A Study on HBV Infection in HBV-HIV Co-infected Patients from Eastern India

Abstract

© 2011, INASL 3 negative samples. For HBV DNA positive cases, HBeAg status was checked and direct sequencing of surface gene, BCP and PC region were done. Surface gene sequences were used to confirm the HBV genotypes/subgenotypes by phylogenetic analysis. The viral load was measured by real time PCR. Results: After initial screening, 204 samples were found to be anti-HBc positive but HBsAg negative. From these 204 samples 31 (15.2%) were found to be positive for HBV DNA. HBV genotype A was present in 9.7% and rest of the samples were HBV/D (90.3). Three subgenotypes of HBV/D was identified, viz D2 (35.7%), D3 (50.0%) and D5 (14.3). In the BCP region most common mutations were C1752, C1753 and triple mutation C1753/T1762/A1764. In 48.4% cases the presence of C1773 was noticed. Notably all the samples were found to be HBeAg negative. No mutation was found in the PC region. Conclusion: Interestingly higher rate of variability in the BCP region, especially C1752, C1753/T1762/A1764 triple mutations and C1773 was noticed. These carriers carrying the mutant strains should be followed up at regular intervals to assess the clinical progression. Conflict of Interest: None A Study on HBV Infection in HBV-HIV Co-infected Patients from Eastern India A Pal*, M Bandopadhyay*, A Biswas*, R Panigrahi*, SK Guha**, S Chakrabarti†, R Chakravarty* *ICMR Virus Unit, Kolkata **Department of Medicine, School of Tropical Medicine, Kolkata †National Institute of Cholera and Enteric Diseases, Kolkata Background: Hepatitis B virus (HBV) and HIV co-infection is frequent due to shared routes of transmission. With improved control of HIV disease with HAART, liver disease has emerged as one of the leading causes of deaths in HIV patients. It has been reported that co-infection with HIV complicates the natural history, diagnosis and management of HBV infection. In India, the study regarding HBV-HIV co-infection is sparse although the prevalence of both viruses is considerable. Objective: The study is aimed to characterize HBV infection in hepatitis B surface antigen (HBsAg) positive cases of HBV-HIV co-infected patients. Methods: Total 48 HIV patients who were registered in our unit for HBV screening were included. Serological markers of HBV and HIV were tested using enzyme linked immunoassays. Detection of HBV DNA was done by nested PCR, followed by genotyping using RFLP. Result: Thirty-two HIV patients were detected positive for HBsAg and HBV DNA resulting in 66.67% of selected HIV patients to be co-infected with HBV. 75% of 32 co-infected patients were also positive for HBeAg. Sexual transmission (47.62%) was found to be more associated with HBV transmission than blood transfusion and surgical operation (9.52% in both cases). When HBV genotype distribution was correlated with CD4 cell count, three genotypes [HBV/A (21.34%), HBV/C (7.14%) and HBV/D (64.29%)] were found to be related with CD4 cell count 6 months included. Patients with cirrhosis, hepatocellular carcinoma, antiviral treatment, HIV/HCV coinfection, excluded. Detailed clinical examination, LFT, USG abdomen, AFP, HBsAg ELISA titers, HBeAg and HBV DNA PCR (Roche Amplicor) assays done. OGD done when indicated. Anti-HBe antibody assessed in HBeAg negative patients. Pearson’s correlation coefficient (r) used for correlation between variables, analyzed using SPSS. 03_JCEH-Abstract.indd 3 3/18/2011 11:13:03 AM