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HIV coinfection among persons diagnosed with hepatitis B in England in 2008–2014
Author(s) -
Ireland G,
Simmons R,
Balogun K,
Kirwan P,
Sabin CA,
Ramsay M,
Delpech V,
Mandal S
Publication year - 2019
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12707
Subject(s) - medicine , coinfection , hbsag , hepatitis b virus , hepatitis b , ethnic group , public health , odds ratio , hepatitis c , human immunodeficiency virus (hiv) , demography , immunology , virus , pathology , sociology , anthropology
Objectives The aim of the study was to estimate HIV prevalence among persons with hepatitis B virus ( HBV ) infection in England and to examine associated risk factors. Methods Persons aged ≥ 15 years with an HBV surface antigen ( HB sAg) test reported to Public Health England ( PHE ) sentinel surveillance during 2008–2014 were linked to the PHE national HIV / AIDS database. Coinfection was defined as an HIV diagnosis prior to, or within 6 months following, a positive HB sAg test. Results During 2008–2014, 2 149 933 persons were tested for HB sAg and 3.9% (1129 of 28 789) of HB sAg‐positive persons were HIV positive. The probable route of HIV infection was heterosexual exposure for 95.3% of female patients and 32.3% of male patients, with 61.5% of male patients reporting sex between men. Among African‐born coinfected persons, 84% probably acquired HIV there. Predictors of HIV positivity included older age [adjusted odds ratio ( aOR ) 1.1] and being of black ethnicity (aOR 15.5 for males; aOR 16.4 for females) or being male and of white ethnicity ( aOR 8.2) compared with being female and of white ethnicity. HIV coinfection was more likely when HBV was diagnosed in sexual health ( aOR 55.0), specialist liver ( aOR 6.7), emergency department ( aOR 5.3) and renal services ( aOR 2.8) compared with general practice. Most (60.4%; 682 of 1129) coinfected persons were diagnosed with HIV infection > 6 months before HBV diagnosis. Conclusions Persons testing positive for HB sAg had a low HIV infection rate and fell largely into two groups: those of black ethnicity with probable Africa‐acquired infections and white men who have sex with men ( MSM ) with probable UK ‐acquired infections. Findings reinforce existing recommendations to sustain and improve both HBV testing of migrants from HBV ‐prevalent countries and vaccination among HIV ‐positive MSM . Findings also support blood‐borne virus testing in sexual health services and emergency departments.