Genotype mixtures of hepatitis B virus in patients treated with interferon.
Little is known about coinfection among several hepatitis B virus (HBV) genotypes, although previous reports of recombination and genotype shifts indicate that this should occur. In the present study, we designed a method to identify mixtures of genotype A and another genotype, regardless of whether one of them predominates. Using this method, signs of genotypic coinfection were found in 20 (67%) of 30 hepatitis B e antigen-positive patients treated with interferon (IFN). In 8 of these patients, coinfection or genotype shifts were detectable by direct sequencing or standard preS genotyping. In most of these cases, genotype changes were detected after a >2-log decrease or increase of the HBV DNA level. The presence of genotype mixtures did not significantly influence IFN response. Because quasi-species selection may occur at or shortly after transmission, patients might acquire HBV infection from subjects who appear to be infected with a different genotype. This should be considered when tracing the source of HBV infection.
Department of Clinical Virology, Göteborg University, Göteborg, Sweden.
Charles
C
Hannoun
Kim
K
Krogsgaard
Peter
P
Horal
Magnus
M
Lindh
D000998:Antiviral Agents / Q000627:therapeutic use*; D001483:Base Sequence; D004279:DNA, Viral / Q000235:genetics; D005814:Genes, Viral / Q000235:genetics*; D005838:Genotype; D006509:Hepatitis B / Q000188:drug therapy* / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008969:Molecular Sequence Data; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy / Q000821:virology
D000998:Antiviral Agents; D004279:DNA, Viral; D007372:Interferons