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. Author manuscript; available in PMC: 2021 Sep 22.
Published in final edited form as: Sex Health. 2021 Jul;18(3):269–279. doi: 10.1071/SH20185

Table 1.

Characteristics of 43 studies included in calculation of association between HBV infections and STIs

 A. Studies using surface antigen (HbsAg) as HBV marker
Hepatitis B prevalence (%)
STI-negatives STI-positives Prevalence ratios 1
Author, Pub., Year Country Setting Quality rating Population STI measure Point est, (Low -High 95% CI) N, point est., (Low-High 95% CI)
Carmo, Gen Hosp Psychiatry, 2014 Brazil 26 public mental health services Fair Randomly selected adults with mental illness under care Past STIs 2.00 1.92, (NR) 2176, 0.93, (0.66–1.36)
Past syphilis 4.17, (NR) 2140, 2.36, (1.36–4.07)
Hart, Sex Transm Dis, 1993 Australia STI clinic, Adelaide Fair All attendees during study period - Females Current gonorrhea 7.10 NR 3998, 2.00, (0.90–4.20)
Hennessey, Urban Health, 2009 USA Jail - Chicago, Detroit, S.F. Fair Incoming jail inmates (M + F) Current syphilis 0.90 2.00, (0.40–3.70) 11165, 6.02, (2.30–14.94)
Miranda, Sex Transm Dis., 2001 Brazil Antenatal clinics in Vitoria Municipality Fair Pregnant women Past STIs 0.80 NR 1608, 1.00, (0.13–7.15)
Current syphilis 10.42 (4.09–22.61) 1608, 12.50, (4.64–33.66)
Parazzini, Genitourin Med.,1992 Italy Two STI clinics Fair Patients who referred themselves to clinic for suspected STD or STD treatment Current syphilis - TPHA 7.80 15.06 (8.45–25.18) 588, 1.55, (0.81–3.59)
Current syphilis - VDRL 6.90 9.09 (3.91–18.78) 588, 0.91, (0.31–2.21)
Souto, Mem Inst Oswaldo Cruz., 2001 Brazil Area comprising 16 gold mine camps in Apiacas county Fair Malaria-exposed gold Miners Past STIs 2.70 8.92 (6.20–12.62) 472, 3.62, (1.29–9.08)
van Duynhoven, Genitourin Med., 1997 Netherlands STI clinic at University Hospital of Rotterdam Fair STD clinic clients Past STIs 1.10 2.72 (1.95–3.80) 2876, 2.46, (1.39–4.33)
Weinbaum, Am J Public Health, 2008 USA MSM-identified venues: Balt, Dallas, L.A., Miami, NYC, S.F., Seattle Good MSM Current STIs 16.00 33.20 (27.40–39) 2824, 1.66, (1.46–1.96)
Zou, Transfusion, 2009 USA Blood donation sites Fair First time blood donors Current syphilis 0.05 0.91 (0.6–1.37) 1203, 16.66, (11.08–24.97)
Repeat blood donors 0.01 1.17 (0.78–1.75) 155, 117.72, (16.57–947)
 B. Studies using core antibody (anti-Hbc) as HBV marker
Author, Pub., Year Country Setting Quality rating Population STI measure Hepatitis B prevalence in STI-negatives Prevalence ratios1
N, point est., (Low-High 95% CI)
Bratos, Sex Transm Dis., 1993 Spain Public health clinic Fair Female prostitutes Current syphilis 9.70 127, 2.54, (1.06–6.08)
Carmo, Gen Hosp Psychiatry, 2014 Brazil 26 public mental health services Fair Randomly selected adults with mental illness under care Past STIs 15.70 2176, 1.20, (1.07–1.33)
Past syphilis 16.20 2140, 1.29, (1.05–1.58)
Carvalho. Cad Saude Publica, 2017 Brazil Public shelter in city
of Goiânia		 Fair Persons experiencing homelessness Past STIs 15.50 271, 1.13, (0.83–1.60)
Corona, Epidemiol Infect., 1991 Italy STI clinic in Rome Fair Consecutive outpatients - non-PWID heterosexuals Past STIs 21.10 1136, 1.56, (1.28–1.86)
Consecutive outpatients - non-PWID homosexuals 50.00 196, 1.25, (0.92–1.54)
Corona, J Med Virol., 1996 Italy STI clinic in Rome Good Non-PWID heterosexuals Past chlamydia / gonorrhea 18.10 1497, 0.98, (0.73–1.27)
Current syphilis 13.00 1497, 2.01, (1.51–2.59)
