Prevalence and Genetic Diversity of Hepatitis B and C Viruses in People Living with HIV in the Capital District of Venezuela

Coinfection between hepatitis viruses and human immunodeficiency virus (HIV) significantly increases liver disease and AIDS progression. This retrospective cross-sectional study evaluated the prevalence and genetic diversity of hepatitis B (HBV) and C viruses (HCV) among people living with HIV (PLWH) in Venezuela’s Capital District. A total of 420 serum samples collected between 2022 and 2025 were tested for serological and molecular markers, including whole-genome HBV sequencing via next-generation sequencing (NGS) to characterize viral genotype distribution and mutations. Seroprevalences for HBsAg, anti-HBc, and anti-HCV were 2.9%, 20%, and 4.0%, respectively. HBV exposure was significantly higher in older men, with no differences between treatment-naïve and treated patients. Occult HBV infection (OBI) prevalence decreased compared to 2014 data (seropositive: 7% vs. 16%, seronegative: 0.9% vs. 20%). This decline, along with the higher HBV exposure among older adults, may be partially attributed to the universal HBV vaccination introduced in Venezuela in 1998, as well as modifications in antiretroviral therapy affecting HBV replication. Notably, key vaccine- and diagnostic-escape mutations were detected in OBI cases, highlighting clinical and public health concerns. Increased HCV prevalence appears to be linked to rising intravenous drug use in the country. HBV phylogenetic analysis revealed genotype F3 as predominant, followed by F1b (Cosmopolitan clade), while HCV showed genotype 1a to be the most frequent, followed by 1b and 3a. These findings underscore the success of immunization efforts but highlight the urgent need for continuous molecular surveillance and updated public health policies, including targeted harm-reduction programs, to control viral hepatitis in vulnerable populations.