Abstract
BackgroundHepatitis B virus (HBV) genotypes have distinct geographical distributions and are associated with different clinical courses. HBV genotype G (HBV/G) is extremely rare among Human immunodeficiency virus (HIV) infected populations in Japan. Genetic analysis and clinical course of recombinant forms with HBV/G infection are seldom reported in the literature.Case presentationA 36-year old homosexual man with HIV infection was referred to a general hospital for assessment of chronic HBV infection. We cloned full-length HBV isolates and determined the complete genome sequences of 2 obtained clones, although mixture of multiple variant with different length is detected by HBV-DNA genotyping. The Bootscaning analysis using a full-length HBV genome revealed the clones represented as the HBV/A2 and the HBV/G/A2 recombinant strain. The HBV-DNA decreased from >9.1 to 2.5 log copies/mL after 24 months of antiretroviral therapy.ConclusionsThis patient was co-infected with HBV/A2 and HBV/G/A2 recombinant strain. This recombinant strain was not identical to HBV/G/A2 strains previously reported from Japan. Recombination with other genotypes could alter the clinical manifestations of chronic hepatitis B in people living with HIV.
Highlights
Hepatitis B virus (HBV) genotypes have distinct geographical distributions and are associated with different clinical courses
This patient was co-infected with HBV genotype A2 (HBV/A2) and HBV genotype G (HBV/G)/A2 recombinant strain
We report here a case of chronic hepatitis caused by Human immunodeficiency virus (HIV)-HBV/G/A2 recombinant strain co-infection
Summary
This patient was infected with HBV/A2 and HBV/G/A2 recombinant which is extremely rare in Japan. These HBV strains had no mutations related to anti-HBV drugs, detectable HBV-DNA levels have lasted for 2 years under TDF/FTC-containing ART. Clinicians should keep the HBV genotyping in mind using tools designed to detect recombinant forms in the management of HIVHBV co-infected patients. EA involved in the clinical management of the patient.and drafted the manuscript. SS and KK involved in the clinical management of the patient. Author details 1 Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4‐6‐1 Shirokanedai, Minato‐ku, Tokyo 108‐8639, Japan.
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