title: Hepatitis B virus sero-profiles and genotypes in HIV-1 infected and uninfected injection and Non-injection drug users from coastal Kenya.
abstract: BACKGROUND
  Information about HBV sero-markers, infection stages and genotypes in HIV-1 infected and uninfected injection and non-injection drug users (IDUs) in Kenya remains elusive.
  
  
  METHODS
  A cross-sectional study examining HBV sero-marker, infection stages and genotypes was conducted among HIV-1 infected and uninfected, respectively, IDUs (n = 157 and n = 214) and non-IDUs (n = 139 and n = 48), and HIV-1 uninfected non-drug using controls (n = 194) from coastal, Kenya. HBV sero-marker and infection stages were based on HBV 5-panel rapid test plasma sero-reactivity. DNA was extracted from acute and chronic plasma samples and genotypes established by nested-PCR and direct sequencing.
  
  
  RESULTS
  HBsAg positivity was higher in HIV-1 infected IDUs (9.6%) relative to HIV-1 uninfected IDUs (2.3%), HIV-1 infected non-IDUs (3.6%), HIV-1 uninfected non-IDUs (0.0%) and non-drug users (2.6%; P = 0.002). Contrastingly, HBsAb positivity was higher in HIV-1 uninfected IDUs (14.6%) and non-IDUs (16.8) in comparison to HIV-1 infected IDUs (8.3%), and non-IDUs (8.6%), and non-drug users (8.2%; P = 0.023). HBcAb positivity was higher in HIV-1 infected IDUs (10.2%) compared to HIV-1 uninfected IDUs (3.3%), HIV-1 infected non-IDUs (6.5%), HIV-1 uninfected non-IDUs (2.1%) and non-drug users (4.6%; P = 0.038). Acute (5.7%, 1.4%, 0.0%, 0.0% and 1.5%) and chronic (5.1%, 0.9%, 3.6%, 0.0% and 1.5%) stages were higher in HIV-1 infected IDUs, compared to HIV-1 uninfected IDUs, HIV-1 infected and uninfected non-IDUs and non-drug users, respectively. However, vaccine type response stage was higher in HIV-1 uninfected IDUs (15.4%) relative to HIV-1 infected IDUs (6.4%), and HIV-1 infected (6.5%), and uninfected (10.4%) non-IDUs, and non-drug users (5.7%; P = 0.003). Higher resolved infection rates were also recorded in HIV-1 uninfected IDUs (11.2%) compared to HIV-1 infected IDUs (8.3%), and HIV-1 infected (7.2%), uninfected (6.3%) non-IDUs, and non-drug users (6.7%; P = 0.479), respectively. Only A1 genotype showing minimal diversity was detected among the study participants.
  
  
  CONCLUSIONS
  HBV sero-markers and infection staging are valuable in diagnosis and genotyping of HBV infections. Among IDUs, higher HBsAg and HBcAb positivity in HIV-1 infected and higher HBsAb positivity in HIV-1 negative IDUs suggests frequent exposure. Additionally, HBV genotype A is the dominant circulating genotype in both high and low risk populations of Kenya.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Webale
authors.affiliation: Department of Biomedical Sciences and Technology, Maseno University, Maseno, Kenya. markkilongosi@gmail.com.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kilongosi
authors.affiliation: Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya. valbudambula@gmail.com.
authors.forename: Valentine
authors.initials: V
authors.lastname: Budambula
authors.affiliation: Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya. lihanaraphael@gmail.com.
authors.forename: Raphael
authors.initials: R
authors.lastname: Lihana
authors.affiliation: Department of Biomedical Sciences and Technology, Maseno University, Maseno, Kenya. fmogollah@gmail.com.
authors.forename: Francis O
authors.initials: FO
authors.lastname: Musumba
authors.affiliation: Department of Microbiology, Kenyatta University, Nairobi, Kenya. akibera2000@gmail.com.
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Nyamache
authors.affiliation: Bomu Hospital, Mombasa, Kenya. nbudambula@yahoo.com.
authors.forename: Nancy L M
authors.initials: NL
authors.lastname: Budambula
authors.affiliation: Department of Biological Sciences, Embu University College, Embu, Kenya. aabid.ahmed@bomuhospital.org.
authors.forename: Aabid A
authors.initials: AA
authors.lastname: Ahmed
authors.affiliation: Department of Biomedical Sciences and Technology, Maseno University, Maseno, Kenya. collinouma@yahoo.com.|African Population and Health Research Centre, Nairobi, Kenya. collinouma@yahoo.com.
authors.forename: Collins
authors.initials: C
authors.lastname: Ouma
authors.affiliation: Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, P. O. Box 190-50100, Kakamega, Kenya. mugogwe@yahoo.com.
authors.forename: Tom
authors.initials: T
authors.lastname: Were
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D005838:Genotype; D015483:HIV Antibodies / Q000032:analysis / Q000097:blood; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis / Q000097:blood; D006509:Hepatitis B / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012698:Serologic Tests; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015483:HIV Antibodies; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens