{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:32:17Z","timestamp":1790890337988,"version":"4.1.0"},"reference-count":16,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW010557"],"award-info":[{"award-number":["D43TW010557"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["HHSN261200800001E"],"award-info":[{"award-number":["HHSN261200800001E"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH090173"],"award-info":[{"award-number":["R01MH090173"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH107275"],"award-info":[{"award-number":["R01MH107275"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI143333"],"award-info":[{"award-number":["R01AI143333"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,7]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate hepatitis B virus (HBV) prevalence and factors associated with viral acquisition in a HIV-hyperendemic fishing community, we tested sera for anti-hepatitis B core (HBc) and hepatitis B surface antigen (HBsAg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Large fishing village on Lake Victoria, one of the HIV-hyperendemic Rakai Community Cohort Study (RCCS) sites (HIV prevalence ~40%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Sample of 460 RCCS participants aged 15\u201349 years from survey conducted from 5 December 2016 to 13 February 2017. These proportionately included HIV-negative, HIV-positive antiretroviral therapy (ART)-na\u00efve and HIV positive on ART participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 460 participants, 49.6% (95% CI 45.0% to 54.1%) had evidence of prior HBV infection and 3.7% (95% CI 2.3% to 5.9%) were either acutely or chronically infected. HBV risk increased with age, number of lifetime sex partners and HIV seropositivity. HBV risk decreased with HIV ART use among HIV-positive participants. Prevalence of prior HBV infection was 17.1% in participants aged 15\u201319 years, 43.2%, 55.3% and 70.1% in participants aged 20\u201339, 30\u201339 and 40\u201349 years, respectively (p&lt;0.001). Additionally, the prevalence of prior HBV infection was 23.8% in participants with 0\u20131 lifetime sex partners, 43.2% and 54.8% in participants with 2\u20133 lifetime sex partners and 4+ lifetime\u2009sex partners, respectively (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings from this fishing community suggest the need to provide HBV vaccination to adults at risk of sexual transmission who have not been previously immunised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050436","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T12:56:15Z","timestamp":1649336175000},"page":"e050436","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Hepatitis B virus infection and factors associated with its acquisition among adults in a Lake Victoria HIV hyperendemic fishing community in Kyotera district, Uganda: a cross-sectional observation"],"prefix":"10.1136","volume":"12","author":[{"given":"Charles","family":"Ssuuna","sequence":"first","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-6525","authenticated-orcid":false,"given":"Victor","family":"Ssempijja","sequence":"additional","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo, Uganda"},{"name":"Clinical Monitoring Research Program Directorate (CMRPD), Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Kalibbala","sequence":"additional","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Serwadda","sequence":"additional","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo, Uganda"},{"name":"Makerere University School of Public Health, College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-0382","authenticated-orcid":false,"given":"Ping Teresa","family":"Yeh","sequence":"additional","affiliation":[{"name":"International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Wawer","sequence":"additional","affiliation":[{"name":"Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Gray","sequence":"additional","affiliation":[{"name":"Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Chang","sequence":"additional","affiliation":[{"name":"Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"School of Medicine, Department of Infectious Disease, Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kagaayi","sequence":"additional","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Reynolds","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Infectious Disease, Johns Hopkins University, Baltimore, Maryland, USA"},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"2025121400073508000_12.4.e050436.1","unstructured":"WHO . Global hepatitis report 2017, 2017. Available: https:\/\/www.who.int\/hepatitis\/publications\/global-hepatitis-report2017\/en\/"},{"key":"2025121400073508000_12.4.e050436.2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22898"},{"key":"2025121400073508000_12.4.e050436.3","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S1665-2681(19)31354-7","article-title":"Epidemiology of hepatocellular carcinoma in sub-Saharan Africa","volume":"12","author":"Kew","year":"2013","journal-title":"Ann Hepatol"},{"key":"2025121400073508000_12.4.e050436.4","first-page":"98","article-title":"Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey","volume":"9","author":"Bwogi","year":"2009","journal-title":"Afr Health Sci"},{"key":"2025121400073508000_12.4.e050436.5","doi-asserted-by":"crossref","first-page":"6930","DOI":"10.1016\/j.vaccine.2006.08.029","article-title":"Hepatitis B infection among health workers in Uganda: evidence of the need for health worker protection","volume":"24","author":"Braka","year":"2006","journal-title":"Vaccine"},{"key":"2025121400073508000_12.4.e050436.6","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/S2468-1253(17)30295-9","article-title":"Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets","volume":"2","author":"Spearman","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025121400073508000_12.4.e050436.7","doi-asserted-by":"crossref","first-page":"e680","DOI":"10.1016\/S2352-3018(19)30190-0","article-title":"Impact of combination HIV interventions on HIV incidence in hyperendemic fishing communities in Uganda: a prospective cohort study","volume":"6","author":"Kagaayi","year":"2019","journal-title":"Lancet HIV"},{"key":"2025121400073508000_12.4.e050436.8","unstructured":"Ministry of Health . Consolidated guidelines for prevention and treatment of HIV in Uganda, 2016."},{"key":"2025121400073508000_12.4.e050436.9","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1002\/jmv.22051","article-title":"Hepatitis B virus and sexual behavior in Rakai, Uganda","volume":"83","author":"Stabinski","year":"2011","journal-title":"J Med Virol"},{"key":"2025121400073508000_12.4.e050436.10","unstructured":"Ministry of Health . Uganda Clinical Guidelines 2012, 2012."},{"key":"2025121400073508000_12.4.e050436.11","doi-asserted-by":"crossref","first-page":"e388","DOI":"10.1016\/S2352-3018(16)30034-0","article-title":"Heterogeneity of the HIV epidemic in agrarian, trading, and fishing communities in Rakai, Uganda: an observational epidemiological study","volume":"3","author":"Chang","year":"2016","journal-title":"Lancet HIV"},{"key":"2025121400073508000_12.4.e050436.12","doi-asserted-by":"crossref","first-page":"419","DOI":"10.15698\/mic2016.09.527","article-title":"Hepatitis B virus and its sexually transmitted infection - an update","volume":"3","author":"Inoue","year":"2016","journal-title":"Microb Cell"},{"key":"2025121400073508000_12.4.e050436.13","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/161.6.1112"},{"key":"2025121400073508000_12.4.e050436.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2016.06.006"},{"key":"2025121400073508000_12.4.e050436.15","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199703000-00001"},{"key":"2025121400073508000_12.4.e050436.16","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/QAD.0000000000001399","article-title":"Hepatitis B incidence and prevention with antiretroviral therapy among HIV-positive individuals in Uganda","volume":"31","author":"Seremba","year":"2017","journal-title":"AIDS"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-050436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:07:43Z","timestamp":1765699663000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-050436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":16,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,7]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjopen-2021-050436"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-050436","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}