{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:05:19Z","timestamp":1779905119729,"version":"3.53.1"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"the President\u2019s Emergency Plan for AIDS Relief"},{"DOI":"10.13039\/100000002","name":"the U.S. National Institutes of Health","doi-asserted-by":"crossref","award":["#HT9425-24-2-0020, #W81XWH-11-2-0174, #W81XWH-18-2-0040, and #HT9425-24-3-0004"],"award-info":[{"award-number":["#HT9425-24-2-0020, #W81XWH-11-2-0174, #W81XWH-18-2-0040, and #HT9425-24-3-0004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share transmission routes and are associated with morbidity in sub-Saharan Africa. Understanding the prevalence and demographic predictors of HBV co-infection among people living with HIV (PLWH) can inform integrated screening and treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed enrollment data from the African Cohort Study (AFRICOS), a prospective study of participants aged \u226515 years with and without HIV across 12 clinical sites in Kenya, Uganda, Tanzania, and Nigeria. HBV was diagnosed via hepatitis B surface antigen (Bio-Rad, Hercules, CA). Descriptive statistics summarized HBV prevalence by HIV status and demographic characteristics. Relative risk (RR) of HBV among PLWH compared to people without HIV was calculated. Among PLWH, multivariable logistic regression identified odds ratios (ORs) and 95% confidence intervals (CIs) for factors independently associated with HBV co-infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4,241 participants with valid HBV results, 3,439 were PLWH. HBV prevalence was 4.7% among PLWH and 4.2% among people without HIV (RR: 1.10; 95% CI: 0.77\u20131.59). Among PLWH, HBV prevalence was highest in Nigeria and lowest in Kenya (11.1% vs. 2.6%, p\u2009&lt;\u20090.001), higher among males than females (6.7% vs. 3.2%, p\u2009&lt;\u20090.001, and highest in participants aged \u226540 years and lowest in participants aged 15\u201319 years (5.8% vs. 0.2%, p\u2009&lt;\u20090.001). In multivariable analysis, male sex (OR: 2.22 [95%CI: 1.59\u20133.09]), Nigeria residence (OR: 5.19 [95%CI: 3.35\u20138.05]), and age\u2009\u2265\u200940 (OR: 2.99 [95%CI: 1.74\u20135.13]) were independently associated with HBV co-infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine HBV screening and targeted interventions are needed within HIV programs, especially for older males and in high-prevalence settings like Nigeria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0337789","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T17:22:26Z","timestamp":1779902546000},"page":"e0337789","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of hepatitis B virus co-infection among people living with HIV in four countries in sub-Saharan Africa"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0106-524X","authenticated-orcid":true,"given":"Josphat","family":"Kosgei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Jaoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Oyugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonah","family":"Maswai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Owuoth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Sing\u2019oei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Bahemana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulwasiu B.","family":"Tiamiyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kibuuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh Anne","family":"Eller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Ake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-265X","authenticated-orcid":true,"given":"Trevor A.","family":"Crowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the African Cohort Study (AFRICOS) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"pone.0337789.ref001","article-title":"Hepatitis B and human immunodeficiency virus coinfection","volume":"49","author":"CL Thio","year":"2009","journal-title":"Hepatology"},{"issue":"4","key":"pone.0337789.ref002","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/QAI.0000000000000059","article-title":"Impact of hepatitis coinfection on hospitalization rates and causes in a multicenter cohort of persons living with HIV","volume":"65","author":"TA Crowell","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0337789.ref003","author":"WHO","year":"2021"},{"issue":"6","key":"pone.0337789.ref004","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/01.aids.0000163936.99401.fe","article-title":"Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort","volume":"19","author":"D Konopnicki","year":"2005","journal-title":"AIDS"},{"issue":"3","key":"pone.0337789.ref005","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.idh.2018.02.006","article-title":"Hepatitis B virus and HIV coinfection among adults residing in Cameroon: a systematic review and meta-analysis of prevalence studies","volume":"23","author":"JJ Bigna","year":"2018","journal-title":"Infect Dis Health"},{"key":"pone.0337789.ref006","volume-title":"R: A language and environment for statistical computing","year":"2023"},{"key":"pone.0337789.ref007","author":"WHO","year":"2017"},{"issue":"12","key":"pone.0337789.ref008","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":"CW Spearman","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"pone.0337789.ref009","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1186\/1756-0500-6-363","article-title":"Prevalence of hepatitis