{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:09:37Z","timestamp":1789150177974,"version":"build-2803163510"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Co-occurrence of HIV and Hepatitis B Virus (HBV) in sub-Saharan Africa, although less prevalent, is often more serious and exhibits rapid clinical deterioration even with appropriate treatment, jeopardizing efforts to reach regional and global targets. Evidence varies in the region and not reported in some countries. We used data from the nationally representative survey to characterize the burden and determinants of HIV and HBV co-occurrence in Tanzania. This secondary data analysis of the Tanzania HIV Impact Survey (THIS) involved 33,263 individuals aged 15 years and above, randomly selected from 14,966,262 households from 31 regions of Tanzania. The main outcome variable was HIV and HBV coinfections. Analyses were conducted using descriptive analysis, to estimate prevalence of co-occurrences, while Chi-square test used to characterize the burden. Through bivariable and multivariable binomial logistic regression models, we could estimate the associations between different independent variables with HIV-HBV co-occurrence. The burdens of HIV and HBV in the general population were 4.4% and 3.5% respectively. The prevalence of dual HIV and HBV infections was 0.3%. Among people diagnosed with HIV, 6.2% had HBV co-occurrence. After adjusting for confounder and other variables, age was significantly associated with coinfection (aOR = 1.02; 95% CI: 1.01\u20131.03; p\u2009&lt;\u20090.001). Participants who were not in union had significantly higher risk of coinfection compared with those in union (aOR = 1.56; 95% CI: 1.01\u20132.41; p\u2009=\u20090.047). Having one lifetime sexual partner remained strongly protective factor against HIV-HBV coinfection (aOR = 0.19; 95% CI: 0.09\u20130.42; p\u2009&lt;\u20090.001). Although the burden of HIV\/HBV coinfection remains as low as 0.3% in the general population in Tanzania, the risk remains high among older adults and those with multiple sexual partnerships. Integrating HBV screening in all opportunities presented in the successful HIV program may help addressing the dual burden. For effectiveness, more efforts should target people with high-risk sexual behaviors and those with advanced age.<\/jats:p>","DOI":"10.1371\/journal.pone.0358242","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:32:22Z","timestamp":1789147942000},"page":"e0358242","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV and Hepatitis B co-infection in Tanzania: Analysis of the 2022\u20132023 Tanzania HIV Impact Survey"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9140-134X","authenticated-orcid":true,"given":"Felistar","family":"Mwakasungura","sequence":"first","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences","place":["Dar es Salaam, Tanzania"],"department":["Department of Community Health, School of Public Health and Social Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfateresia","family":"Mwasangama","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences","place":["Dar es Salaam, Tanzania"],"department":["Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences"]},{"name":"Aga Khan University","place":["Dar es Salaam, Tanzania"],"department":["School of Nursing and Midwifery"]},{"name":"University of Cape Town","place":["Cape Town, South Africa"],"department":["Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis","family":"Amani","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences","place":["Dar es Salaam, Tanzania"],"department":["Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Bukundi","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences","place":["Dar es Salaam, Tanzania"],"department":["Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Sunguya","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences","place":["Dar es Salaam, Tanzania"],"department":["Department of Community Health, School of Public Health and Social Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"pone.0358242.ref001","article-title":"Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings","author":"L Stabinski","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0358242.ref002","unstructured":"Global HIV & AIDS statistics \u2014 Fact sheet. UNAIDS. [cited 2026 Mar 10]. Available from: https:\/\/www.unaids.org\/en\/resources\/fact-sheet"},{"issue":"29","key":"pone.0358242.ref003","doi-asserted-by":"crossref","first-page":"3793","DOI":"10.3748\/wjg.v28.i29.3793","article-title":"Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma","volume":"28","author":"B Gnyawali","year":"2022","journal-title":"World J Gastroenterol"},{"key":"pone.0358242.ref004","article-title":"Prevalence of HBV\/HCV co-infection and associated risk factors in people living with HIV","volume":"20","author":"S Senoglu","year":"2020","journal-title":"Hepat Mon"},{"key":"pone.0358242.ref005","doi-asserted-by":"crossref","first-page":"275","DOI":"10.11604\/pamj.2017.28.275.11926","article-title":"The prevalence of hepatitis B virus among HIV-positive patients at Kilimanjaro Christian Medical Centre Referral