Hepatitis B and Associated Risk Factors among Specific Populations in Lubumbashi (Democratic Republic of the Congo)

Abstract

Background: Hepatitis B virus (HBV) infection remains a major public health issue in sub-Saharan Africa. In Lubumbashi (DRC), data on HBV transmission risk factors are limited, however some cultural practices (e.g., scarification) and specific groups (key populations, HIV co-infection) are identified and may influence the epidemiology trend of infection. Objective: To identify risk factors associated with HBV infection among the population of Lubumbashi. Methodology: An analytical cross-sectional study was conducted between March and August 2024, including 469 participants recruited from hospitals, shelters for key populations, and Kasapa Central Prison. Sociodemographic, behavioral, and biological data were collected. Statistical analysis involved bivariate tests and robust Poisson regression to identify independent predictors of HBsAg positivity. The confidence interval used was 95%. Results: The median age of participants was 31 years. HBV infection was more common among married people, individuals living with HIV and non-key population. However, in the multivariate analysis, only key population membership remained significantly associated, showing a protective effect against HBV infection (aPR = 0.18; 95% CI: 0.12 - 0.28; p < 0.001). Conclusion: Belonging to a key population (e.g., MSM, sex workers, prisoners) appeared to be a protective factor, likely due to better access to targeted prevention and awareness programs. These findings highlight the need for differentiated and context-specific strategies to combat HBV in Lubumbashi, while expanding preventive services to the general population.