PF-2 Hepatitis B virus and risk factors among HIV+ and HIV− Nigerian men who have sex with men

Introduction: Despite the advent of hepatitis B virus infection (HBV) vaccine since 1982, HBV prevalence among men who have sex with men (MSM) ranges between 8% and 18%, differing by population settings and geographic regions of Nigeria. Because of shared risk factors for viral acquisition, HBV is more common in HIV infected individuals and MSM are 2–4 times more likely to be infected with HBV as compared to the general population. We conducted a cross sectional study to estimate the prevalence and risk factors of HBV among HIV-infected and HIV-uninfected MSM. Methods: From March 2013 to December 2017, the TRUST/RV368 study recruited MSM into HIV care and treatment services in Abuja and Lagos, Nigeria using respondent driven sampling. Men were screened for Hepatitis B surface antigen using ELISA and confirmed to have active infection with PCR detection of HBV DNA. All participants with HBV and HIV diagnoses at baseline were included in the analysis (n = 717). Differences in demographics and behavioral characteristics were compared using Pearson χ 2 test for categorical outcomes. Bivariate and multivariable analyses were conducted using logistic regression models. Results: Median age was 24 years (Inter quartile range: 21–27) and the prevalence of HBV was similar between the HIV uninfected and HIV-infected (9% vs 10%, P = 0.60). Among the HIV-infected, prevalence was higher for those not on an ART regimen with anti-HBV activity (tenofovir, lamivudine, or emtricitabine) as compared to those with anti-HBV regimen (11% vs 5%), although not statistically significant ( P = 0.12). In the multivariable analysis, HIV infection status was not associated with HBV prevalence (OR = 1.1, 95% CI: 0.6 to 2.0). Any condomless sex at last anal intercourse was associated with a 2-fold higher odds of HBV as compared to those always using condoms (OR = 2.3, 95% CI: 1.3 to 3.5). Those self-reporting as homosexual as compared to bisexual trended towards a higher odds of HBV (OR = 1.5, 95% CI: 0.9 to 2.5). Age, access to health care, concurrent STIs, receptive partnerships, and concurrency were not associated with HBV. Conclusions: HBV prevalence was modest in this high risk population and did not differ by HIV status. This lower than expected prevalence may be attributed to ART with anti-HBV activity. Although condomless sex continues to elevate the risk of HBV, reinforcing the need to increase communication and education on HBV and its potential complications.