{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:49:28Z","timestamp":1785408568594,"version":"3.56.0"},"reference-count":86,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sub-Saharan African Network for TB\/HIV Research Excellence","award":["Del-22-007"],"award-info":[{"award-number":["Del-22-007"]}]},{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["INV-070862"],"award-info":[{"award-number":["INV-070862"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"award":["INV-070862"],"award-info":[{"award-number":["INV-070862"]}],"id":[{"id":"https:\/\/ror.org\/0456r8d26","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences Inc.","doi-asserted-by":"crossref","award":["19275"],"award-info":[{"award-number":["19275"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Hepatitis B virus (HBV) remains a leading cause of chronic liver disease worldwide, contributing to cirrhosis and hepatocellular carcinoma. Sub-Saharan Africa accounts for an estimated 68% of incident HBV infections, where co-infection with human immunodeficiency virus (HIV) is common and associated with poorer clinical outcomes. In Botswana, limited HBV screening and the absence of established HBV management guidelines persist despite reported HIV-HBV co-infection rates ranging from 1.1% to 10.6%. This scoping review aimed to summarise existing research on HBV and HIV-HBV co-infection in Botswana and assess clinical and policy implications. Following PRISMA methodology, searches were conducted across PubMed, Google Scholar, Semantic Scholar, and Consensus databases. Thirty eligible peer-reviewed studies were identified and evaluated for prevalence data, virological characteristics, genotypes, mutations, treatment outcomes, vaccination programs, and the availability of guidelines. Findings indicate intermediate-to-high HBV and HIV-HBV disease burden, substantial occult HBV infection, and gaps in diagnostic and preventive practices. The lack of routine screening, deficient infant birth-dose and adult vaccination, and established treatment pathways likely increase the risk of HBV-associated morbidity and mortality. Strengthened public health interventions, including expanded testing, enhanced vaccination coverage, and prevention of mother-to-child transmission strategies, are recommended to improve disease control and clinical outcomes in Botswana.<\/jats:p>","DOI":"10.3390\/v18050523","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:32:21Z","timestamp":1777555941000},"page":"523","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Review of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection in Botswana"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8833-1805","authenticated-orcid":false,"given":"Linda","family":"Mpofu-Dobo","sequence":"first","affiliation":[{"name":"Botswana Harvard Health Partnership, Gaborone Private Bag BO320, Botswana"},{"name":"Department of Biological Sciences and Biotechnology, School of Life Sciences, Botswana International University of Science and Technology, Palapye Private Bag 16, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8927-091X","authenticated-orcid":false,"given":"Kebaneilwe","family":"Lebani","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences and Biotechnology, School of Life Sciences, Botswana International University of Science and Technology, Palapye Private Bag 16, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2876-3811","authenticated-orcid":false,"given":"Jason T.","family":"Blackard","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA"},{"name":"Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3821-4592","authenticated-orcid":false,"given":"Sikhulile","family":"Moyo","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership, Gaborone Private Bag BO320, Botswana"},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"},{"name":"Department of Pathology, Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-9684","authenticated-orcid":false,"given":"Motswedi","family":"Anderson","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership, Gaborone Private Bag BO320, Botswana"},{"name":"Africa Health Research Institute, Private Bag X7, Congella, Durban 4013, South Africa"},{"name":"The Francis Crick Institute, London NW1 1AT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simani","family":"Gaseitsiwe","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership, Gaborone Private Bag BO320, Botswana"},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","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":"Platt","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/S2468-1253(23)00156-5","article-title":"A global investment case for hepatitis B elimination: A modelling study","volume":"8","author":"Seaman","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_3","unstructured":"(2024, December 17). Guidelines for the Prevention, Diagnosis, Care and Treatment for People with Chronic Hepatitis B Infection 2024. