Epidemiological, Biological and Progressive Aspects of Hepatitis B Virus B (HBV) Infection among Patients Infected by Human Immunodeficiency Virus (HIV) in the Day Hospital of Bobo-Dioulasso, Burkina Faso

Objective: To determine the epidemiological, bioclinical and evolving characteristics of viral hepatitis B infection in HIV-infected patients. Methods: This is a retrospective longitudinal study carried out at the Bobo-Dioulasso Day Hospital from January 1, 2008 to March 31, 2013. The study included HIV-infected patients aged at least 18 years old, naïve of Antiretroviral Treatment (ART) and who underwent HBsAg testing during the initial visit. The HBsAg was determined by the rapid test Determine (ABBOTT®). The FIB-4 score was used to assess liver fibrosis. The Cox Proportional Hazard model was used to identify factors associated with survival. Results: The study included 543 patients, of whom 385 (70.9%) were women. The majority of patients (93%) were infected with HIV-1. At the initial visit, the mean age of patients was 37.3 years (IQR 30.9 to 44.2) and the median CD4 count was 211 cells/l (IQR 104-377). HBsAg seroprevalence was 15.3% with a male predominance (22.2% vs 12.5%, p=0.006). HbsAg positivity was associated with a high FIB-4 score. There was no statistically significant difference between the immuno-virological responses to ART between HBsAg positive and HBsAg negative patients. Body Mass Index (BMI)<18.5 and CD4<100 cells/µl at the time of introduction of HAART was associated with higher risk of death. However, HbsAg positivity was not associated with a higher risk of death. Stage 3 liver fibrosis occurrence was significantly associated with higher risk of death in the univariate analysis; however, this association disappeared in the multivariate analysis. Conclusion: The search for hepatitis B markers and testing for liver damage should be systematic during HIV infection. In the absence of resources to test for HBV, TDF could be systematically included in first-line ART in areas were hepatitis B is highly endemic.