EVOLVE-HBV: A cross-sectional study of HBV sero-epidemiology in a rural population in South Africa
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Motswedi Anderson Lusanda Mazibuko Gloria Sukali Tongai G Maponga Marion Delphin Elizabeth Waddilove Janine Upton Vasudevan G Naidoo Stephen Olivier Gregory Ording-Jespersen Dickman Gareta Emily Martyn Resign Gunda Kobus Herbst Willem A Hanekom Nokukhanya Msomi Lulama Mthethwa Malcolm Ellapen Theresa Smit Thumbi Ndung'u Emily B Wong Mark J Siedner Thandeka Khoza Kathy Baisley Collins Iwuji Philippa Matthews
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Abstract
OBJECTIVES: The 'EVoLVE' study set out to investigate the population prevalence of HBV infection, immunity and treatment eligibility in a rural South African setting. METHODS: We tested plasma samples from 2200 participants in a population-based study in KwaZulu-Natal, of whom 50% were living with HIV, for HBV surface antigen (HBsAg), HBV core antibody (anti-HBc), and HBV surface antibody (anti-HBs). For samples testing HBsAg-positive, we quantified alanine transferase (ALT) and HBV DNA viral load. We evaluated demographic and clinical correlates of HBV biomarkers, explored the geographical distribution of HBsAg, and assessed HBV treatment eligibility. RESULTS: Weighted HBV infection prevalence was 10.4% (95% CI: 9.0%-12.1%). Evidence of HBV exposure and clearance was found in 34.9% (95% CI: 32.4 - 37.5). Overall prevalence of vaccine-mediated HBV immunity was 8.9% (95% CI: 7.5%-10.4%) but for the sub-group born between 2000-2005 (after the HBV vaccine was implemented) this increased to 20.2% (95% CI 15.8-25.4). Infection prevalence was highest in the South of the region. Over 60% of individuals testing HBsAg-positive met treatment eligibility criteria. CONCLUSION: Prevalence of HBV in this setting is high, while vaccine-mediated immunity is low. These data highlight a pressing need for scale-up of interventions to support progress towards elimination targets.
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10.1016/j.ijid.2026.108998
Europe PubMed Central
42492834
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42492834
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The publication was previously a preprint.
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