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Occult Hepatitis B in HIV Positive Batswana

Ryan, Kathleen T, M.D.

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2016, MPH, University of Cincinnati, Medicine: Epidemiology.
Hepatitis B infection is the leading cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide. Diagnosis of chronic hepatitis B virus (HBV) occurs through detection of the hepatitis B surface antigen (HBsAg). In contrast, occult hepatitis B infection (OBI) is defined as the presence of HBV DNA in the absence of HBsAg. A literature review of OBI in Africa demonstrated that OBI was present throughout much of the African continent. Most cases of OBI in Africa are positive for HBV core antibody with low (less than 200 IU/mL) HBV viral loads. Persons with HIV or hepatitis C co-infection have higher rates of OBI. In HIV positive cohorts, the rate of OBI is only slightly lower (80%) than the chronic HBV infection rate. There is no consistent information available regarding risk factors associated with OBI in Africa. Botswana is hyperedemic for chronic HBV (greater than 8%) and has a HIV prevalence of 25%. Despite this, OBI had never been studied in Botswana. This study discovered an OBI prevalence of 24% in HIV positive adults of Botswana. Detection of hepatitis B core antibody was more common in chronic HBV/HIV co-infected subjects than HIV/OBI subjects. However, both groups had significantly increased rates of HBV core antibody positivity compared to HIV mono-infected individuals. More than 30% of OBI cases had undetectable core antibody, demonstrating that core antibody positivity is not an appropriate screening tool for OBI in this population. No sociodemographic factors were associated with OBI in univariate or multivariate analysis. Tenofovir/emtricitabine-containing HIV therapy suppressed OBI DNA detection in almost all (65 of 66) individuals evaluated one year after start of therapy.
Jason Blackard, Ph.D. (Committee Chair)
Elizabeth P. Schlaudecker, M.D. M.P.H (Committee Member)
Susan Pinney, Ph.D. (Committee Member)
52 p.

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Citations

  • Ryan, M.D., K. T. (2016). Occult Hepatitis B in HIV Positive Batswana [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1468335589

    APA Style (7th edition)

  • Ryan, M.D., Kathleen. Occult Hepatitis B in HIV Positive Batswana. 2016. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1468335589.

    MLA Style (8th edition)

  • Ryan, M.D., Kathleen. "Occult Hepatitis B in HIV Positive Batswana." Master's thesis, University of Cincinnati, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1468335589

    Chicago Manual of Style (17th edition)