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240090903."},{"key":"ref_4","unstructured":"(2024, December 17). Global Hepatitis Report 2024: Action for Access in Low- and Middle-Income Countries 2024. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240091672."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"229","DOI":"10.21037\/jgo.2017.03.14","article-title":"Viral hepatitis and hepatocellular carcinoma: Etiology and management","volume":"8","author":"Zamor","year":"2017","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rizzo, G.E.M., Cabibbo, G., and Crax\u00ec, A. (2022). Hepatitis B virus-associated hepatocellular carcinoma. Viruses, 14.","DOI":"10.3390\/v14050986"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.cld.2015.01.001","article-title":"Global epidemiology of hepatocellular carcinoma: An emphasis on demographic and regional variability","volume":"19","author":"McGlynn","year":"2015","journal-title":"Clin. Liver Dis."},{"key":"ref_8","unstructured":"Statistics Botswana (2023). The Fifth Botswana AIDS Impact Survey 2021 (BAIS V) Report, 2021."},{"key":"ref_9","unstructured":"(2025, February 17). Implementing the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2022\u20132030 n.d. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240094925."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Anderson, M., Mangogola, T., Phinius, B.B., Mpebe, G., Aimakhu, C.O., Choga, W.T., Phakedi, B., Bhebhe, L.N., Baruti, K., and Mpofu-Dobo, L. (2024). Hepatitis B virus prevalence among HIV-uninfected people living in rural and Peri-urban areas in Botswana. Microorganisms, 12.","DOI":"10.20944\/preprints202405.0483.v1"},{"key":"ref_11","unstructured":"(2025, February 17). Global Health Sector Strategy on Viral Hepatitis 2016\u20132021. Towards Ending Viral Hepatitis 2016. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-HIV-2016.06."},{"key":"ref_12","first-page":"14","article-title":"Chronic hepatitis B and HIV coinfection","volume":"31","author":"Corcorran","year":"2023","journal-title":"Top. Antivir. Med."},{"key":"ref_13","unstructured":"WHO (2026, January 21). Hepatitis B Fact-Sheet 2025. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-b."},{"key":"ref_14","unstructured":"(2026, March 11). Hepatitis B Vaccination Coverage. Immunization Data. n.d. Available online: https:\/\/immunizationdata.who.int\/global\/wiise-detail-page."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.14218\/JCTH.2018.00037","article-title":"Hepatitis B vaccine and immunoglobulin: Key concepts","volume":"7","author":"Das","year":"2019","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_16","unstructured":"(2025, February 19). Hepatitis B Immune Globulin on Portico n.d. Available online: https:\/\/access.portico.org\/Portico\/auView?auId=ark:%2F27927%2Fpjbf7dd4nn1."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4161\/hv.34306","article-title":"Hepatitis B vaccination: Are escape mutant viruses a matter of concern?","volume":"11","author":"Paladini","year":"2015","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1093\/inthealth\/ihu084","article-title":"Hepatitis B vaccination of healthcare workers at the Princess Marina Hospital, Botswana","volume":"7","author":"Machiya","year":"2015","journal-title":"Int. Health"},{"key":"ref_19","unstructured":"Padma, T.V. (2025, February 21). Scaling Up Hepatitis B Birth Dose Vaccination Will Save Lives, and Livers, Experts Say 2024. Available online: https:\/\/www.gavi.org\/vaccineswork\/scaling-hepatitis-b-birth-dose-vaccination-will-save-lives-and-livers-experts-say."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1136\/bmj.38719.435833.7C","article-title":"Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen: Systematic review and meta-analysis","volume":"332","author":"Lee","year":"2006","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jinf.2020.04.037","article-title":"Treatment advantage in HBV\/HIV coinfection compared to HBV monoinfection in a South African cohort","volume":"81","author":"Maponga","year":"2020","journal-title":"J. