{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:21:44Z","timestamp":1789042904614,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":78,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006939","name":"Emory University","doi-asserted-by":"publisher","award":["D43TW007124"],"award-info":[{"award-number":["D43TW007124"]}],"id":[{"id":"10.13039\/100006939","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with TB disease in Georgia are not routinely tested for HBV and the prevalence of chronic HBV among TB patients is unknown. We aimed to assess the prevalence of HBV coinfection and immunity among persons with TB in Georgia and evaluate their HBV-related knowledge and attitudes toward vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study among persons with active TB disease at the National Center for Tuberculosis and Lung Diseases in Georgia from September 20, 2024 to February 20, 2025. Participants underwent serologic testing (HBsAg, anti-HBs, anti-HBc) and completed a questionnaire on HBV knowledge, vaccination history, and willingness to vaccinate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 110 participants (median age\u2009=\u200944.0, IQR:35.0-56.3), of which 63.6% were male. Four participants (3.6%) were HBsAg positive. HBV test results showed 14 (12.7%) had past HBV infection with anti-HBc+\/anti-HBs+, and 7 (6.4%) had isolated anti-HBc positivity (anti-HBc+\/anti-HBs-). Another seven (6.4%) had vaccine-induced immunity (anti-HBc-\/anti-HBs+), and 82 (74.5%) were susceptible to HBV infection. While 74.5% reported having heard of HBV, only 50.0% correctly identified transmission routes. Only 16 patients (14.5%) were willing to receive vaccination. Among those unwilling, the main barriers were concerns about vaccine safety (34.9%), effectiveness (23.3%), and perceived infection risk (20.9%). Participants aged\u2009\u2264\u200940 years were significantly more likely to be aware of HBV compared to those over 40 (OR=3.39, 95% CI: 1.25\u20139.20).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TB-HBV coinfection observed in this study suggests that routine HBV screening among TB patients in Georgia may be beneficial. Low vaccination coverage and limited knowledge highlight the importance of integrating HBV education and vaccination into TB programs to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13816-3","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:31:40Z","timestamp":1782300700000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis B coinfection and awareness among patients with active tuberculosis in Georgia: a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7116-6142","authenticated-orcid":false,"given":"Giorgi","family":"Kanchelashvili","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaza","family":"Avaliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Kipiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestani","family":"Tukvadze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamuka","family":"Chincharauli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasha","family":"Gulbiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nino","family":"Bzishvili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kamkamidze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Butsashvili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"13816_CR1","unstructured":"World Health Organization. Tuberculosis [Fact sheet]. 2025 [cited 2025 Mar 14]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis."},{"key":"13816_CR2","unstructured":"Georgia National Tuberculosis Program. National strategy for tuberculosis control in Georgia 2019\u20132022. 2022. Available from: http:\/\/www.georgia-ccm.ge\/wp-content\/uploads\/National-Strategy-for-Tuberculosis-Control-in-Georgia-2019-2022.pdf."},{"key":"13816_CR3","unstructured":"Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; National Center for Disease Control and Public Health. Tuberculosis, Georgia brief 2020. 2020. Available from: https:\/\/test.ncdc.ge\/Handlers\/GetFile.ashx?ID=27d0aa1a-91c0-4f19-9d10-6427b5534856."},{"key":"13816_CR4","unstructured":"World Health Organization. TB profile: Georgia (Global tuberculosis report 2024, version 4.0). 2024. Retrieved September 25, 2025. Available from: https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/?_inputs_&tab=%22tables%22&lan=%22EN%22&iso3=%22GEO%22&entity_type=%22country%22."},{"key":"13816_CR5","unstructured":"WHO. Hepatitis B [Fact sheet]. 2025 [cited 2023 Jul 23]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-b."},{"key":"13816_CR6","unstructured":"CDC NCDC. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia. Georgia hepatitis elimination program progress report. 2021 [cited 2022 Oct 4]. Available from: https:\/\/www.cdc.gov\/hepatitis\/media\/georgiahepeliminationprogressreport2020-2021.pdf?utm_source=chatgpt.com."},{"key":"13816_CR7","unstructured":"WHO. Hepatitis B vaccines: WHO position paper \u2013 July 2017. 2017 [cited 2023 Apr 6]. Available from: https:\/\/www.who.int\/publications\/i\/item\/WER9227."},{"issue":"6","key":"13816_CR8","doi-asserted-by":"publisher","first-page":"2646","DOI":"10.1007\/s10620-021-07056-5","volume":"67","author":"J Chen","year":"2022","unstructured":"Chen J, Hubbard A, Bagley L, Shiau R, Wong RJ, Chitnis AS. Prevalence of Latent Tuberculosis Infection Among Persons with Chronic Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis. Dig Dis Sci. 2022;67(6):2646\u201354. https:\/\/doi.org\/10.1007\/s10620-021-07056-5 . Epub 2021 May 30. PMID: 34056681.","journal-title":"Dig Dis Sci"},{"key":"13816_CR9","doi-asserted-by":"publisher","unstructured":"Wong RJ, Kaufman HW, Niles JK, Meyer WA 3rd, Chitnis AS. Prevalence of hepatitis B virus and latent tuberculosis coinfection in the United States. Journal of Public Health Management and Practice. 