Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up
Background and aims There is no data on hepatitis B virus (HBV) prevalence and treatment eligibility among the general population in Lesotho. We aimed to determine the prevalence of HBV infection in a large-scale cross-sectional survey among the general population in Lesotho, assess determinants of...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/2/e001195.full |
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| author | Ravi Gupta Frédérique Chammartin Niklaus D Labhardt Alain Amstutz Maja Weisser Emmanuel Firima Rameno Ntsoaki Blaise Lukau Mosa Tlahali Lucia Gonzalez Fernandez Molulela Manthabiseng Mamoronts’ane P Sematle Matumaole Bane Makhebe Khomolishoele Leisa Ikhetheleng Lefokosane Retselisitsoe Stephen McCrosky Tristan Lee |
| author_facet | Ravi Gupta Frédérique Chammartin Niklaus D Labhardt Alain Amstutz Maja Weisser Emmanuel Firima Rameno Ntsoaki Blaise Lukau Mosa Tlahali Lucia Gonzalez Fernandez Molulela Manthabiseng Mamoronts’ane P Sematle Matumaole Bane Makhebe Khomolishoele Leisa Ikhetheleng Lefokosane Retselisitsoe Stephen McCrosky Tristan Lee |
| author_sort | Ravi Gupta |
| collection | DOAJ |
| description | Background and aims There is no data on hepatitis B virus (HBV) prevalence and treatment eligibility among the general population in Lesotho. We aimed to determine the prevalence of HBV infection in a large-scale cross-sectional survey among the general population in Lesotho, assess determinants of seropositivity, and evaluate treatment eligibility according to the 2024 WHO guidelines.Approach and results We conducted a household-based, cross-sectional survey among participants≥10 years old in 120 randomly sampled village clusters in two districts. From participants screened positive for HBV surface antigen (HBsAg), we collected dried blood spots for HBV DNA measurement and referred the participants to health facilities for clinical assessment and treatment eligibility evaluation.Out of 6709 participants screened, 6705 had a valid HBsAg test result (3509 (52.3%) female, median age 33 years (IQR: 20–53)), which was positive in 78 participants, yielding a prevalence of 1.2% (95% CI: 0.9 to 1.4). Being≥18 years old, male, living in urban areas, living with HIV, consuming tobacco and belonging to higher wealth index quintiles, were associated with increasing odds of HBV infection. Of the 78 participants with HBV infection, 62 (79.5%) linked to care. Among these, 25/62 (40.3%) were also living with HIV and 23/25 (92%) already taking antiretroviral treatment active against HBV. Among the remaining, 10/37 (27.0%) were eligible for antiviral treatment based on HBV DNA, Aspartate aminotransferase to Platelet Ratio Index or alanine aminotransferase levels.Conclusions We observed a low prevalence of HBV infection among Basotho. Treatment eligibility was high mostly due to the presence of HIV co-infection. However, nearly one-third of HBV mono-infected participants were eligible for treatment, suggesting a testing and treatment gap in this population. |
| format | Article |
| id | doaj-art-6f466f76c3fb4e4b90d9290eb73bd204 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-6f466f76c3fb4e4b90d9290eb73bd2042024-12-15T23:10:26ZengBMJ Publishing GroupBMJ Public Health2753-42942024-12-012210.1136/bmjph-2024-001195Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-upRavi Gupta0Frédérique Chammartin1Niklaus D Labhardt2Alain Amstutz3Maja Weisser4Emmanuel Firima5Rameno Ntsoaki6Blaise Lukau7Mosa Tlahali8Lucia Gonzalez Fernandez9Molulela Manthabiseng10Mamoronts’ane P Sematle11Matumaole Bane12Makhebe Khomolishoele13Leisa Ikhetheleng14Lefokosane Retselisitsoe15Stephen McCrosky16Tristan Lee17SolidarMed, Partnerships for Health, Maseru, LesothoUniversity of Basel, Basel, SwitzerlandDepartment of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerlandpostdoctoral researcherDepartment of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Dar es Salaam, United Republic of TanzaniaDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, SwitzerlandButha Buthe Government Hospital, Butha Buthe, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoMokhotlong District Health Management Team, Mokhotlong, LesothoDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, SwitzerlandSolidarMed, Partnerships for Health, Maseru, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoSolidarMed, Partnerships for Health, Maseru, LesothoDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, SwitzerlandDivision of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, SwitzerlandBackground and aims There is no data on hepatitis B virus (HBV) prevalence and treatment eligibility among the general population in Lesotho. We aimed to determine the prevalence of HBV infection in a large-scale cross-sectional survey among the general population in Lesotho, assess determinants of seropositivity, and evaluate treatment eligibility according to the 2024 WHO guidelines.Approach and results We conducted a household-based, cross-sectional survey among participants≥10 years old in 120 randomly sampled village clusters in two districts. From participants screened positive for HBV surface antigen (HBsAg), we collected dried blood spots for HBV DNA measurement and referred the participants to health facilities for clinical assessment and treatment eligibility evaluation.Out of 6709 participants screened, 6705 had a valid HBsAg test result (3509 (52.3%) female, median age 33 years (IQR: 20–53)), which was positive in 78 participants, yielding a prevalence of 1.2% (95% CI: 0.9 to 1.4). Being≥18 years old, male, living in urban areas, living with HIV, consuming tobacco and belonging to higher wealth index quintiles, were associated with increasing odds of HBV infection. Of the 78 participants with HBV infection, 62 (79.5%) linked to care. Among these, 25/62 (40.3%) were also living with HIV and 23/25 (92%) already taking antiretroviral treatment active against HBV. Among the remaining, 10/37 (27.0%) were eligible for antiviral treatment based on HBV DNA, Aspartate aminotransferase to Platelet Ratio Index or alanine aminotransferase levels.Conclusions We observed a low prevalence of HBV infection among Basotho. Treatment eligibility was high mostly due to the presence of HIV co-infection. However, nearly one-third of HBV mono-infected participants were eligible for treatment, suggesting a testing and treatment gap in this population.https://bmjpublichealth.bmj.com/content/2/2/e001195.full |
| spellingShingle | Ravi Gupta Frédérique Chammartin Niklaus D Labhardt Alain Amstutz Maja Weisser Emmanuel Firima Rameno Ntsoaki Blaise Lukau Mosa Tlahali Lucia Gonzalez Fernandez Molulela Manthabiseng Mamoronts’ane P Sematle Matumaole Bane Makhebe Khomolishoele Leisa Ikhetheleng Lefokosane Retselisitsoe Stephen McCrosky Tristan Lee Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up BMJ Public Health |
| title | Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up |
| title_full | Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up |
| title_fullStr | Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up |
| title_full_unstemmed | Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up |
| title_short | Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up |
| title_sort | prevalence of hepatitis b virus infection and treatment eligibility in lesotho southern africa a population based cross sectional study with case based follow up |
| url | https://bmjpublichealth.bmj.com/content/2/2/e001195.full |
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