A retrospective study of HIV and hepatitis B co-infection at a tertiary hospital in the Western Cape province of South Africa.
- 1Division of Infectious Diseases, Department of Medicine, Faculty of Health and Sciences, Stellenbosch University, Cape Town, South Africa.
Abstract
Background
HIV and hepatitis B virus (HBV) coinfection is a clinical concern because of shared transmission routes and accelerated liver disease progression. Data from sub-Saharan Africa (SSA) remain limited.Objectives
To describe the clinical, laboratory, radiological, and outcome characteristics of adults with chronic HIV/HBV coinfection attending a tertiary hospital in South Africa.Method
A retrospective observational study of adults with HIV and chronic HBV infection attending an infectious diseases clinic between 01 January 2019 and 31 October 2024. Chronic HBV was defined as hepatitis B surface antigen positivity for at least 6 months. Eligible patients had at least two clinic visits. Data were extracted from clinical, laboratory, imaging, and pharmacy records.Results
Of the 179 patients screened, 140 met inclusion criteria. The cohort had a female predominance of 51.4% and a median age of 42 years; most were diagnosed through routine HIV care. The median CD4 count was 214 cells/μL, and many had advanced immunosuppression. Most were receiving antiretroviral therapy (ART), with 78.8% on tenofovir (TDF)-based regimens. HIV and HBV viral load (VL) was low, and the median HBV VL was 81 IU/mL. Liver assessment showed that 36.3% had an abnormal Aspartate Aminotransferase to Platelet Ratio Index score and 40.2% had an elevated liver stiffness measurement (> 7 kPa) suggestive either of significant fibrosis or cirrhosis. Fifteen patients died, 3 of whom died from HBV-related causes. Retention in care was poor, with only one-third remaining in follow-up.Conclusion
Chronic HBV remains an important comorbidity among people living with HIV in South Africa, particularly in those born before widespread vaccination. Despite high ART coverage, important gaps remain in fibrosis assessment and retention in care. Strengthening prevention, vaccination, diagnostic access, and continuity of care is essential to reduce HBV-related morbidity and mortality.
Related
- Molecular Etiology and Mortality Risk Stratification of Non-SARS-CoV-2 Severe Acute Respiratory Infection in a Predominantly Pediatric Cohort: A Retrospective Study From a Tertiary Care Hospital in North India
- Seroprevalence of Hepatitis B Virus Infection and Associated Factors Among Blood Donors at a District Hospital in Ghana: A 2-Year Retrospective Study
- Correlation analysis between hand hygiene product consumption trends and healthcare-associated infections in a tertiary comprehensive hospital in Yunnan Province, China (2015–2024)
- A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province
- Clinical and Microbiological Characteristics of Septic Arthritis in 25 Adults at a Tertiary Hospital in Cambodia: A Single-Center Retrospective Case Series
BibTeX
@article{hugo2026retrospective,
title = {{A retrospective study of HIV and hepatitis B co-infection at a tertiary hospital in the Western Cape province of South Africa.}},
author = {Alida M Hugo and Tamsin Lovelock and Jantjie J Taljaard},
journal = {Southern African journal of HIV medicine},
year = {2026},
month = oct,
doi = {10.4102/sajhivmed.v27i1.1847},
url = {https://europepmc.org/article/MED/43011457},
note = {CC BY},
}
RIS
TY - JOUR
TI - A retrospective study of HIV and hepatitis B co-infection at a tertiary hospital in the Western Cape province of South Africa.
AU - Alida M Hugo
AU - Tamsin Lovelock
AU - Jantjie J Taljaard
PY - 2026
DA - 2026/10/06
JO - Southern African journal of HIV medicine
DO - 10.4102/sajhivmed.v27i1.1847
UR - https://europepmc.org/article/MED/43011457
AB - Background HIV and hepatitis B virus (HBV) coinfection is a clinical concern because of shared transmission routes and accelerated liver disease progression. Data from sub-Saharan Africa (SSA) remain limited.Objectives To describe the clinical, laboratory, radiological, and outcome characteristics of adults with chronic HIV/HBV coinfection attending a tertiary hospital in South Africa.Method A retrospective observational study of adults with HIV and chronic HBV infection attending an infectious diseases clinic between 01 January 2019 and 31 October 2024. Chronic HBV was defined as hepatitis B surface antigen positivity for at least 6 months. Eligible patients had at least two clinic visits. Data were extracted from clinical, laboratory, imaging, and pharmacy records.Results Of the 179 patients screened, 140 met inclusion criteria. The cohort had a female predominance of 51.4% and a median age of 42 years; most were diagnosed through routine HIV care. The median CD4 count was 214 cells/μL, and many had advanced immunosuppression. Most were receiving antiretroviral therapy (ART), with 78.8% on tenofovir (TDF)-based regimens. HIV and HBV viral load (VL) was low, and the median HBV VL was 81 IU/mL. Liver assessment showed that 36.3% had an abnormal Aspartate Aminotransferase to Platelet Ratio Index score and 40.2% had an elevated liver stiffness measurement (> 7 kPa) suggestive either of significant fibrosis or cirrhosis. Fifteen patients died, 3 of whom died from HBV-related causes. Retention in care was poor, with only one-third remaining in follow-up.Conclusion Chronic HBV remains an important comorbidity among people living with HIV in South Africa, particularly in those born before widespread vaccination. Despite high ART coverage, important gaps remain in fibrosis assessment and retention in care. Strengthening prevention, vaccination, diagnostic access, and continuity of care is essential to reduce HBV-related morbidity and mortality.
SN - 1608-9693
SN - 2078-6751
ER -