2022 Sep\u2013Oct;28(5):452\u2013462. https:\/\/doi.org\/10.1097\/PHH.0000000000001536.\u00a0PMID: 35867500.","DOI":"10.1097\/PHH.0000000000001536"},{"issue":"1","key":"13816_CR10","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1186\/s12879-018-3192-8","volume":"18","author":"L Chen","year":"2018","unstructured":"Chen L, Bao D, Gu L, Gu Y, Zhou L, Gao Z, Huang Y. Co-infection with hepatitis B virus among tuberculosis patients is associated with poor outcomes during anti-tuberculosis treatment. BMC Infect Dis. 2018;18(1):295. https:\/\/doi.org\/10.1186\/s12879-018-3192-8 . PMID: 29970037; PMCID: PMC6029116.","journal-title":"BMC Infect Dis"},{"key":"13816_CR11","unstructured":"Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia. National strategic plan for tuberculosis control in Georgia 2016\u20132020. 2020 [cited 2026 Apr 24]. Available from: https:\/\/www.georgia-ccm.ge\/wp-content\/uploads\/TB-NSP-2016-20201.pdf."},{"key":"13816_CR12","unstructured":"Emory University. Georgia TB program overview. 2026 [cited 2026 Apr 24]. Available from: https:\/\/tb.emory.edu\/institutions\/international\/georgia.html."},{"issue":"12","key":"13816_CR13","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1111\/jvh.13751","volume":"29","author":"C Chou","year":"2022","unstructured":"Chou C, Veracruz N, Chitnis AS, Wong RJ. Risk of drug-induced liver injury in chronic hepatitis B and tuberculosis co-infection: A systematic review and meta-analysis. J Viral Hepat. 2022;29(12):1107\u201314. https:\/\/doi.org\/10.1111\/jvh.13751 . Epub 2022 Oct 14. PMID: 36138556.","journal-title":"J Viral Hepat"},{"issue":"7","key":"13816_CR14","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1097\/MCG.0000000000001533","volume":"56","author":"RJ Wong","year":"2022","unstructured":"Wong RJ, Hubbard A, Bagley L, Shiau R, Chitnis AS. Estimating Prevalence of Hepatitis B Virus Coinfection Among Adults With Tuberculosis: A Systematic Review With Meta-analysis. J Clin Gastroenterol. 2022;56(7):601\u201317. Epub 2021 Apr 8. PMID: 34009841.","journal-title":"J Clin Gastroenterol"},{"key":"13816_CR15","unstructured":"Aung T, Khaing W. Seroprevalence of hepatitis B and C virus infections and related risk factors of hepatitis B virus infection among newly diagnosed tuberculosis patients at National Tuberculosis Program (Central), Mandalay Office, Myanmar. 2022;37. Available from: https:\/\/he01.tci-thaijo.org\/index.php\/JMedGlob\/article\/view\/256489."},{"issue":"5","key":"13816_CR16","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.4269\/ajtmh.15-0797","volume":"94","author":"JD Debes","year":"2016","unstructured":"Debes JD, Kayandabila J, Pogemiller H. Knowledge of Hepatitis B Transmission Risks Among Health Workers in Tanzania. Am J Trop Med Hyg. 2016;94(5):1100\u20132. https:\/\/doi.org\/10.4269\/ajtmh.15-0797 . Epub 2016 Feb 29. PMID: 26928835; PMCID: PMC4856610.","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"13816_CR17","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1186\/s12879-018-3235-1","volume":"18","author":"YL Qin","year":"2018","unstructured":"Qin YL, Li B, Zhou YS, Zhang X, Li L, Song B, Liu P, Yuan Y, Zhao ZP, Jiao J, Li J, Sun Y, Sevalie S, Kanu JE, Song YJ, Jiang JF, Sahr F, Jiang TJ, Chinese Military Medical Experts Group in Sierra Leone. Prevalence and associated knowledge of hepatitis B infection among healthcare workers in Freetown, Sierra Leone. BMC Infect Dis. 2018;18(1):315. https:\/\/doi.org\/10.1186\/s12879-018-3235-1 . PMID: 29986658; PMCID: PMC6038231.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"13816_CR18","doi-asserted-by":"publisher","first-page":"3156","DOI":"10.1186\/s12889-024-20646-y","volume":"24","author":"MS Bazrafshani","year":"2024","unstructured":"Bazrafshani MS, Mehmandoost S, Tavakoli F, Shahesmaeili A, Ghalekhani N, Sharafi H, SeyedAlinaghi S, Haghdoost A, Karamouzian M, Sharifi H. Self-reported lifetime Hepatitis B virus testing, and vaccination uptake among people who inject drugs in Iran: a nationwide study in 2020. BMC Public Health. 2024;24(1):3156. https:\/\/doi.org\/10.1186\/s12889-024-20646-y . PMID: 39538214; PMCID: PMC11562248.","journal-title":"BMC Public Health"},{"key":"13816_CR19","doi-asserted-by":"publisher","first-page":"660","DOI":"10.15585\/mmwr.mm7330a1","volume":"73","author":"RA Tohme","year":"2024","unstructured":"Tohme RA, Shadaker S, Adamia E, et al. Progress Toward the Elimination of Hepatitis B and Hepatitis C in the Country of Georgia, April 2015\u2013April 2024. MMWR Morb Mortal Wkly Rep. 2024;73:660\u20136. https:\/\/doi.org\/10.15585\/mmwr.mm7330a1.","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-13816-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13816-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13816-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:03:40Z","timestamp":1789041820000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-13816-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["13816"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-13816-3","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"assertion":[{"value":"13 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Institutional Review Boards of the Health Research Union (IRB00009520; IORG0005619), the National Center for Tuberculosis and Lung Diseases (IORG0009467; FWA00020831), and Emory University (IRB ID: STUDY00007701). The research was conducted in compliance with the Georgian legislation, U.S. Department of Health and Human Services regulations (45 CFR 46), and relevant international guidelines for biomedical research. The study was conducted in accordance with the Declaration of Helsinki and its later amendments.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1625"}}