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"ofw140","DOI":"10.1093\/ofid\/ofw140","article-title":"Slow CD4(+) T-Cell Recovery in Human Immunodeficiency Virus\/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana","volume":"3","author":"Anderson","year":"2016","journal-title":"Open Forum Infect. Dis."},{"key":"ref_23","unstructured":"(2025, July 28). Prevention of Mother-to-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy 2020. Available online: https:\/\/www.who.int\/publications\/i\/item\/978-92-4-000270-8."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Torimiro, J.N.E., Duri, K., Goumkwa, N.M., Atah, S.M., Ndzie Ondigui, J.-L., Lobe, C., Bouyou, M., Ndeboko, B., Moussa, A.M., and Police, C. (2024). Toward the elimination of hepatitis B: Networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1283350"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S343","DOI":"10.1093\/infdis\/jiaa668","article-title":"Hepatitis B Vaccines","volume":"224","author":"Pattyn","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Romano\u2019, L., and Zanetti, A.R. (2022). Hepatitis B vaccination: A historical overview with a focus on the Italian achievements. Viruses, 14.","DOI":"10.3390\/v14071515"},{"key":"ref_27","unstructured":"(2024, December 17). HIV and Hepatitis B. n.d, Available online: https:\/\/hivinfo.nih.gov\/understanding-hiv\/fact-sheets\/hiv-and-hepatitis-b."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Otto, A.O., Rivera, C.G., Zeuli, J.D., and Temesgen, Z. (2021). Hepatotoxicity of contemporary antiretroviral drugs: A review and evaluation of published clinical data. Cells, 10.","DOI":"10.3390\/cells10051263"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cheng, Z., Lin, P., and Cheng, N. (2021). HBV\/HIV coinfection: Impact on the development and clinical treatment of liver diseases. Front. Med., 8.","DOI":"10.3389\/fmed.2021.713981"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2147\/PROM.S226936","article-title":"Impact of stigma on people living with chronic hepatitis B","volume":"11","author":"Cerri","year":"2020","journal-title":"Patient Relat. Outcome Meas."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1086\/508865","article-title":"Serological evidence of HIV-associated infection among HIV-1-infected adults in Botswana","volume":"43","author":"Wester","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"390","DOI":"10.4269\/ajtmh.2011.10-0510","article-title":"Prevalence of Hepatitis B and Hepatitis C Coinfections in an Adult HIV Centre Population in Gaborone, Botswana","volume":"85","author":"Patel","year":"2011","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Matthews, P.C., Beloukas, A., Malik, A., Carlson, J.M., Jooste, P., Ogwu, A., Shapiro, R., Riddell, L., Chen, F., and Luzzi, G. (2015). Prevalence and characteristics of hepatitis B virus (HBV) coinfection among HIV-positive women in South Africa and Botswana. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0134037"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/20786190.2016.1272230","article-title":"Prevalence of human immunodeficiency virus\u2014Hepatitis B virus co-infection amongst adult patients in Mahalapye, Ngami, Serowe, Botswana: A descriptive cross-sectional study","volume":"59","author":"Mandiwana","year":"2017","journal-title":"S. Afr. Fam. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mbangiwa, T., Kasvosve, I., Anderson, M., Thami, P.K., Choga, W.T., Needleman, A., Phinius, B.B., Moyo, S., Leteane, M., and Leidner, J. (2018). Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana. Genes, 9.","DOI":"10.3390\/genes9050259"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e19341","DOI":"10.1097\/MD.0000000000019341","article-title":"Incidence of hepatitis B virus infection among human immunodeficiency virus-infected treatment naive adults in Botswana","volume":"99","author":"Phinius","year":"2020","journal-title":"Medicine"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Baruti, K., Lentz, K., Anderson, M., Ajibola, G., Phinius, B.B., Choga, W.T., Mbangiwa, T., Powis, K.M., Sebunya, T., and Blackard, J.T. (2020). Hepatitis B virus prevalence and vaccine antibody titers in children HIV exposed but uninfected in Botswana. