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The extent of HIV\u2010HBsAg co\u2010infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co\u2010infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002\u20102018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV\u2010exposure category. The global burden of co\u2010infection was estimated by applying regional co\u2010infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta\u2010analysis to estimate the odds of HBsAg among PLHIV compared to HIV\u2010negative individuals. We identified 506 estimates (475 studies) of HIV\u2010HBsAg co\u2010infection prevalence from 80\/195 (41.0%) countries. Globally, the prevalence of HIV\u2010HBsAg co\u2010infection is 7.6% (IQR 5.6%\u201012.1%) in PLHIV, or 2.7 million HIV\u2010HBsAg co\u2010infections (IQR 2.0\u20104.2). The greatest burden (69% of cases; 1.9 million) is in sub\u2010Saharan Africa. Globally, there was little difference in prevalence of HIV\u2010HBsAg co\u2010infection by population group (approximately 6%\u20107%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%\u201016.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV\u2010negative individuals. There is therefore, a high global burden of HIV\u2010HBsAg co\u2010infection, especially in sub\u2010Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth\u2010dose. Findings also highlight the importance of targeting PLHIV, especially high\u2010risk groups for testing, catch\u2010up HBV vaccination and other preventative interventions. The global scale\u2010up of antiretroviral therapy (ART) for PLHIV using a tenofovir\u2010based ART regimen provides an opportunity to simultaneously treat those with HBV co\u2010infection, and in pregnant women to also reduce mother\u2010to\u2010child transmission of HBV alongside HIV.<\/jats:p>","DOI":"10.1111\/jvh.13217","type":"journal-article","created":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T16:14:31Z","timestamp":1570810471000},"page":"294-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":194,"title":["Prevalence and burden of HBV co\u2010infection among people living with HIV: A global systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-0045","authenticated-orcid":false,"given":"Lucy","family":"Platt","sequence":"first","affiliation":[{"name":"Faculty of Public Health &amp; Policy London School of Hygiene &amp; Tropical 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London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Stone","sequence":"additional","affiliation":[{"name":"NIHR Health Protection Research Unit in Evaluation of Interventions Population Health Sciences Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2603-5418","authenticated-orcid":false,"given":"Philippa","family":"Easterbrook","sequence":"additional","affiliation":[{"name":"World Health Organisation Geneva 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