Epidemiology, Risk Factors and Genotypes of HBV in HIV-Infected Patients in the Northeast Region of Colombia: High Prevalence of Occult Hepatitis B and F3 Subgenotype Dominance

Abstract

IntroductionChronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission.ObjectivesOur aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city.MethodsA cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009–2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg) through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART) variables of HIV infection.ResultsParticipants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4–16.4) of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI.ConclusionsThe present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.

Immune activation in the course of HIV‐1 infection: Causes, phenotypes and persistence under therapy

“…Moreover, the suppression of HCV by PEGylated alpha interferon and ribavirin treatment reduces this T cell activation . HIV/HBV co‐infection accelerates the inflammation and development of liver disease and contributes towards hepatic morbidity and mortality . Likewise, herpes simplex virus type 2 and human herpesvirus 8 co‐infections are associated with CD4+ and CD8+ T cell activation , and Epstein–Barr Virus (EBV) DNA load with the level of the inflammatory cytokines IL‐6 and tumour necrosis factor α (TNF‐α) .…”

Molecular analysis of Hepatitis B virus sub‐genotypes and incidence of preS1/preS2 region mutations in HBV‐infected Egyptian patients from Mansoura

“…6,7 Therefore, it is not surprising that several research efforts in the last decade have been directed to discover the different HBV sub-genotyping in several countries. [8][9][10][11] During HBV replication, the lack of proofreading ability of the reverse transcriptase leads to an error rate that is 10-fold higher than Mohammed El-Mowafy and Abdelaziz Elgaml contributed equally in this work.…”

Occult Hepatitis B Virus Infection in Egyptian HIV-Infected Patients with Isolated Anti-HBc

“…(18) In the same context, a Colombian study documented an OBI in 8.7% of HIV patients. (22) Higher OBI prevalence of 26.8% was recorded in Sudanese HIV patients. (10) In Egypt, OBI has been studied in different populations with a varying prevalence.…”

“…On the other hand, Bautista-Amorocho et al, reported isolated anti-HBc in 5.1% of HIV patients in Colombia. (22) The sole presence of anti-HBc can be attributed to one of the following: resolved remote infection with undetectable anti-HBs, false positive anti-HBc, "low level'' chronic infection and last; resolving acute infection. The current results regarding anti-HBc are in line with other studies highlighting anti-HBc as the sole serological surrogate of OBI, yet anti-HBc alone does not necessarily indicate high frequency of OBI.…”