Serologic and genotypic characterization of hepatitis B virus in HIV-1 infected patients from South West and Littoral Regions of Cameroon.

Tshifhiwa Magoro,Helen K Kimbi,Lufuno Mavhandu,George Gachara,Pascal Bessong,Roland N Ndip,Emmaculate Lum

doi:10.1186/s12985-016-0636-x

Abstract

BackgroundHBV and HIV share similar transmission routes. Concurrent infection with the two viruses usually results in more severe and progressive liver disease, and a higher incidence of cirrhosis, liver cancer and mortality. Further, this co-infection may lead to cross-resistance between HIV and HBV drugs and increased liver injury, either due to direct hepatotoxicity or drug-related immune-reconstitution hepatitis. These challenges necessitate continuous surveillance for HBV among HIV infected individuals to guide patient management. We conducted this study to understand the serologic and genotypic characteristics of HBV among HIV/HBV infected patients in South West and Littoral Regions of Cameroon.MethodsPlasma samples were screened for HBsAg, HBeAg, Anti-HBs and anti-HBc using ELISA followed by DNA extraction from all HBsAg positive samples. A 366 bp region covering the overlapping surface/polymerase gene was amplified by a nested PCR and the product sequenced using Big Dye sequencing chemistry. The resulting sequences were then analyzed for genotypes and both escape and drug resistance mutations.ResultsOf the 455 samples in this study, 25.5 % (n = 116) were HBsAg positive and 46 of these had their DNA successfully amplified. Genotype E was found in 32 samples (69.6 %) and genotype A in the rest of the samples. Escape mutations associated with failure of diagnosis (Y100C, R122K and Q129H) and with vaccine escape (Q129R and T131N) were detected in varying frequencies in the population. Polymerase mutations implicated in resistance to lamivudine and other ʟ-nucleoside analogues were detected in seven patients (15.2 %), while all the samples lacked mutations associated with resistance to adefovir and tenofovir.ConclusionsThese findings suggest the endemicity of HBV and the predominance of genotypes A and E in the study population. Also, drug resistance findings support the use of tenofovir based ART regimens among HIV/HBV co-infected persons. There is need for continuous HBV screening and monitoring in HIV infected individuals in these regions.

Highlights

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share similar transmission routes
Failure of viral clearance following acute infection may result in inactive carriage or chronic hepatitis which can progress to both cirrhosis and hepatocellular carcinoma (HCC) [1]
In patients co-infected with HBV and HIV, it has been demonstrated that the HBV X-protein (HBx) super-induces ongoing HIV-1 replication and HIV-1 long-term repeated transcription by synergizing with tat- protein and with T-cell activation signals [10]. These findings indicate that HBx could contribute to a faster progression to AIDS in HBV/HIV-co-infected individuals [11]

Summary

Introduction

Concurrent infection with the two viruses usually results in more severe and progressive liver disease, and a higher incidence of cirrhosis, liver cancer and mortality. This co-infection may lead to cross-resistance between HIV and HBV drugs and increased liver injury, either due to direct hepatotoxicity or drug-related immune-reconstitution hepatitis. These challenges necessitate continuous surveillance for HBV among HIV infected individuals to guide patient management. The virus contains a partly double-stranded DNA genome with approximately 3200 base pairs. The toll of approximately 1 million deaths from chronic liver disease and hepatocellular carcinoma per year is a clear demonstration of the global health problem posed by this virus [3]

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