Hospital, Northern Tanzania","volume":"28","author":"T Kamenya","year":"2017","journal-title":"Pan Afr Med J"},{"issue":"8","key":"pone.0358242.ref006","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad366","article-title":"Hepatitis B virus prevalence and mother-to-child transmission risk in an HIV early intervention cohort in KwaZulu-Natal, South Africa","volume":"10","author":"J Millar","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"pone.0358242.ref007","first-page":"14","article-title":"Chronic hepatitis B and HIV coinfection","volume":"31","author":"MA Corcorran","year":"2023","journal-title":"Top Antivir Med"},{"issue":"5","key":"pone.0358242.ref008","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.3390\/biomedicines11051306","article-title":"HIV-HBV coinfection-current challenges for virologic monitoring","volume":"11","author":"S Ruta","year":"2023","journal-title":"Biomedicines"},{"key":"pone.0358242.ref009","doi-asserted-by":"crossref","first-page":"713981","DOI":"10.3389\/fmed.2021.713981","article-title":"HBV\/HIV coinfection: impact on the development and clinical treatment of liver diseases","volume":"8","author":"Z Cheng","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"pone.0358242.ref010","first-page":"216","article-title":"Prevalence and associated factors of hepatitis B surface antigen (HBsAg) among people living with HIV (PLWHIV) attending at CTC Mawenzi Regional Hospital Kilimanjaro, Northern Tanzania","volume":"11","author":"BS Nyalika","year":"2021","journal-title":"Adv Infect Dis"},{"key":"pone.0358242.ref011","unstructured":"Tanzania Summary Sheet 2022-2023 - PHIA Project. [cited 2026 Mar 10]. Available from: https:\/\/phia.icap.columbia.edu\/tanzania-summary-sheet-2022-3\/"},{"issue":"1","key":"pone.0358242.ref012","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4314\/ahs.v23i1.17","article-title":"Prevalence of hepatitis-B virus co-infection among people living with HIV in Mthatha region of South Africa","volume":"23","author":"R Kaswa","year":"2023","journal-title":"Afr Health Sci"},{"issue":"3","key":"pone.0358242.ref013","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/jvh.13217","article-title":"Prevalence and burden of HBV co-infection among people living with HIV: a global systematic review and meta-analysis","volume":"27","author":"L Platt","year":"2020","journal-title":"J Viral Hepat"},{"issue":"1","key":"pone.0358242.ref014","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1186\/s12889-020-09012-w","article-title":"Prevalence and risk factors associated with HIV\/hepatitis B and HIV\/hepatitis C co-infections among people who inject drugs in Mozambique","volume":"20","author":"C Sem\u00e1 Baltazar","year":"2020","journal-title":"BMC Public Health"},{"key":"pone.0358242.ref015","article-title":"Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings","author":"L Stabinski","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0358242.ref016","unstructured":"Closing the gap in a generation: health equity through action on the social determinants of health - Final report of the commission on social determinants of health. [cited 2026 Feb 2]. Available from: https:\/\/www.who.int\/publications\/i\/item\/WHO-IER-CSDH-08.1"},{"key":"pone.0358242.ref017","first-page":"7089150","article-title":"HIV epidemic in Tanzania: the possible role of the key populations","volume":"2017","author":"BCT Mpondo","year":"2017","journal-title":"AIDS Res Treat"},{"key":"pone.0358242.ref018","doi-asserted-by":"crossref","first-page":"4178240","DOI":"10.1155\/2024\/4178240","article-title":"Prevalence of hepatitis B virus infection in Tanzania: a systematic review and meta-analysis","volume":"2024","author":"SB Kilonzo","year":"2024","journal-title":"J Trop Med"},{"issue":"1","key":"pone.0358242.ref019","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1186\/s12884-022-04687-y","article-title":"High risk of adverse birth outcomes among adolescents living with HIV in Botswana compared to adult women living with HIV and adolescents without HIV","volume":"22","author":"M Jackson-Gibson","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"pone.0358242.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0321623","article-title":"Hepatitis B virus: prevalence, vaccination coverage and immune responses to immunization among healthcare workers at Muhimbili National Hospital","volume":"20","author":"M Orotta","year":"2025","journal-title":"PLoS One"},{"key":"pone.0358242.ref021","doi-asserted-by":"crossref","first-page":"4239646","DOI":"10.1155\/2018\/4239646","article-title":"Hepatitis B virus infection in Tanzania: current status and challenges","volume":"2018","author":"SB Kilonzo","year":"2018","journal-title":"J Trop Med"},{"key":"pone.0358242.ref022","doi-asserted-by":"crossref","first-page":"176","DOI":"10.11604\/pamj.2021.38.176.26105","article-title":"Unprotected sexual practices and associated factors among adult people living with HIV on antiretroviral therapy in public hospitals of Kembata Tembaro Zone, Southern Ethiopia","volume":"38","author":"DL Anore","year":"2021","journal-title":"Pan Afr Med J"},{"key":"pone.0358242.