Hepatitis B Virus Sub-genotype A1 Infection Is Characterized by High Replication Levels and Rapid Emergence of Drug Resistance in HIV-Positive Adults Receiving First-line Antiretroviral Therapy in Malawi

Aoudjane, Samir; Chaponda, Mas; Castillo, Antonio Adrián González del; O'Connor, Jemma; Noguera, María; Beloukas, Apostolos; Hopkins, Mark; Khoo, Saye; Oosterhout, Joep J. van; Geretti, Anna María

doi:10.1093/cid/ciu630

Cited by 28 publications

(47 citation statements)

References 41 publications

(87 reference statements)

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“…Therefore, HBsAg positivity at any time‐point is an indication that HBV infection has not cleared. Similar findings were observed in a study in Malawi, which found that participants, who were HBsAg‐positive at any point during the study, were unable to clear HBV DNA . Although seven participants lost HBsAg during the present study, their viral loads remained comparable to when they were HBsAg‐positive.…”

Section: Discussionsupporting

confidence: 89%

“…Inconsistent return for follow-up was an important limitation of the study, as has been reported in similar studies elsewhere in Africa. 37,38 Poor compliance and the development of viral resistance have been implicated as causes of VBT. 39 Liver biochemistry data and CD4+ cell counts were not available for any follow-up time-points.…”

Section: Occult and False Occult Infectionmentioning

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: 89%

Section: Occult and False Occult Infectionmentioning

confidence: 99%

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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“…Data on HBV genetic diversity is also crucial for disease management, considering that different HBV genotypes might influence the response to antiviral therapy and the clinical outcomes [ 30 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

HBV infection in untreated HIV-infected adults in Maputo, Mozambique

et al. 2017

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BackgroundHIV/ HBV coinfected patients are at high risk of developing chronic HBV infection, liver cirrhosis and hepatocellular carcinoma. In Mozambique, where HIV prevalence is one of the highest in the world, HIV-infected patients are scarcely characterized in terms of HBV coinfection and 3TC-resistance mutations profile.MethodsTo characterize ART-naïve HIV-infected adults, with and without HBV coinfection, a cross-sectional study was conducted between May and November 2012 in two health centers from Maputo city, Mozambique. Subjects were consecutively enrolled in the study and, then, tested for hepatitis B surface antigen (HBsAg). Moreover, CD4+ T cells count, HBV DNA in plasma, HBV genotyping and 3TC-resistance mutations profile of HBV were assessed in HIV/HBV coinfected patients.ResultsIn total, 518 patients were enrolled in the study. The median age was 33 years old and 66.8% were women. The median CD4+ T cells count was 361 cells/mm3 and 47 (9.1%) were coinfected with HBV. Out of 46 coinfected patients, 24 (55.2%) had HBV DNA ≥ 20 - < 20 000 and 12 (26.1%) had HBV-DNA ≥20 000. APRI > 2.0 was reported in 4.3% of coinfected and 1.7% of monoinfected patients (p = 0.228), while FIB-4 > 3.25 was reported in 4.4% of coinfected and 1.3% of monoinfected patients (p = 0.112). Genotype A was the most frequent, identified in 25/27 (92.6%) patients, whereas genotype E was present in 2/27 (7.4%) patients. No patient had 3TC-resistance mutations.ConclusionsThis study showed that HBV coinfection was prevalent among ART-naïve HIV-infected adults in Mozambique. Overall, these data highlight the importance of screening HBV coinfection as an integrated measure of HIV routine care to improve health conditions and treatment of HIV/HBV coinfected patients.

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“…In most of African countries, HBV is hyperendemic and the coinfection prevalence rate with HIV is as high as 15-20% [15]. In many developing countries, HBV remains unscreened, however, HBV active HIV ART becomes 'HBV status blind' [16,17] partly because of health-care cost and/or total attention shift to the sole management of HIV [18]. Similarly, in Ethiopia, HBV is also hyperendemic and seroprevalence of HBsAg in HIV-infected population was reported up to 14% [19].…”

mentioning

confidence: 99%

HIV Therapy with Unknown HBV Status is Responsible for Higher Rate of HBV Genome Variability in Ethiopia

2016

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Hepatitis B Virus Sub-genotype A1 Infection Is Characterized by High Replication Levels and Rapid Emergence of Drug Resistance in HIV-Positive Adults Receiving First-line Antiretroviral Therapy in Malawi

Abstract: HBV sub-genotype A1 infections showed a severe virologic expression in HIV-positive Malawians. The findings strengthen the urgency of interventions to improve ascertainment and management of chronic hepatitis B in the region.

Cited by 28 publications

References 41 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

HBV infection in untreated HIV-infected adults in Maputo, Mozambique

HIV Therapy with Unknown HBV Status is Responsible for Higher Rate of HBV Genome Variability in Ethiopia

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