B and C viral co-infections among HIV-1 infected individuals in Nairobi, Kenya","volume":"6","author":"BM Muriuki","year":"2013","journal-title":"BMC Res Notes"},{"issue":"1","key":"pone.0337789.ref010","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1186\/s12879-024-09746-7","article-title":"Hepatitis B prevalence and risk factors among adults living with HIV in South Africa: a clinic-based cohort study","volume":"24","author":"M Shivakumar","year":"2024","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0337789.ref011","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1186\/s12879-016-2090-1","article-title":"Hepatitis viruses in Ethiopia: a systematic review and meta-analysis","volume":"16","author":"Y Belyhun","year":"2016","journal-title":"BMC Infect Dis"},{"issue":"8","key":"pone.0337789.ref012","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1002\/jmv.21236","article-title":"Hepatitis B, C seroprevalence and delta viruses in HIV-1 Senegalese patients at HAART initiation (retrospective study)","volume":"80","author":"H Diop-Ndiaye","year":"2008","journal-title":"J Med Virol"},{"issue":"7","key":"pone.0337789.ref013","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0068152","article-title":"Suppression of HBV by tenofovir in HBV\/HIV coinfected patients: a systematic review and meta-analysis","volume":"8","author":"H Price","year":"2013","journal-title":"PLoS One"},{"issue":"1","key":"pone.0337789.ref014","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1186\/s12879-017-2695-z","article-title":"Prevalence of hepatitis B in people living with HIV\/AIDS in Latin America and the Caribbean: a systematic review and meta-analysis","volume":"17","author":"FM Tengan","year":"2017","journal-title":"BMC Infect Dis"},{"issue":"12","key":"pone.0337789.ref015","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijid.2010.06.013","article-title":"Hepatitis B\/C and HIV in sub-Saharan Africa: an association between highly prevalent infectious diseases. A systematic review and meta-analysis","volume":"14","author":"RE Barth","year":"2010","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pone.0337789.ref016","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1186\/s12879-024-09355-4","article-title":"Investigating factors associated to HBV\/HIV co-infected patients in antiretroviral treatment clinic, in Northeast Ethiopia","volume":"24","author":"Y Wasihun","year":"2024","journal-title":"BMC Infect Dis"},{"issue":"7","key":"pone.0337789.ref017","doi-asserted-by":"crossref","first-page":"589","DOI":"10.26719\/2013.19.7.589","article-title":"Prevalence of hepatitis B and C virus infections and their related risk factors in Libya: a national seroepidemiological survey","volume":"19","author":"A-N Elzouki","year":"2013","journal-title":"East Mediterr Health J"},{"issue":"8","key":"pone.0337789.ref018","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1007\/s10461-018-2160-z","article-title":"What role do masculine norms play in men\u2019s HIV testing in Sub-Saharan Africa?: a scoping review","volume":"22","author":"KM Sileo","year":"2018","journal-title":"AIDS Behav"},{"issue":"10","key":"pone.0337789.ref019","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"SL Klein","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"pone.0337789.ref020","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.3389\/fimmu.2018.02302","article-title":"Sex-dependent outcome of hepatitis B and C viruses infections: synergy of sex hormones and immune responses?","volume":"9","author":"A Ruggieri","year":"2018","journal-title":"Frontiers in Immunology"},{"issue":"9349","key":"pone.0337789.ref021","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1016\/S0140-6736(02)11913-1","article-title":"HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS)","volume":"360","author":"CL Thio","year":"2002","journal-title":"Lancet"},{"issue":"11","key":"pone.0337789.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0310923","article-title":"Prevalence of hepatitis B virus infection in Kenya: a study nested in the Kenya population-based HIV impact assessment 2018","volume":"19","author":"RO Ondondo","year":"2024","journal-title":"PLoS One"},{"issue":"9","key":"pone.0337789.ref023","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/cit002","article-title":"Patterns and causes of suboptimal response to tenofovir-based therapy in individuals coinfected with HIV and hepatitis B virus","volume":"56","author":"GV Matthews","year":"2013","journal-title":"Clin Infect Dis"},{"issue":"9","key":"pone.0337789.ref024","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1093\/infdis\/jit351","article-title":"Hepatitis B virus infection is associated with impaired immunological recovery during antiretroviral therapy in the Swiss HIV cohort study","volume":"208","author":"G Wandeler","year":"2013","journal-title":"J Infect Dis"},{"key":"pone.0337789.ref025","author":"WHO","year":"2021"},{"key":"pone.0337789.ref026","volume-title":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. In","year":"2021"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T17:22:31Z","timestamp":1779902551000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337789"}},"subtitle":[],"editor":[{"given":"Pierre","family":"Roques","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":26,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0337789","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]}}}