Deininger, Klin Wochenschr., 1990 Germany HIV Clinic Fair Gay and bisexual men Past syphilis 52.30 1961, 2.00, (1.80–2.13)
Fiscus, Sex Transm Dis.,1994 USA STI clinics; three counties in N. Carolina Fair STD clinic clients tested for syphilis Current syphilis 5.60 139, 1.50, (1.10–2.10)
Gilson, Sex Transm Infect., 1998 United Kingdom Open access GUM clinic in central London Fair HIV-neg homosexual men Past STIs
>2 vs <2 lifetime episodes		 28.90 441, 5.19, (3.38–7.65)
HIV-neg heterosexual men 6.30 527, 0.94, (0.38–2.27)
HIV-neg women 4.60 821, 1.00, (0.03–2.66)
Hakre, Sex Transm Infect., 2013 Panama Venues for registered and unregistered
FSWs in 8 Provinces		 Good FSWs Current syphilis 8.00 38, 2.21, (1.10–4.46)
Hawkins, J Infect Dis.,1992 USA (see “Setting”) Six US Navy ships on deployment to S. America, W. Africa & Mediterranean Good Crew members and Marine Corp personnel Past STIs 3.70 2071, 1.84, (1.10–4.21)
Hennessey, J Urban Health, 2009 USA Jail - Chicago, Detroit, San Francisco Fair Incoming jail inmates (M + F) Current syphilis 16.00 11166, 1.80, (1.50–2.14)
 C. Studies using core antibody (anti-Hbc) as HBV marker
Author, Pub., Year Country Setting Quality rating Population STI measure Hepatitis B prevalence in STI-negatives Prevalence ratios
N, point est., (Low-High 95% CI)
Juarez-Figueroa, Sex Transm Infect., 1998 Mexico Centre for HIV/STI detection in FSWs Fair FSWs Current syphilis 5.80 1498, 1.81, (0.91–3.06)
Mele, Eur J Epidemiol., 1988 Italy STI clinic Fair STD clinic clients, male; heterosexual & gay/bisexual Past STIs 46.40 913, 1.32, (1.15–1.58)
Oliveira, Mem Inst Oswaldo Cruz, 2001 Brazil STI Clinic, Universidade Federal Fluminense, State of Rio de Janeiro Fair STD clinic clients Current syphilis 11.60 440, 1.80, (1.03–3.54)
Past STIs 12.60 433, 1.12, (0.68–1.85)
Clinic STI history 9.50 440, 1.50, (0.82–2.75)
Ribeiro, Int J Environ Res Public Health, 2017 Brazil Private hemodialysis clinic & public hematology center, Fortaleza, Brazil Fair Male & female pts with chronic renal failure Past STIs 54.90 141, 1.07, (0.78–1.47)
Male and female pts with coagulapathy 20.00 50, 4.00, (2.00–8.00)
Tien, Clin Infect Dis., 2004 USA At home or work Fair Females at risk of HIV - PWID Past gonorrhea
Past chlamydia		 76.00 581, 1.06, (0.97–1.16)
581, 1.03, (0.89–1.13)
Females at risk of HIV - non-PWID 30.00 512, 1.46, (1.15–1.85)
512, 1.67, (1.23–2.26)
Females at risk of HIV - no illicit drug use 17.00 850, 1.25, (0.84–1.87)
850, 0.88, (0.42–1.83)
Females at risk of HIV - PWID Past syphilis 76.00 581, 1.07, (0.90–1.18)
Females at risk of HIV - non-PWID 512, 1.18, (1.08–1.24)
Females at risk of HIV - no illicit drug use 850, 1.11, (0.95–1.21)
Trepka, Sex Transm Dis, 2003 USA Large public STI clinic Fair Male clinic clients 18+ yo Past STIs 20.00 376, 2.32, (1.63–3.30)
Female clinic clients 18+ yo 16.00 242, 1.59, (1.00–2.63)
van Duynhoven, Genitourin Med., 1997 Netherlands STI clinic at University Hospital of Rotterdam Fair STD clinic clients Past STIs 12.90 2848, 1.33, (1.09–1.56)
Weinstock, JAMA., 1993 USA Public STI Clinic; San Francisco Fair Patients with new problem and routine screening for syphilis Past gonorrhea 18.80 1159, 2.30, (1.95–2.68)
Past syphilis 24.40 1155, 2.72, (2.33–3.06)
 D. Studies using either surface (HBsAg) or core (anti-HBc) HBV markers
Authors Country Setting Quality rating Population STI measure Hepatitis B prevalence in STI-negatives Prevalence ratios1
N, point est., (Low-High 95% CI)
Baddour, Sex Transm Dis, 1988 USA STI clinic Fair African American females Past STIs 8.60 136, 2.83, (1.12–7.12)