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237252"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/QAD.0000000000003183","article-title":"Decreased hepatitis B virus vaccine response among HIV-positive infants compared with HIV-negative infants in Botswana","volume":"36","author":"Shaver","year":"2022","journal-title":"AIDS"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"ofac707","DOI":"10.1093\/ofid\/ofac707","article-title":"High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana","volume":"10","author":"Phinius","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1093\/ofid\/ofv133.1231","article-title":"Occult and chronic hepatitis B in HIV-positive batswana","volume":"2","author":"Ryan","year":"2015","journal-title":"Open Forum Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Saitta, C., Pollicino, T., and Raimondo, G. (2022). Occult Hepatitis B Virus Infection: An Update. Viruses, 14.","DOI":"10.3390\/v14071504"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"ofx195","DOI":"10.1093\/ofid\/ofx195","article-title":"High Rates of Occult Hepatitis B Virus Infection in HIV-Positive Individuals Initiating Antiretroviral Therapy in Botswana","volume":"4","author":"Ryan","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.jiph.2022.11.008","article-title":"Epidemiology of occult hepatitis B and C in Africa: A systematic review and meta-analysis","volume":"15","author":"Ondigui","year":"2022","journal-title":"J. Infect. Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/tmi.12623","article-title":"Variation in attrition at subnational level: Review of the Botswana National HIV\/AIDS Treatment (Masa) programme data (2002\u20132013)","volume":"21","author":"Farahani","year":"2016","journal-title":"Trop. Med. Int. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1001\/jama.2013.280923","article-title":"Effect of micronutrient supplementation on disease progression in asymptomatic, antiretroviral-naive, HIV-infected adults in Botswana: A randomized clinical trial: A randomized clinical trial","volume":"310","author":"Baum","year":"2013","journal-title":"JAMA"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Anderson, M., Phinius, B.B., Phakedi, B.K., Mudanga, M., Bhebhe, L.N., Tlhabano, G.N., Motshosi, P., Ratsoma, T., Baruti, K., and Mpebe, G. (2024). Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-na\u00efve people living with HIV in Botswana. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1342862"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e95569","DOI":"10.5812\/hepatmon.95569","article-title":"Maternal Hepatitis B Virus Infection, Pregnancy, and Infant Health Outcomes in Botswana","volume":"19","author":"Mbangiwa","year":"2019","journal-title":"Hepat. Mon."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Phinius, B.B., Anderson, M., Mokomane, M., Gobe, I., Choga, W.T., Ratsoma, T., Phakedi, B., Mpebe, G., Ditshwanelo, D., and Musonda, R. (2023). Atypical hepatitis B virus serology profile-hepatitis B surface antigen-positive\/hepatitis B core antibody-negative-in hepatitis B virus\/HIV coinfected individuals in Botswana. Viruses, 15.","DOI":"10.3390\/v15071544"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jceh.2012.10.003","article-title":"Molecular Biology of the Hepatitis B Virus for Clinicians","volume":"2","author":"Datta","year":"2012","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"a021436","DOI":"10.1101\/cshperspect.a021436","article-title":"Hepatitis B virus genotypes and variants","volume":"5","author":"Lin","year":"2015","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5723","DOI":"10.1038\/s41598-023-32865-1","article-title":"Mapping hepatitis B virus genotypes on the African continent from 1997 to 2021: A systematic review with meta-analysis","volume":"13","author":"Kafeero","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1038\/s41575-020-0296-6","article-title":"The evolution and clinical impact of hepatitis B virus genome diversity","volume":"17","author":"Revill","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"102180","DOI":"10.1016\/j.clinre.2023.102180","article-title":"A review of epidemiology and clinical relevance of Hepatitis B virus genotypes and subgenotypes","volume":"47","author":"Chen","year":"2023","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Phinius, B.B., Choga, W.T., Anderson, M., Mokomane, M., Gobe, I., Ratsoma, T., Phakedi, B.B., Mpebe, G., Bhebhe, L., and Gaseitsiwe, S. (2024). Molecular characterization of hepatitis B virus in people living with HIV in rural and Peri-urban communities in Botswana. Biomedicines, 12.","DOI":"10.20944\/preprints202406.0322.v1"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Anderson, M., Gaseitsiwe, S., Moyo, S., Wessels, M.J.C., Mohammed, T., Sebunya, T.K., Powell, E.A., Makhema, J., Blackard, J.T., and Marlink, R. (2015). Molecular characterisation of hepatitis B virus in HIV-1 subtype C infected patients in Botswana. