Characterization of occult hepatitis B in highrisk populations in Kenya
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Date
2020
Authors
Kiptoon, Beatrice Jepkemei
Missiani, Ochwoto
Swidinsky, Ken
Day, Jacqueline
Gebrebrhan, Henok
McKinnon, Lyle R.
Andonov, Anton
Oyugi, Julius
Kimani, Joshua
Gachara, George
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
Occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA
in the liver or serum in the absence of detectable HBV surface antigen (HBsAg). OBI poses
a risk for the development of cirrhosis and hepatocellular carcinoma. The prevalence of OBI
in Kenya is unknown, thus a study was undertaken to determine the prevalence and molecular
characterization of OBI in Kenyan populations at high risk of HBV infection. Sera from
two Nairobi cohorts, 99 male sex workers, primarily having sex with men (MSM-SW), and
13 non-MSM men having HIV-positive partners, as well as 65 HBsAg-negative patients presenting
with jaundice at Kenyan medical facilities, were tested for HBV serological markers,
including HBV DNA by real-time PCR. Positive DNA samples were sequenced and MSMSW
patients were further tested for hepatitis C virus (HCV) infection. Of the 166 HBsAg-negative
samples tested, 31 (18.7%; 95% confidence interval [CI] 13.5–25.3) were HBV DNA
positive (i.e., occult), the majority (20/31; 64.5%) of which were HBV core protein antibody
positive. HCV infection was not observed in the MSM-SW participants, although the prevalence
of HBsAg positivity was 10.1% (10/99; 95% CI 5.6–17.6). HBV genotype A was predominant
among study cases, including both HBsAg-positive and OBI participants,
although the data suggests a non-African network transmission source among MSM-SW.
The high prevalence of HBV infection among MSM-SW in Kenya suggests that screening
programmes be instituted among high-risk cohorts to facilitate preventative measures, such
as vaccination, and establish entry to treatment and linkage to care.
Description
A research article published in Plose One
Keywords
occult hepatitis B, Kenya
Citation
Jepkemei KB, Ochwoto M, Swidinsky K, Day J, Gebrebrhan H, McKinnon LR, et al. (2020) Characterization of occult hepatitis B in high-risk populations in Kenya. PLoS ONE 15(5): e0233727. https://doi.org/10.1371/journal.pone.0233727