Genotyping and virological characteristics of hepatitis B virus in HIV-infected individuals in Sudan

Yousif, Mukhlid; Mudawi, Hatim; Hussein, Waleed M.; Mukhtar, Maowia M.; Nemeri, Omer; Glebe, Dieter; Kramvis, Anna

doi:10.1016/j.ijid.2014.07.002

Cited by 33 publications

(42 citation statements)

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“…Baseline HBV DNA levels in HBsAg‐positive participants were comparable to those in HBsAg‐negative participants, although higher levels of VBT occurred in the HBsAg‐negative group. These findings confirm previous calls for the need for nucleic acid testing to detect HBV infection, particularly in high‐risk populations, such as HIV‐positive individuals receiving lamivudine . Clinical consequences of undetected HBV infection include increased risk of HCC.…”

Section: Discussionsupporting

confidence: 86%

“…These findings confirm previous calls for the need for nucleic acid testing to detect HBV infection, particularly in high-risk populations, such as HIV-positive individuals receiving lamivudine. 9,10,25,40 Clinical consequences of undetected HBV infection include increased risk of HCC. Although lamivudine is still being used in some African countries, including Ethiopia, 12 the findings of the present study further support the need to replace lamivudine with tenofovir to treat HBV/HIV coinfected individuals.…”

Section: Occult and False Occult Infectionmentioning

confidence: 99%

“…Second, the burden of HBV is compounded by the high prevalence of human immunodeficiency virus (HIV) infection in this region. Of the almost 37 million HIV‐positive individuals globally, approximately two‐thirds are found in sub‐Saharan Africa, with HBV/HIV coinfection rates of up to 10%, without considering HBsAg‐negative HBV infection, which increases this value to 25% . Third, antiretroviral treatment (ART) containing lamivudine (3TC), which also acts against HBV, has been, and continues, to be used in sub‐Saharan Africa to treat HIV‐positive individuals .…”

Section: Introductionmentioning

confidence: 99%

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Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg‐positive and HBsAg‐negative HIV‐positive South African adults

Singh

Bell

Yousif

et al. 2018

Journal of Medical Virology

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Both hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection are highly endemic in sub‐Saharan Africa. This study examined serological and clinical follow‐up data from 39 HBV DNA‐positive, HIV‐positive black South African adults, who returned for follow‐up at 3, 6, 12, and 18 months post‐initiation of antiretroviral therapy (ART). Of the 39 participants, 10 experienced full suppression of HBV and 29 experienced no suppression, with 10 of these showing a virological breakthrough. All 10 patients who fully suppressed were HBsAg‐negative, with 16 of the 29 who did not suppress being HBsAg‐positive and 13 HBsAg‐negative (P < 0.05). Participants fully suppressing the virus had significantly lower aminotransferase levels and were all HBsAg‐negative compared to those who did not suppress (P < 0.05). HBV viral loads between HBsAg‐positive and HBsAg‐negative samples were similar at baseline and at the final time‐point. In these South African patients with HBV/HIV coinfection, HBsAg‐negative status at baseline was a predictor of the outcome of HBV suppression in response to ART containing lamivudine.

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Section: Discussionsupporting

confidence: 86%

Section: Occult and False Occult Infectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg‐positive and HBsAg‐negative HIV‐positive South African adults

Singh

Bell

Yousif

et al. 2018

Journal of Medical Virology

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“…However, the observed prevalence is slightly lower than the 6.9 and 9.8% reported in Yaoundé, Cameroon and Khartoum, Sudan respectively [12, 19]. It should be noted however that the prevalence of OBI is dependent on the sensitivity of the DNA assay used, demography and the population studied [7].…”