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-1096-4"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11262-018-1610-z","article-title":"Molecular characterization of hepatitis B virus in blood donors in Botswana","volume":"55","author":"Choga","year":"2018","journal-title":"Virus Genes"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Anderson, M., Choga, W.T., Moyo, S., Bell, T.G., Mbangiwa, T., Phinius, B.B., Bhebhe, L., Sebunya, T.K., Lockman, S., and Marlink, R. (2018). Molecular Characterization of Near Full-Length Genomes of Hepatitis B Virus Isolated from Predominantly HIV Infected Individuals in Botswana. Genes, 9.","DOI":"10.3390\/genes9090453"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Phinius, B.B., Anderson, M., Gobe, I., Mokomane, M., Choga, W.T., Phakedi, B., Ratsoma, T., Mpebe, G., Makhema, J., and Shapiro, R. (2024). High prevalence of hepatitis B virus drug resistance mutations to lamivudine among people with HIV\/HBV coinfection in rural and Peri-urban communities in Botswana. Viruses, 16.","DOI":"10.20944\/preprints202403.0750.v1"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Anderson, M., Choga, W.T., Moyo, S., Bell, T.G., Mbangiwa, T., Phinius, B.B., Bhebhe, L., Sebunya, T.K., Makhema, J., and Marlink, R. (2018). In Silico Analysis of Hepatitis B Virus Occult Associated Mutations in Botswana Using a Novel Algorithm. Genes, 9.","DOI":"10.3390\/genes9090420"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Sandhu, P., Haque, M., Humphries-Bickley, T., Ravi, S., and Song, J. (2017). Hepatitis B Virus Immunopathology, Model Systems, and Current Therapies. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.00436"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1146\/annurev-immunol-041015-055318","article-title":"CD8 T cell exhaustion during chronic viral infection and cancer","volume":"37","author":"McLane","year":"2019","journal-title":"Annu. Rev. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"4215","DOI":"10.1128\/JVI.02844-06","article-title":"Characterization of hepatitis B virus (HBV)-specific T-cell dysfunction in chronic HBV infection","volume":"81","author":"Boni","year":"2007","journal-title":"J. Virol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1136\/gutjnl-2018-316641","article-title":"Phenotypic and functional differences of HBV core-specific versus HBV polymerase-specific CD8+ T cells in chronically HBV-infected patients with low viral load","volume":"68","author":"Schuch","year":"2019","journal-title":"Gut"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.livres.2020.09.004","article-title":"B cell dysfunction in chronic hepatitis B virus infection","volume":"5","author":"Ma","year":"2021","journal-title":"Liver Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/hep4.1113","article-title":"A global perspective on hepatitis B-related single nucleotide polymorphisms and evolution during human migration","volume":"1","author":"Tai","year":"2017","journal-title":"Hepatol. Commun."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/infdis\/jiv592","article-title":"HLA-A is a Predictor of Hepatitis B e Antigen Status in HIV-Positive African Adults","volume":"213","author":"Matthews","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Choga, W.T., Anderson, M., Zumbika, E., Phinius, B.B., Mbangiwa, T., Bhebhe, L.N., Baruti, K., Kimathi, P.O., Seatla, K.K., and Musonda, R. (2020). In silico prediction of human leukocytes antigen (HLA) class II binding hepatitis B virus (HBV) peptides in Botswana. Viruses, 12.","DOI":"10.3390\/v12070731"},{"key":"ref_69","unstructured":"Government of Botswana (2023). 2023 Botswana Integrated HIV Clinical Care Guidelines."