Viral hepatitis B co-infection among people living with HIV: a National cross-sectional survey in Togo in 2023.

Context HIV/HBV co-infection accelerates the progression of chronic hepatitis towards end-stage liver disease. In Togo, little is known about the prevalence of hepatitis B in people living with HIV (PLWH). The objective of this study was to estimate the determinants of hepatitis B virus (HBV) infection among PLWH in Togo in 2023.Methods A cross-sectional study was carried out between May and October 2023 among PLWH receiving antiretroviral treatment in HIV care centers in the six health regions of Togo. Serological tests were used for the detection of HBV surface antigen (HBsAg), anti-HBs antibody, and total anti-HBc antibody. The HBV DNA viral load was measured in HBsAg positive PLWH. Logistic regression analyses were performed to assess associated factors with HIV/HBV co-infection.Results A total of 897 PLWH (74.9% women) were included. The median age was 45 years (IQR: 38-53). The prevalence of viral hepatitis B was 6.5%, 95% CI [5.0 - 8.3]. This prevalence was higher in northern Togo (12.0%) than in southern Togo (5.2%) (OR: 2,7 IC 95% 1,44 - 4,98). Among 58 HBsAg+ PLWH, 93% had an undetectable HBV viral load (<10IU/ml) on Tenofovir/Lamivudine/Dolutegravir. Among HBsAg-negative PLWH (n=100), 2% were vaccinated against HBV, 61% had been exposed to HBV and 37% were not protected against HBV.Conclusion HBV prevalence is high among PLWH, especially in northern Togo, and the HBV viral load is suppressed in almost all patients on ART treatment. One third of our study population was susceptible to HBV infection, and in urgent need of HBV vaccination.