]; p = 0.028), dialysis exposure (PRa = 6.91; 95% CI [2.41 , 19.80; p = 0.001), non-heterosexual sexual orientation (PRa = 1.89; 95% CI [1.01 , 3.54]; p = 0.046), and discontinuous condom use (PRa = 2.21; 95% CI [1.12 , 4.36]; p = 0.022). Age and sex were not significantly associated after adjustement. HBV vaccination coverage was low (3.8%). Knowledge assessment using aggregated scores revealed an overall insufficient level of health literacy regarding HIV and HBV, with significant generational and socio economic disparities. The HIV/HBV co-infection in our setting is characterized by a low prevalence of chronic HBV, very low vaccination coverage, and inadequate knowledge levels. These findings highlight the need to strengthen systemic screening, vaccination strategies, and targeted prevention and education interventions focusing on behavioral risk factors and percutaneous exposures.