Outbreak of Infections by Hepatitis B Virus Genotype A and Transmission of Genetic Drug Resistance in Patients Coinfected with HIV-1 in Japan

Abstract

The major routes of hepatitis B virus (HBV) infection inThe narrow genetic diversity in genotype A cases suggests that genotype A has been recently introduced into the MSM population and that sexual contacts among MSM were more active than speculated from HIV-1 tree analyses. In addition, we found a lamivudine resistance mutation in one naïve case, suggesting a risk of drug-resistant HBV transmission. As genotype A infection has a higher risk than infection with other genotypes for individuals to become HBV carriers, prevention programs are urgently needed for the target population.

Is There Any Value to Hepatitis B Virus Genotype Analysis?

“…This undoubtedly has and will change further due to mass immunisation, migration and co-infection [101,102]. Regardless there appear to be differences in the disease profile between patients infected with different genotypes [103].…”

Recent Population Expansions of Hepatitis B Virus in the United States

“…Although locally circulating HBV strains may be expected to be genetically (20,21). As noted, rapid transmissions among acutely infected MSM in the Netherlands and Japan (25,26) were associated with genetically identical or closely related A2 strains. The data from Japan also indicate a greater propensity of primary infection with A2, compared to other genotypes, associated with persistent HBV infection (29,30).…”

Advances in treating drug-resistant hepatitis B virus in HIV-infected patients

“…This may translate into failure of diagnostic tests, vaccine escape, or both [45][46][47][48]. Finally and to a lesser extent than in HIV, transmission of drug-resistant HBV strains has already been reported [49][50][51]. They seem restricted to 3TC although mutations conferring resistance to other anti-HBV agents have occasionally been seen [52,53].…”

“…Of note, 3TC would never be a good option in cirrhotic patients, as eventual virological failures may produce potentially lifethreatening hepatic decompensation [64]. As previously mentioned, primary 3TC resistance, as found in persons that acquired HBV mutants at first infection, seems to be very rare [49][50][51][52][53]. However, if this phenomenon gains frequency in certain regions, 3TC use in the scenarios described above should be totally discouraged.…”