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
Bonolo B. Phinius,
Motswedi Anderson,
Margaret Mokomane,
Irene Gobe,
Wonderful T. Choga,
Tsholofelo Ratsoma,
Basetsana Phakedi,
Gorata Mpebe,
Doreen Ditshwanelo,
Rosemary Musonda,
Joseph Makhema,
Sikhulile Moyo,
Simani Gaseitsiwe
Affiliations
Bonolo B. Phinius
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Motswedi Anderson
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Margaret Mokomane
School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
Irene Gobe
School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
Wonderful T. Choga
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Tsholofelo Ratsoma
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Basetsana Phakedi
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Gorata Mpebe
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Doreen Ditshwanelo
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Rosemary Musonda
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Joseph Makhema
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Sikhulile Moyo
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
Simani Gaseitsiwe
Botswana Harvard AIDS Institute Partnership, Private Bag BO 320, Gaborone, Botswana
(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. The samples were screened for HBsAg and anti-HBc. Next-generation sequencing was performed using the GridION platform. The Wilcoxon rank-sum test and Chi-squared tests were used for the 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 p = 0.02) and ART-naïve (p = 0.04) and had a detectable HIV viral load (p = 0.02). There was no statistically significant difference in the number of mutations observed in participants with HBsAg+/anti-HBc- vs. 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.
