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Seroprevalence of Hepatitis B Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy in the TREAT Asia Pediatric HIV Observational Database

Aurpibul L 1 , Kariminia A 2 , Vibol U 3 , Fong MS 4 , Le ON 5 , Hansudewechakul R 6 Show all authors , Bunupuradah T 7 , Kurniati N 8 , Chokephaibulkit K 9 , Kumarasamy N 10 , Wati DK 11 , Yusoff NKN 12 , Razali KAM 13 , Nallusamy RA 14 , Sohn AH 15 , Lumbiganon P 16 , TREAT Asia Pediatric HIV Observational Database (TApHOD) of IeDEA Asia-Pacific

Affiliations 

  • 1 From the Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
  • 2 The Kirby Institute, UNSW Australia, Sydney, Australia
  • 3 University of Health Sciences and National Pediatric Hospital, Phnom Penh, Cambodia
  • 4 Hospital Likas, Kota Kinabalu, Malaysia
  • 5 Worldwide Orphans Foundation, Ho Chi Minh City, Vietnam
  • 6 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 7 HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 8 Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 9 Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 10 YRGCARE Medical Centre, CART CRS, Chennai, India
  • 11 Sanglah Hospital, Udayana University, Bali, Indonesia
  • 12 Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
  • 13 Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 14 Penang Hospital, Penang, Malaysia
  • 15 TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand
  • 16 Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Pediatr Infect Dis J, 2018 Aug;37(8):788-793.
PMID: 29846357 DOI: 10.1097/INF.0000000000001901

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 multisite cross-sectional study was conducted in HIV-infected patients currently <25 years old receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), or HBV surface antibody (anti-HBs) 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 3380 patients from 6 countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia and India) were included. The current median (interquartile range) age was 11.2 (7.8-15.1) years. Of the 2755 patients (81.5%) with HBsAg testing, 130 (4.7%) were positive. Of 1558 (46%) with anti-HBc testing, 77 (4.9%) were positive. Thirteen of 1037 patients with all 3 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 144/2759 (5.2%) (95% confidence interval: 4.4-6.1). Of 1093 patients (32%) with anti-HBs testing, 257 (23.5%; confidence interval: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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