High rates of hepatitis B virus (HBV),hepatitis C virus (HCV),and human immunodeficiency virus infections and uncommon HBV genotype/subtype and HCV subtype distributions among transgender individuals in Surabaya,Indonesia

Transgender people are at a high risk for sexually transmitted viruses such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Moreover,Indonesia has a moderate-to-high rate of HBV infection and rapid epidemic growth of HIV infection; hepatitis C virus (HCV) infection can co-occur with HBV and HIV infections. In this study,10 of 107 individuals (9.3z) were positive for HBV surface antigen (HBsAg) and/or HBV DNA,whereas 19 of 101 individuals (18.8z) with negative results for HBsAg were positive for HBV core antibody (anti-HBc). Seven of the 107 individuals (6.5z) were anti-HCV positive,and 16 of the 100 tested samples (16.0z) were HIV positive. Genotype and subtype analyses of all 10 HBV DNA (6 HBsAg positive and 4 anti-HBc positive) strains showed that 3 were of the HBV genotype/HBsAg subtype C/adrq⁺,one was of C/adw2,and 5 were of B/adw2. The HCV subtype distribution showed that 33.3z were of HCV-1b,and 66.7z were of HCV-3k (n ＝ 6). These distributions differed from those found in the general population of Surabaya,Indonesia. Interestingly,HIV subtype analysis showed a high prevalence of HIV,with possible recombinants of CRF01_AE and subtype B.