Seroepidemiological Evidence of HIV/HBV Coinfection among People Living with HIV in Abakaliki, Ebonyi State, Nigeria

Hepatitis B virus (HBV) and human immunodeficiency virus type 1 (HIV-1) remain major global public health concerns, particularly in low- and middle-income countries where both infections are highly endemic. This study investigated the seroprevalence and associated factors of HBV infection among HIV-1-infected individuals in Abakaliki, Ebonyi State, Southeast Nigeria. A cross-sectional study was conducted among HIV-1-infected patients attending the Alex Ekwueme Federal Teaching Hospital (AE-FETHA), Abakaliki. Hepatitis B surface antigen (HBsAg) was detected using commercially available enzyme-linked immunosorbent assay (ELISA) kits following the manufacturer’s instructions, with appropriate positive and negative controls included in each assay. Sociodemographic and clinical variables were analysed to determine their association with HIV/HBV co-infection. The prevalence of HIV/HBV co-infection among the study participants was 33.5%, while 66.5% had HIV infection only without evidence of HBsAg. Age showed a statistically significant association with HIV/HBV co-infection (χ² = 15.88, p = 0.001), indicating increased vulnerability to HBV infection with advancing age. Gender was also significantly associated with HBsAg seropositivity (χ² = 10.08, p = 0.001), with males exhibiting a higher prevalence of co-infection. Marital status demonstrated a significant relationship with HIV/HBV co-infection (χ² = 5.42, p = 0.020), with single individuals showing a higher risk. Educational status was strongly associated with co-infection (χ² = 44.01, p < 0.001), as lower educational attainment was associated with higher HBV prevalence. However, no statistically significant associations were observed between occupation (χ² = 6.76, p = 0.080) or religion (χ² = 4.35, p = 0.114) and HBV infection. Clinical parameters revealed significant associations between HIV/HBV co-infection and both CD4⁺ T-cell count (χ² ≈ 9.82, p = 0.007) and HIV viral load (χ² ≈ 11.64, p = 0.003). HBV co-infection was more prevalent among individuals with advanced immunosuppression and higher HIV viral loads, suggesting that poor immunological and virological control may facilitate HBV persistence. Overall, the findings highlight a substantial burden of HIV/HBV co-infection in Abakaliki and emphasise the need for routine HBV screening and integrated management strategies among people living with HIV.