HIV and Hepatitis B co-infection in Tanzania: Analysis of the 2022–2023 Tanzania HIV Impact Survey

Co-occurrence of HIV and Hepatitis B Virus (HBV) in sub-Saharan Africa, although less prevalent, is often more serious and exhibits rapid clinical deterioration even with appropriate treatment, jeopardizing efforts to reach regional and global targets. Evidence varies in the region and not reported in some countries. We used data from the nationally representative survey to characterize the burden and determinants of HIV and HBV co-occurrence in Tanzania. This secondary data analysis of the Tanzania HIV Impact Survey (THIS) involved 33,263 individuals aged 15 years and above, randomly selected from 14,966,262 households from 31 regions of Tanzania. The main outcome variable was HIV and HBV coinfections. Analyses were conducted using descriptive analysis, to estimate prevalence of co-occurrences, while Chi-square test used to characterize the burden. Through bivariable and multivariable binomial logistic regression models, we could estimate the associations between different independent variables with HIV-HBV co-occurrence. The burdens of HIV and HBV in the general population were 4.4% and 3.5% respectively. The prevalence of dual HIV and HBV infections was 0.3%. Among people diagnosed with HIV, 6.2% had HBV co-occurrence. After adjusting for confounder and other variables, age was significantly associated with coinfection (aOR = 1.02; 95% CI: 1.01-1.03; p < 0.001). Participants who were not in union had significantly higher risk of coinfection compared with those in union (aOR = 1.56; 95% CI: 1.01-2.41; p = 0.047). Having one lifetime sexual partner remained strongly protective factor against HIV-HBV coinfection (aOR = 0.19; 95% CI: 0.09-0.42; p < 0.001). Although the burden of HIV/HBV coinfection remains as low as 0.3% in the general population in Tanzania, the risk remains high among older adults and those with multiple sexual partnerships. Integrating HBV screening in all opportunities presented in the successful HIV program may help addressing the dual burden. For effectiveness, more efforts should target people with high-risk sexual behaviors and those with advanced age.