Viral hepatitis among key populations

Export Indicator

Prevalence of hepatitis and coinfection with HIV among key populations
What it measures

Comorbidity with HIV and potential need for appropriate treatment

Rationale
Appreciation of hepatitis and HIV coinfection has improved recently. Many people living with HIV receiving antiretroviral therapy are dying from liver disease resulting from untreated viral hepatitis. HIV treatment regimens can be adjusted to treat chronic hepatitis B infection as well. New, highly effective hepatitis C treatment is available and has a high rate of virus clearance regardless of hepatitis C virus subtype. Measuring the hepatitis
burden among key populations living with HIV can help national planners determine the resources needed to address the syndemic.
Numerator
Number of people in a key population who test positive for antibody to hepatitis C virus
 
or
 
Number of people in a key population who test positive for hepatitis B surface antigen
 
and
 
Number of people in a key population who also test positive for HIV together with one of the above
Denominator

Number of respondents tested for both HIV and one or both of hepatitis B and C

Calculation

Numerator/denominator

Method of measurement

Integrated Biological and Behavioural Surveillance Survey

Measurement frequency

Every two years

Disaggregation
  • Age (<25 and 25+ years).
  • Gender (male, female and transgender).
  • Key population.
Additional information requested

If the testing algorithm is available for hepatitis C screening, please include this information, especially if complementary or PCR testing is conducted.

Strengths and weaknesses
Probability-based estimates of coinfection with HIV and hepatitis C virus or HIV and hepatitis B virus among key populations are generally unavailable, although several biobehavioural surveys have conducted hepatitis antibody testing. Improving knowledge about coinfection will help to improve treatment programmes and help to maximize the survival of the affected populations. The numbers of people coinfected are likely to be small, with
the possible exception of people who inject drugs, so the confidence intervals will be large.
Further information
Global HIV Strategic Information Working Group. 2017. Biobehavioural survey guidelines for populations at risk for HIV. Geneva: World Health Organization; 2017 (http://www.who.int/hiv/pub/guidelines/biobehavioral-hiv-survey/en/).