title: Hepatitis B infection in HIV-1-infected patients receiving highly active antiretroviral therapy in Lomé, Togo: Prevalence and molecular consequences.
abstract: BACKGROUND
  No data are available on HIV/hepatitis B virus (HBV) or hepatitis C virus coinfection in Togo, and patients are not routinely tested for HBV infection.
  
  
  OBJECTIVE
  To determine the prevalence of HBV and the risk of HBV drug resistance during antiretroviral treatment in HIV-coinfected patients in Togo.
  
  
  METHODS
  This cross-sectional study was carried out in Lomé, Togo, from January 2010 to December 2011 among HIV-infected patients who had been on antiretroviral therapy (ART) for at least 6 months.
  
  
  RESULTS
  In total, 1 212 patients (74.9% female) living with HIV/AIDS and treated with ART were included in the study. The seroprevalence of hepatitis B surface antigen (HBsAg) was 9.7% (117/1 212; 95% confidence interval (CI) 8.04 - 11.45). Of these 117 HBsAg-positive patients, 16 (13.7%) were hepatitis B e-antigen (HBeAg)-positive, and 115 (98.3%) were on lamivudine. The HBV DNA load was &gt;10 IU/mL in 33/117 patients overall (38%), and in 87.5% of 16 HBeAg-positive patients (p&lt;0.0001). In multivariate analysis, factors associated with HBV DNA load &gt;10 IU/mLwere HBeAg positivity (adjusted odds ratio (aOR) 6.4; p=0.001) and a higher level of education (aOR 6.5; p=0.026). The prevalence of HBV resistance to lamivudine was 13.0% (15/115; 95% CI 7.0 - 19.0). The detected resistance mutations were rtL180M (14/15 patients) and rtM204V/I (15/15).
  
  
  CONCLUSIONS
  The seroprevalence of HBV among ART-treated HIV-infected patients in Togo was 9.7%. The prevalence of HBV lamivudine resistance mutations after 2 years of ART was 13.0%. These results suggest that HBV screening before ART initiation can be based on HBsAg testing.
authors.affiliation: Service Maladies Infectieuses et Pneumologie CHU Sylvanus Olympio, Lomé, Togo. apatassi@gmail.com.
authors.forename: Akouda
authors.initials: A
authors.lastname: Patassi
authors.forename: Sihem
authors.initials: S
authors.lastname: Benaboud
authors.forename: Dadja Essoya
authors.initials: DE
authors.lastname: Landoh
authors.forename: M
authors.initials: M
authors.lastname: Salou
authors.forename: Anoumou Claver
authors.initials: AC
authors.lastname: Dagnra
authors.forename: Bayaki
authors.initials: B
authors.lastname: Saka
authors.forename: Anne
authors.initials: A
authors.lastname: Krivine
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Meritet
authors.forename: Palokinam
authors.initials: P
authors.lastname: Pitché
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon-Ceron