Assessing and improving the quality of guideline-adherent hepatitis B virus care in people with HIV: A cross-sectional study

Patrick G.A. Oomen, Vincent J.P. van Kraaij, Anna M. Gerritsma, Frans M. Verduyn Lunel, Greet J. Boland, Andy I.M. Hoepelman, Berend J. van Welzen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The increasing use of non-tenofovir containing antiretroviral regimens calls for renewed attention to the prevention and management of hepatitis B virus (HBV) in people with HIV (PWH). We retrospectively assessed adherence to HBV guidelines, including complete HBV screening in PWH. In people with HIV/HBV co-infection, this included HBV therapy, screening for hepatitis delta virus (HDV) and on-therapy virologic response monitoring. HIV/HBV co-infection in PWH was defined as the presence of hepatitis B surface antigen (HBsAg) at the last measurement before study entry or detectable HBV-DNA for ≥6 months. After assessment, missing laboratory tests were performed to optimize HBV monitoring and screening for co-infections. Of all PWH under follow-up, 1484/1633 (90.9%) were adequately screened for HBV. After performing missing screening tests, 466 of 1618 PWH with complete screening results (28.8%) were non-immune for HBV infection. Fifty-one (3.2%) with HIV/HBV co-infection were identified. HBV treatment was adequate in 51/51 (100%). Screening for hepatitis A, C and delta virus antibodies and fibrosis was performed in 51/51 (100%), 49/51 (96.1%), 17/51 (35.3%) and 38/51 (74.5%). Annual HBV-DNA or HBsAg monitoring was done in 18/51 (35.3%) and hepatocellular carcinoma (HCC) surveillance in 2/9 (22.2%) of those indicated. Additional testing in those with missing data identified 4/34 (11.8%) persons with HDV antibodies and 3/30 (10%) with HBsAg seroclearance. Our study demonstrates the feasibility and added value of evaluating HBV care components and performing missing laboratory tests, identifying a large number of HBV vaccination candidates and HDV antibody screening, HBsAg monitoring and HCC surveillance as key areas for improvement.

Original languageEnglish
Pages (from-to)910-915
Number of pages6
JournalInternational Journal of STD and AIDS
Volume35
Issue number11
Early online date20 Sept 2023
DOIs
Publication statusPublished - Oct 2024

Keywords

  • guideline-adherence
  • Hepatitis B
  • HIV
  • HIV/HBV co-infection
  • quality of care

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