Prevalence and burden of HBV co-infection among people living with HIV:A global systematic review and meta-analysis

Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Modeling and properties of generalized Kanban controlled assembly systems

International audienc

In, out, or somewhere else entirely: Going beyond binary constructions of the closet in the lives of LGBTQ people from a Muslim background living in Brussels

This paper analyses and critically discusses experiences and narratives of sexuality disclosure and concealment of LGBTQ people from a Muslim background living in Brussels. It does so by presenting data collected over a year of ethnographic research in the city. The "closet/coming out" metaphor is central in western discourses around LGBTQ identities and sexualities, and its wide circulation resulted in its conflations with a number of different meanings. Rather than simply being a descriptive metaphor, it comes to represent a linear, tautological, and normative path of LGBTQ liberation, leading the LGBTQ subject from an "in" of darkness and secrecy to an "out" of transparency and authenticity. Queer of colour scholars have noted how the metaphor, and the prescriptive path it traces, often fails to capture and understand the experiences of racialised LGBTQ people. Elaborating on queer of colour critiques to the normativity charted by coming out discourses, this paper argues for the unpacking and deconstruction of the binary and linear trajectory from "in" to "out" of the closet to understand the experiences of LGBTQ people from a Muslim background. In particular, it argues for a focus on silence as a productive site, on non-disclosure of sexuality as a functional strategy, and on the ways in which knowledge about sexualities can often circulate in tacit ways. As a result, the rigidity of the closet is disrupted, and its borders emerge as porous and flexible in the experiences of LGBTQ people from a Muslim background.</p