Hepatitis B genotype G and high frequency of lamivudine-resistance mutations among human immunodeficiencyvirus/hepatitis B virus co-infected patients in Brazil

Abstract

In this study, we evaluated the hepatitis B virus (HBV) genotype distribution and HBV genomic mutations among a group of human immunodeficiency virus-HBV co-infected patients from an AIDS outpatient clinic in São Paulo. HBV serological markers were detected by commercially available enzyme immunoassay kits. HBV DNA was detected using in-house nested polymerase chain reaction and quantified by Cobas Amplicor. HBV genotypes and mutations in the basal core promoter (BCP)/pre-core/core regions and surface/polymerase genes were determined by sequencing. Among the 59 patients included in this study, 55 reported prior use of lamivudine (LAM) or tenofovir. HBV DNA was detected in 16/22 patients, with a genotype distribution of A (n = 12,75%), G (n = 2,13%), D (n = 1,6%) and F (n = 1,6%). The sequence data of the two patients infected with genotype G strongly suggested co-infection with genotype A. In 10 patients with viremia, LAM-resistance mutations in the polymerase gene (rtL180M + rtM204V and rtV173L + rtL180M + rtM204V) were found, accompanied by changes in the envelope gene (sI195M, sW196L and sI195M/sE164D). Mutations in the BCP and pre-core regions were identified in four patients. In conclusion, genotype G, which is rarely seen in Brazil, was observed in the group of patients included in our study. A high prevalence of mutations associated with LAM-resistance and mutations associated with anti-HBs resistance were also found among these patients

Evolution of hepatitis B serological markers in HIV coinfected patients: a case study

“…Genotype G has been associated with the presence of two codons responsible for the translation termination in the HBV precore region, which seem to inhibit the synthesis of HBeAg 22 . It is interesting to note that the presence of genotype G was previously described by other authors in a few patients from the same study population 23 . The presence of the HBV genotypes C and F could also have been associated with a greater chance of HBeAg seroreversion in that population 24 .…”

New amino acid changes in drug resistance sites and HBsAg in hepatitis B virus genotype H

“…Noteworthy, in this study, several amino acids changes identified were different to previously reported in other populations. In one strain of genotype G isolated from a naïve‐treatment patient, we identified the classical mutations reported for LMV, these mutations have been reported in patients with genotype G and co‐infection with HIV/HBV [Silva et al, ; Mata et al, ]. At this moment, remains to be elucidated if the mutants found in the RT domain of the viral polymerase in genotype H HBV (rtI169M and rtQ215E) affect the replicative capacity of the virus or really interfere with NAs treatment, due to the fact that amino acids identified are different from the previously reported (rtI169T/K and rtQ215S/H/P) [Delaney et al, ; Tenney et al, ; Amini‐Bavil‐Olyaee et al, ; Pastor et al, ].…”

Predictors of HBeAg status and hepatitis B viraemia in HIV-infected patients with chronic hepatitis B in the HAART era in Brazil

“…Absolute quantification of HBV DNA was carried out by an in-house real-time polymerase chain reaction (PCR) [12] assay using primers capable of amplifying HBV genotypes A to H (28 samples), or by the commercially available COBAS Amplicor HBV Monitor Test assay (Roche Molecular Systems, Pleasanton, CA, USA) according to the manufacturer's instructions (58 samples), as previously described [13,14]. …”