Seroprevalence, associated factors, and molecular detection of hepatitis B virus co-infection among HIV-positive adults in Okene, Nigeria

Background: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection constitutes an important clinical and public health challenge in sub-Saharan Africa. Beyond the burden of co-existing viral infections, HBV/HIV co-infection may be associated with alterations in nutritional status, micronutrient availability, antioxidant capacity, and immune function, which may influence the clinical course of liver disease. Despite this dual burden, locally specific data on HBV co-infection prevalence, sociodemographic characteristics, risk factors, and molecular confirmation among HIV-positive patients in Kogi State remain limited. In addition, the potential contribution of nutrition and functional food- derived bioactive compounds to the health of individuals with HBV/HIV co-infection remains an area requiring further investigation. Methods: A hospital-based cross-sectional study was conducted among 90 consenting HIV-positive adult patients at Reference Hospital, Okene. HBV co-infection was assessed using HBsAg rapid immunochromatographic testing. Sociodemographic and HBV transmission-related exposure data were collected using a structured questionnaire. Molecular confirmation was performed by polymerase chain reaction (PCR) targeting the HBV surface (S) gene, with amplicons of approximately 640 bp resolved by agarose gel electrophoresis. Data were entered into Microsoft Excel and analyzed using IBM SPSS Statistics version 26.0. Categorical variables were summarized using frequencies and percentages, while HBV prevalence was calculated as the proportion of HBsAg-positive participants within the relevant population or category. Fisher's exact test and the Fisher–Freeman–Halton exact test were used to assess associations involving categorical variables because of the small number of HBsAg-positive participants and small expected cell frequencies. Statistical significance was set at p < 0.05. Results: Of the 90 participants tested, 7 (7.8%) were HBsAg-reactive. HBsAg prevalence was 9.1% among males and 6.5% among females, with no statistically significant association between gender and HBsAg positivity (p = 0.711). Similarly, no statistically significant associations were observed with marital status (p = 0.872), educational level (p = 0.624), occupation (p = 1.000), residential area (p = 0.684), or age group (p = 0.864). Among the assessed HBV transmission-related exposures, prevalence was higher among participants reporting blood transfusion history (12.5%), sharing of sharp objects (10.9%), multiple sexual partners (10.0%), history of surgery or invasive procedures (11.1%), and traditional scarification or tattooing (11.8%); however, none of these associations was statistically significant (p = 0.378, 0.435, 0.695, 0.431, and 0.419, respectively). Participants reporting a history of mother-to-child transmission had an HBsAg prevalence of 11.1%, with no statistically significant association observed (p = 0.624). DNA concentrations ranged from 71.6 to 89.7 ng/µL, exceeding the 70 ng/µL quality cut-off. PCR confirmed HBV S-gene amplification in 3 of 5 samples (60%). Conclusion: An HBsAg seroprevalence of 7.8% was identified among HIV-positive patients attending Reference Hospital, Okene, indicating a continued burden of HBV/HIV co-infection in the study population. Although variations in HBsAg prevalence were observed across sociodemographic characteristics and HBV transmission-related exposures, none demonstrated a statistically significant association with HBsAg positivity. The findings support the importance of routine HBV screening among HIV-positive patients, appropriate HBV vaccination and preventive strategies, and continued molecular surveillance. Although nutritional status and functional food interventions were not directly evaluated in this study, evidence-based nutritional support represents a potentially valuable complementary area for future investigation, particularly regarding micronutrients and bioactive compounds that may contribute to immune and hepatic health. Further clinical and intervention-based studies are required to establish the effectiveness of specific nutritional or functional food strategies among HBV/HIV co-infected populations. Novelty of the Study: This study provides locally relevant epidemiological and molecular evidence on HBV/HIV co-infection among HIV-positive patients in Okene, Kogi State. Its novelty lies particularly in the integration of HBV serological assessment with molecular confirmation within an understudied local population, while also highlighting the potential relevance of nutritional and functional-food approaches as areas for future investigation in the management of HBV/HIV co-infection. Keywords: Hepatitis B Virus; HIV co-infection; HBsAg seroprevalence; functional foods; immunomodulatory bioactive compounds; PCR; S gene; Okene; Kogi State; Nigeria