Section: Discussionmentioning

confidence: 91%

Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon

et al. 2017

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PurposeOccult hepatitis B infection (OBI) among HIV positive patients varies widely in different geographic regions. We undertook a study to determine the prevalence of occult hepatitis B infection among HIV infected individuals visiting a health facility in South West Cameroon and characterized occult HBV strains based on sequence analyses.MethodsPlasma samples (n = 337), which previously tested negative for hepatitis B surface antigen (HBsAg), were screened for antibodies against hepatitis B core (anti-HBc) and surface (anti-HBs) antigens followed by DNA extraction. A 366 bp region covering the overlapping surface/polymerase gene of HBV was then amplified in a nested PCR and the amplicons sequenced using Sanger sequencing. The resulting sequences were then analyzed for genotypes and for escape and drug resistance mutations.ResultsTwenty samples were HBV DNA positive and were classified as OBI giving a prevalence of 5.9%. Out of these, 9 (45%) were anti-HBs positive, while 10 (52.6%) were anti-HBc positive. Additionally, 2 had dual anti-HBs and anti-HBc reactivity, while 6 had no detectable HBV antibodies. Out of the ten samples that were successfully sequenced, nine were classified as genotype E and one as genotype A. Three sequences possessed mutations associated with lamivudine resistance. We detected a number of mutations within the major hydrophilic region of the surface gene where most immune escape mutations occur.ConclusionsFindings from this study show the presence of hepatitis B in patients without any of the HBV serological markers. Further prospective studies are required to determine the risk factors and markers of OBI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12981-017-0136-0) contains supplementary material, which is available to authorized users.

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“…A molecular study involving multiple countries in West Africa found preS2 deletions in 30.6% (33/108), including 15/35 (42.8%) from Nigeria with unknown HIV status [18]. Other studies including patients from SSA or with GTE have reported lower frequencies of preS2 deletions, and the effect of HIV infection on the presence of these mutations in this region is unclear [29,32,41,42]. In this study, preS2 indel mutations were associated with baseline liver fibrosis severity, but not fibrosis regression; liver fibrosis information was not available for the GTE patients in the prior studies.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B virus sequencing and liver fibrosis evaluation in HIV/HBV co‐infected Nigerians

Grant

Agbaji

Kramvis

et al. 2017

Tropical Med Int Health

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Objectives Molecular characteristics of hepatitis B virus (HBV), such as genotype and genomic mutations, may contribute to liver-related morbidity and mortality. The association of these characteristics with liver fibrosis severity in sub-Saharan Africa is uncertain. We aimed to characterize molecular HBV features in HIV/HBV co-infected Nigerians and evaluate associations between these characteristics and liver fibrosis severity before and after antiretroviral therapy (ART) initiation. Methods HIV/HBV co-infected Nigerians underwent liver fibrosis estimation by transient elastography (TE) prior to and 36 months after ART initiation. Basal core promoter/precore (BCP/PC) and preS1/preS2/S regions of HBV were sequenced from baseline plasma samples. We evaluated associations between HBV mutations and liver fibrosis severity by univariate and multivariable regression. Results At baseline, 94 patients underwent TE with median liver stiffness of 6.4 (IQR 4.7–8.7) kPa. Patients were predominantly infected with HBV genotype E (45/46) and HBe-antigen negative (75/94, 79.8%). We identified BCP A1762T/G1764A in 15/35 (43%), PC G1896A in 20/35 (57%), ‘a’ determinant mutations in 12/45 (26.7%), and preS2 deletions in 6/16 (37.5%). PreS2 mutations were associated with advanced fibrosis in multivariable analysis. At follow-up, median liver stiffness was 5.2 (IQR 4.1–6.6) kPa. No HBV molecular characteristics were associated with lack of fibrosis regression, although HIV virologic control, body-mass-index (BMI) and baseline CD4+ T-cell count were associated with a decline in fibrosis stage. Conclusion Frequent BCP/PC and preS1/preS2/S mutations were found in ART-naïve HIV/HBV co-infected Nigerians. Median liver stiffness declined after initiation of ART, regardless of pre-ART HBV mutational pattern or virologic characteristics.

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Genotyping and virological characteristics of hepatitis B virus in HIV-infected individuals in Sudan

Abstract: In HBV/HIV co-infected Sudanese patients, the ratio of genotype A to non-A was higher than that in mono-infected patients. The genotype E intra-group divergence in HBV/HIV co-infected individuals was significantly higher than that in HBV mono-infected patients.

Cited by 33 publications

References 51 publications

Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg‐positive and HBsAg‐negative HIV‐positive South African adults

Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg‐positive and HBsAg‐negative HIV‐positive South African adults

Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon

Hepatitis B virus sequencing and liver fibrosis evaluation in HIV/HBV co‐infected Nigerians

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