Zimbabwe is highly endemic for hepatitis B virus (HBV) and also has high human immunodeficiency virus (HIV) prevalence rates which may result in HIV/HBV coinfection, and as HIV/HBV coinfection may affect the classical HBV serology patterns and cause interpretation challenges, we assessed the seroprevalence of HBV in HIV positive patients and determined their serology profiles. This was a cross-sectional study on 957 HIV positive specimens from treatment naive patients. HBV serology tests were done using enzyme immunoassays for the detection of HBV markers in human serum or plasma. Hepatitis B surface antigen (HBsAg) prevalence was 17.1% (males 19.0%, females 15.8%). Previous and/or current HBV exposure was evident in 59.8% of the patients and hepatitis B e antigen markers were present in 103 (10.8%) specimens. There was high prevalence of unusual HBV patterns with 14.1% of total specimens showing an anti-HBc alone profile and an additional 4.3% HBsAg positive specimens that were anti-HBc negative. 1. Introduction Hepatitis B virus (HBV) can cause both acute and chronic disease and is the leading cause of viral hepatitis worldwide [1]. An estimated two billion people have been infected with HBV and more than 350 million have chronic HBV liver infections resulting in about 600？000 deaths every year [2]. It was previously reported that Zimbabwe has an overall HBV surface antigen (HBsAg) seroprevalence rate of 15.4% in the general population [3] and is classified as a high HBV endemic area. Zimbabwe also has high HIV prevalence rates of around 15% in the general population [4], but there is little or no data on HBV and HIV coinfection. The prevalence of HIV infected Zimbabweans carrying HBV serological markers is not known. Although some studies in sub-Saharan Africa have shown no major increase of HBV prevalence in HIV patients [5] other studies have reported higher HBV prevalence in HIV patients [6, 7]. This piece of information will be important as the clinical impact of HBV infection in HIV positive patients has progressively grown since the introduction of highly active antiretroviral therapy (HAART) given the increase in survival rates experienced by these patients who now experience the effect of other chronic infections such as HBV. Chronic HBV infection is defined as persistent detection of HBV surface antigen (HBsAg) for more than 6 months [8, 9]. HIV/HBV coinfections may have negative implications on chronic HBV patients including increased rates of chronic HBsAg positivity, high HBV DNA levels, and lower rates of anti-hepatitis B virus e antigen
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