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-025-21945-8","article-title":"Knowledge, attitude, and practice of HIV\/AIDS transmission and prevention among barbing and beauty salon operators in Mogadishu, Somalia","volume":"25","author":"SA Hussein","year":"2025","journal-title":"BMC Public Health"},{"issue":"7","key":"pone.0358242.ref024","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-058722","article-title":"Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment","volume":"12","author":"DL Ejalu","year":"2022","journal-title":"BMJ Open"},{"issue":"8","key":"pone.0358242.ref025","article-title":"Prevalence and associated factors for HIV, HBV and syphilis coinfections among pregnant women attending antenatal care in Tanzania","volume":"20","author":"AF Njau","year":"2025","journal-title":"PLoS One"},{"key":"pone.0358242.ref026","unstructured":"Hepatitis B. [cited 2026 Mar 10]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-b"},{"issue":"15","key":"pone.0358242.ref027","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1097\/QAD.0000000000001574","article-title":"HIV-hepatitis B virus coinfection: epidemiology, pathogenesis, and treatment","volume":"31","author":"KP Singh","year":"2017","journal-title":"AIDS"},{"issue":"6","key":"pone.0358242.ref028","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/S2468-1253(24)00089-X","article-title":"WHO 2024 hepatitis B guidelines: an opportunity to transform care","volume":"9","author":"PJ Easterbrook","year":"2024","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"5","key":"pone.0358242.ref029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0269250","article-title":"Epidemiology of hepatitis B virus and\/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: a systematic review and meta-analysis","volume":"17","author":"R Kenfack-Momo","year":"2022","journal-title":"PLoS One"},{"key":"pone.0358242.ref030","unstructured":"Consolidated guidance on hepatitis B and C prevention, testing, treatment, service delivery and monitoring: an implementation handbook for a public health approach. [cited 2026 Apr 26]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240119529"},{"issue":"2","key":"pone.0358242.ref031","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1179\/146532810X12703902516167","article-title":"Immunity to hepatitis B vaccine in Tanzanian under-5 children","volume":"30","author":"J Metodi","year":"2010","journal-title":"Ann Trop Paediatr"},{"issue":"1","key":"pone.0358242.ref032","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":"8","key":"pone.0358242.ref033","article-title":"Prevalence and associated factors for HIV, HBV and syphilis coinfections among pregnant women attending antenatal care in Tanzania","volume":"20","author":"AF Njau","year":"2025","journal-title":"PLoS One"},{"issue":"1","key":"pone.0358242.ref034","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":"46","key":"pone.0358242.ref035","doi-asserted-by":"crossref","first-page":"17360","DOI":"10.3748\/wjg.v20.i46.17360","article-title":"Hepatitis B and human immunodeficiency virus co-infection","volume":"20","author":"B-C Phung","year":"2014","journal-title":"World J Gastroenterol"},{"issue":"1","key":"pone.0358242.ref036","article-title":"HBV elimination in Africa-Current status and challenges","volume":"23","author":"MW Sonderup","year":"2024","journal-title":"Clin Liver Dis (Hoboken)"},{"issue":"3","key":"pone.0358242.ref037","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0058468","article-title":"Viral hepatitis and rapid diagnostic test based screening for HBsAg in HIV-infected patients in rural Tanzania","volume":"8","author":"FC Franzeck","year":"2013","journal-title":"PLoS One"},{"key":"pone.0358242.ref038","doi-asserted-by":"crossref","first-page":"100058","DOI":"10.1016\/j.glmedi.2024.100058","article-title":"Advancing public health policies to combat Hepatitis B in Africa: challenges, advances, and recommendations for meeting 2030 targets","volume":"2","author":"AA Faniyi","year":"2024","journal-title":"J Med Surg Public Health"},{"issue":"9","key":"pone.0358242.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0332152","article-title":"Evaluation of statistical regression models in predicting factors influencing HBV and HIV among female sex workers in Ghana: a bio-behavioural survey","volume":"20","author":"J Adjei-Roger","year":"2025","journal-title":"PLoS One"},{"key":"pone.0358242.ref040","doi-asserted-by":"crossref","first-page":"105733","DOI":"10.1016\/j.jcv.2024.105733","article-title":"Hepatitis B virus (HBV) viremia despite tenofovir disoproxil fumarate-containing antiretroviral therapy in persons with HBV\/HIV coinfection","volume":"175","author":"P Ryan","year":"2024","journal-title":"J Clin Virol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:32:33Z","timestamp":1789147953000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358242"}},"subtitle":[],"editor":[{"given":"Hans L.","family":"Tillmann","sequence":"first","affiliation":[{"name":"East Carolina University Brody School of Medicine","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358242","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]}}}