Background: Information about HBV sero-markers, infection stages and
genotypes in HIV-1 infected and uninfected injection and non-injection
drug users (IDUs) in Kenya remains elusive. Methods: A cross-sectional
study examining HBV sero-marker, infection stages and genotypes was
conducted among HIV-1 infected and uninfected, respectively, IDUs (n = 157
and n = 214) and non-IDUs (n = 139 and n = 48), and HIV-1 uninfected
non-drug using controls (n = 194) from coastal, Kenya. HBV sero-marker and
infection stages were based on HBV 5-panel rapid test plasma
sero-reactivity. DNA was extracted from acute and chronic plasma samples
and genotypes established by nested-PCR and direct sequencing. Results:
HBsAg positivity was higher in HIV-1 infected IDUs (9.6 %) relative to
HIV-1 uninfected IDUs (2.3 %), HIV-1 infected non-IDUs (3.6 %), HIV-1
uninfected non-IDUs (0.0 %) and non-drug users (2.6 %; P = 0.002).
Contrastingly, HBsAb positivity was higher in HIV-1 uninfected IDUs (14.6
%) and non-IDUs (16.8) in comparison to HIV-1 infected IDUs (8.3 %), and
non-IDUs (8.6 %), and non-drug users (8.2 %; P = 0.023). HBcAb positivity
was higher in HIV-1 infected IDUs (10.2 %) compared to HIV-1 uninfected
IDUs (3.3 %), HIV-1 infected non-IDUs (6.5 %), HIV-1 uninfected non-IDUs
(2.1 %) and non-drug users (4.6 %; P = 0.038). Acute (5.7 %, 1.4 %, 0.0 %,
0.0 % and 1.5 %) and chronic (5.1 %, 0.9 %, 3.6 %, 0.0 % and 1.5 %) stages
were higher in HIV-1 infected IDUs, compared to HIV-1 uninfected IDUs,
HIV-1 infected and uninfected non-IDUs and non-drug users, respectively.
However, vaccine type response stage was higher in HIV-1 uninfected IDUs
(15.4 %) relative to HIV-1 infected IDUs (6.4 %), and HIV-1 infected (6.5
%), and uninfected (10.4 %) non-IDUs, and non-drug users (5.7 %;
P = 0.003). Higher resolved infection rates were also recorded in HIV-1
uninfected IDUs (11.2 %) compared to HIV-1 infected IDUs (8.3 %), and
HIV-1 infected (7.2 %), uninfected (6.3 %) non-IDUs, and non-drug users
(6.7 %; P = 0.479), respectively. Only A1 genotype showing minimal
diversity was detected among the study participants. Conclusion: HBV
sero-markers and infection staging are valuable in diagnosis and
genotyping of HBV infections. Among IDUs, higher HBsAg and HBcAb
positivity in HIV-1 infected and higher HBsAb positivity in HIV-1 negative
IDUs suggests frequent exposure. Additionally, HBV genotype A is the
dominant circulating genotype in both high and low risk populations of
Kenya. Hepatitis B Virus
Sero-profiles and Genotypes in HIV-1 Infected and Uninfected Injection and
Non-Injection Drug Users from Coastal KenyaNeighbour-Joining method
based on 1000 bootstrap replicates and P-distances were used for
generating the phylogenetic tree. HBV genotype sequences from GenBank
together with their country of origin and accession numbers are presented.
Wooly monkey HBV (AY226578-WMHBV) was used as the out-group. Relevant
bootstrap values are indicated. HBV isolates from study participants are
indicated by diamond signs. The scale bar represents 5% sequence
divergence.