: Estimating the prevalence of hepatitis B virus (HBV) infection and HBV/HIV coinfection is important given successful scale up of Antiretroviral Therapy (ART) in Zambia and concerns about HBV treatment resistance of current treatment regimens recommended in Zambia.
We used data from the 2016 Zambia Population-based HIV Impact Assessment (ZAMPHIA), a national household survey that includes rapid hepatitis B surface antigen (HBsAg) and HIV rapid tests in the home. Current HBV infection was defined by HBsAg+ results. We estimated the prevalence of HBV and HBV/HIV coinfection and conducted multivariate logistic regression to determine associated predictors using weighted data.
ZAMPHIA recruited 26,888 individuals aged 0-59 years. The national HBV prevalence was 5.6% (95% CI=5.2-6.0%,) for adults and 1.3% (Table 1) for children, which translates to an estimated 410,377 adults and 93,753 children (Table 1), nationally. Amongst those HBV+, 13.6% were found to be coinfected with HIV (Table 1). Provincial HBV prevalence was highest in Luapula (5.1%) with the highest rates of HIV infection amongst those HBV+ in Lusaka and Western (Table 1). HBV positivity was most common amongst men, those 25-34 years of age and lowest amongst the 0-14 age group (Table 1). HBV positivity was higher among HIV positive persons (aORHIV+ vs.HIV-]=1.49, 95% CI=1.24-1.79); male sex (aORMale vs.Female=1.69, 95% CI=1.47-1.93); highest among persons residing in Luapula (aORLuapula vs.Eastern=2.19, 95% CI=1.51-3.17) and among persons aged 25-34 years (aOR25-34y vs.15-24y=1.39, 95% CI=1.16-1.66). Persons aged 35-44 years were most likely to be coinfected with HIV (aOR34-44yvs.15-24y4= 6.61, 95% CI=3.75-11.64) as well as those residing in Western province (aORWestern vs.Eastern= 2.32, 95% CI=1.08-4.96).
These findings highlight, for the first time in Zambia, high levels of chronic HBV infection, and a need for hepatitis B vaccination programs, screening and treatment programs, and for careful attention to national HIV and HIV/HBV treatment and pre-exposure prophylaxis guidelines.