title: Hepatitis B virus and sexual behavior in Rakai, Uganda.
abstract: HIV and hepatitis B virus (HBV) co-infection poses important public health considerations in resource-limited settings. Demographic data and sera from adult participants of the Rakai Health Sciences Program Cohort in Southwestern Uganda were examined to determine HBV seroprevalence patterns in this area of high HIV endemicity prior to the introduction of anti-retroviral therapy. Commercially available EIAs were used to detect prevalent HBV infection (positive for HBV core antibody [anti-HBc] and/or positive HBV surface antigen [HBsAg]), and chronic infection (positive for HBsAg). Of 438 participants, 181 (41%) had prevalent HBV infection while 21 (5%) were infected chronically. Fourteen percent of participants were infected with HIV. Fifty three percent showed evidence of prevalent HBV infection compared to 40% among participants infected with HIV (P = 0.067). Seven percent of participants infected with HIV were HBsAg positive compared to 4% among participants not infected with HIV (P = 0.403). The prevalence of prevalent HBV infection was 55% in adults aged >50 years old, and 11% in persons under 20 years. In multivariable analysis, older age, HIV status, and serologic syphilis were significantly associated with prevalent HBV infection. Transfusion status and receipt of injections were not significantly associated with HBV infection. Contrary to expectations that HBV exposure in Uganda occurred chiefly during childhood, prevalent HBV infection was found to increase with age and was associated sexually transmitted diseases (HIV and syphilis.) Therefore vaccination against HBV, particularly susceptible adults with HIV or at risk of HIV/STDs should be a priority.
authors.affiliation: Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA. stabinskil@niaid.nih.gov
authors.forename: Lara
authors.initials: L
authors.lastname: Stabinski
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
authors.forename: Ponsiano
authors.initials: P
authors.lastname: Ocama
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Ron H
authors.initials: RH
authors.lastname: Gray
authors.forename: Maria
authors.initials: M
authors.lastname: Wawer
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology* / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens