Preprint Brief Report Version 1 Preserved in Portico This version is not peer-reviewed

Atypical Hepatitis B Virus Serology Profile – HBsAg Posi-Tive/Anti-HBc Negative – in Hbv/HIV Coinfected Individuals in Botswana

Bonolo B. Phinius
ORCID logo ,
Motswedi Anderson
,
Margaret Mokomane
,
Irene Gobe
,
Wonderful T. Choga
ORCID logo ,
Tsholofelo Ratsoma
,
Basetsana Phakedi
,
Gorata Mpebe
,
Doreen Ditshwanelo
,
Rosemary Musonda
,
Joseph Makhema
,
Sikhulile Moyo
,
Simani Gaseitsiwe
*
Version 1 : Received: 20 June 2023 / Approved: 20 June 2023 / Online: 20 June 2023 (09:42:20 CEST)

A peer-reviewed article of this Preprint also exists.

Phinius, B.B.; Anderson, M.; Mokomane, M.; Gobe, I.; Choga, W.T.; Ratsoma, T.; Phakedi, B.; Mpebe, G.; Ditshwanelo, D.; Musonda, R.; Makhema, J.; Moyo, S.; Gaseitsiwe, S. Atypical Hepatitis B Virus Serology Profile—Hepatitis B Surface Antigen-Positive/Hepatitis B Core Antibody-Negative—In Hepatitis B Virus/HIV Coinfected Individuals in Botswana. Viruses 2023, 15, 1544. Phinius, B.B.; Anderson, M.; Mokomane, M.; Gobe, I.; Choga, W.T.; Ratsoma, T.; Phakedi, B.; Mpebe, G.; Ditshwanelo, D.; Musonda, R.; Makhema, J.; Moyo, S.; Gaseitsiwe, S. Atypical Hepatitis B Virus Serology Profile—Hepatitis B Surface Antigen-Positive/Hepatitis B Core Antibody-Negative—In Hepatitis B Virus/HIV Coinfected Individuals in Botswana. Viruses 2023, 15, 1544.

Abstract

: (1) Background: Hepatitis B core antibodies (anti-HBc) are a marker of hepatitis B virus (HBV) exposure; hence a normal HBV serology profile is characterized by HBV surface antigen (HBsAg) and anti-HBc positivity. However atypical HBV serologies occur and we aimed to determine the prevalence of an atypical profile (HBsAg+/anti-HBc-) in a cohort of people with HIV-1 (PWH) in Botswana. (2) Methods: Plasma samples from an HIV-1 cohort in Botswana (2013-2018) were used. Samples were screened for HBsAg and anti-HBc. Next generation sequencing was done using the GridION platform. Wilcoxon rank-sum test and Chi-squared tests were used for comparison of continuous and categorical variables respectively. (3) Results: HBsAg+/anti-HBc- prevalence was 13.7% (95% CI 10.1 – 18.4) (36/263). HBsAg+/anti-HBc- participants were significantly younger (p<0.001), female (p=0.02), ART naïve (p=0.04) and had detectable HIV viral load (p=0.02). There were no mutational differences in sequences isolated from participants with HBsAg+/anti-HBc- versus those with HBsAg+/anti-HBc+ serology. (4) Conclusions: We report a high HBsAg+/anti-HBc– atypical serology profile prevalence among PWH in Botswana. We caution against HBV testing algorithms that consider only anti-HBc+ samples for HBsAg testing as they are likely to underestimate HBV prevalence. Studies to elucidate the mechanisms and implications of this profile are warranted.

Keywords

Hepatitis B surface antigen (HBsAg); Hepatitis B core antibodies (anti-HBc); HBV; HIV; Botswana; Africa

Subject

Biology and Life Sciences, Virology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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