Barrett, Sex Transm Dis, 1992 USA STI Clinic Jefferson Cty Dept. of Health; Birmingham, Ala. Fair Women 19 y.o.+; not pregnant and planning to use contraception for trial period Current gon. / chlamydia 0.01 – 0.23 STIs 14.00 557, 0.91, (0.54–1.48)
Current gon. / chlamydia 0.24 – 1.00 STIs 557, 1.33, (0.82–2.07)
El Maerrawi, International J STD AIDS, 2015 Brazil Sao Paulo prison for men Fair Sao Paulo prison for men; all inmates were included Past STIs 21.00 21, 1.81, (1.15–2.57)
Hwang, Clin Infect Dis, 2000 USA Two drug treatment clinics in Houston & drug treatment clinic in Lubbock, Texas Good Indigent residents addicted to drugs and alcohol Past STIs 22.40 407, 1.41, (0.84–2.07)
Lama, Am J Trop Med Hyg, 2010 Peru Sentinel surveillance survey in 6 HBV-endemic cities Fair Men 18+ y.o. and had sexual intercourse with 1+ men during previous year Current syphilis 25.50 354, 1.46, (1.21–1.74)
Levine, Am J Epi, 1995 USA Baltimore; extensive community outreach Fair Former and current IV drug users who were subjects of ALIVE HIV longitudinal study Past syphilis 83.50 2193, 1.02, (0.97–1.08)
Matos, Sex Transm Infect, 2008 Brazil Highway through Goiania City Good Truck drivers Past STIs 14.60 615, 1.78, (1.05–3.00)
Moura, International J Inf Dis, 2015 Brazil Maceio, capital of State of Alagoas, Municipal Health Office Fair Pregnant women Current syphilis 0.40 54729, 0.81, (0.33–1.97)
Oliveira, PLOS One, 2016 Brazil MSM in City of Goiania Fair MSM recruited using Respondent-Driven Sampling Past STIs 15.40 522, 3.33, (1.83–4.80)
Pando, Sex Transm Dis, 2006 Argentina Recruitment from gay nightclubs, porn cinemas, gyms, and streets Fair MSM Past STIs 32.40 694, 1.47, (1.18–1.77)
Pando, Am J trop Med Hyg, 2006 Argentina FSWs in 6 cities contacted through an NGO Fair FSWs Current syphilis 14.40 625, 1.80, (1.25–2.64)
Pando, J Med Micro, 2008 Argentina Three public hospitals in Buenos Aires Fair TB patients > 18 years old Past STIs 11.6% 181, 2.3 (1.2–4.7)
Remis, Am J Pub Health, 2000 Canada Clinic and community settings Fair HIV-neg MSM Past STIs 40.9% 328, 2.14 (1.57–2.39)
Past gonorrhea or chlamydia 328, 1.80 (1.38–2.11)
Rosenblum, J Infect Dis, 1990 USA Belle Glade, Florida Fair Adults from randomly selected households Current syphilis 21.0% 723, 2.05 (2.00–4.80)
Past syphilis 29.0% 714, 1.64 (1.16–2.32)
Past gonorrhea 26.0% 712, 1.65 (1.32–2.06)
Rosenblum, JAMA, 1992 USA Detention centers in Miami and L.A., brothels in NV, STI clinics in CO, drug Tx programs in NJ, street / social network outreach in Atlanta, NJ, and S.F. Fair Women 18 years old+ who had exchanged sexual services for money or drugs at least once since 1978 Past syphilis 70.0% 646, 2.7 (1.9–4.0)
Seage, Pub Health Rep, 1997 USA Student participants recruited via outreach at colleges. Other participants recruited from Fenway Community Health Center, and gay nightclubs Fair MSM enrolled in college in Boston area and younger than 30 or, if not students, 18 to 24 years old. Past STIs 11.7% 317, 3.11 (1.11–8.76)
Segura, AIDS Care, 2010 Argentina NGO clinic Fair MSM Current syphilis 25.0% 811, 2.40 (1.50–3.11)
Zocratto, Sub Use Misuse, 2010 Argentina and Uruguay Outreached clients recruited by civil associations. Hospitalized or outpatients recruited from 2 public and 1 nonpublic hospital for drug user and psychiatric diseases Fair Out-of-treatment and in-treatment Non-Injecting Cocaine Users from low-income neighborhoods in Montevideo and Buenos Aires. Current syphilis 10.8% 89, 3.62 (2.16–5.33)