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/QAD.0000000000003753","article-title":"Hepatitis B surface antigen loss in individuals with chronic hepatitis B virus and HIV-1 infections in Botswana","volume":"38","author":"Mpebe","year":"2024","journal-title":"AIDS"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"ofab116","DOI":"10.1093\/ofid\/ofab116","article-title":"Incidence and predictors of hepatitis B surface antigen clearance in HIV patients: A retrospective multisite study","volume":"8","author":"Jain","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1093\/infdis\/jiz450","article-title":"High rates of hepatitis B virus (HBV) functional cure among human immunodeficiency virus-HBV coinfected patients on antiretroviral therapy in Zambia","volume":"221","author":"Chihota","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Boyd, A., Dezanet, L.N.C., and Lacombe, K. (2021). Functional Cure of Hepatitis B Virus Infection in Individuals With HIV-Coinfection: A Literature Review. Viruses, 13.","DOI":"10.3390\/v13071341"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Moini, M., and Fung, S. (2022). HBsAg loss as a treatment endpoint for chronic HBV infection: HBV cure. Viruses, 14.","DOI":"10.3390\/v14040657"},{"key":"ref_75","first-page":"275","article-title":"Seroprevalence and risk factors of hepatitis B, C and D virus infection amongst patients with features of hepatitis in a referral hospital in Botswana: A cross-sectional study","volume":"36","author":"Souda","year":"2021","journal-title":"S. Afr. J. Infect. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"477","DOI":"10.15585\/mmwr.mm7113a1","article-title":"Universal hepatitis B vaccination in adults aged 19-59 years: Updated recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2022","volume":"71","author":"Weng","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"7152","DOI":"10.3748\/wjg.v20.i23.7152","article-title":"Molecular identification of hepatitis B virus genotypes\/subgenotypes: Revised classification hurdles and updated resolutions","volume":"20","author":"Pourkarim","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Inoue, T., and Tanaka, Y. (2020). Cross-protection of hepatitis B vaccination among different genotypes. Vaccines, 8.","DOI":"10.3390\/vaccines8030456"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"101096","DOI":"10.1016\/j.genrep.2021.101096","article-title":"A systematic review and meta-analysis of killer-cell immunoglobulin-like receptor (KIR) family genes association with risk of hepatitis B virus (HBV)","volume":"23","author":"Mohammadhosayni","year":"2021","journal-title":"Gene Rep."},{"key":"ref_80","unstructured":"WHO (2024, December 17). Immunization Data Portal\u2014African Region. Immunization Data n.d. Available online: https:\/\/immunizationdata.who.int\/dashboard\/regions\/african-region."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Statistics Botswana (2025). Vital Statistics Report 2023, Statistics Botswana.","DOI":"10.5089\/9798229019750.019"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Statistics Botswana (2025). Botswana Population Housing Census 2022 Analytical Report, Statistics Botswana.","DOI":"10.5089\/9798229019750.019"},{"key":"ref_83","first-page":"207","article-title":"Non-veneteal Syphilis and Australia Antigen amng the G\/WI and G\/\/Ana San of the Central Kalahari Reserve, Botswana","volume":"19","author":"Nurse","year":"1973","journal-title":"Cent. Afr. J. Med."},{"key":"ref_84","first-page":"941","article-title":"The prevalence of hepatitis B (Australia) antigen in Southern Africa","volume":"48","author":"Bersohn","year":"1974","journal-title":"S. Afr. Med. J."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/0035-9203(89)90731-1","article-title":"An outbreak of suspected water-borne epidemic non-A non-B hepatitis in northern Botswana with a high prevalence of hepatitis B carriers and hepatitis delta markers among patients","volume":"83","author":"Byskov","year":"1989","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/njcp.njcp_464_19","article-title":"Prevalence and risk factors for hepatitis b and c among end-stage renal disease patients on hemodialysis in Gaborone, Botswana","volume":"24","author":"Mahupe","year":"2021","journal-title":"Niger. J. Clin. Pract."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/5\/523\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:11:16Z","timestamp":1777695076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/5\/523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":86,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["v18050523"],"URL":"https:\/\/doi.org\/10.3390\/v18050523","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}