title: Major role of hepatitis B genotypes in liver fibrosis during coinfection with HIV.
abstract: BACKGROUND
  Little is know about the determinants of liver fibrosis progression and genomic variability in hepatitis B virus (HBV) in HIV/HBV-coinfected patients.
  
  
  METHODS
  A cross-sectional analysis examined common characteristics of HBV infection in an ongoing cohort study of 308 patients with both HIV-1-positive Western blot and plasma HBV surface antigen (HBsAg) seropositivity. Risk factors for liver fibrosis were studied in a subset of 104 patients for whom liver biopsy and complete HBV genomic analysis were available. Analysis was performed by exact multiple regression analysis.
  
  
  RESULTS
  Mean age of the study population was 40.3 years, with a ratio male to female of 5.3 and a mean duration of HIV infection of 9.3 years. In the subset of 104 patients, plasma HBV e antigen (HBeAg) in HBV-replicative patients could not be detected in 28.4% and lamivudine-resistant mutants were detected in 67.8%. HBV genotype A was the most frequent genotype (73/104) and 25 patients were infected by the usually rare genotype G. METAVIR fibrosis score was rated F2-F4 in 70 patients. After adjustment for the most common known determinants of liver fibrosis, HBV genotype G [odds ratio (OR), 12.60; 95% confidence interval (CI), 1.72-infinite; P < 0.009], efavirenz exposure (OR, 3.55; 95% CI, 1.14-12.14; P < 0.03), and the duration of HIV infection (3.86; 95% CI, 1.27-12.64; P < 0.01) were strongly associated with the risk of grade F2-F4 fibrosis.
  
  
  CONCLUSIONS
  HBV genotype G is a determinant of liver fibrosis in HIV/HBV-coinfected patients and HBV genotyping should be considered as part of the management of patients with multiple risk factors for rapid progression of liver fibrosis.
authors.affiliation: Inserm U707, Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Véronique
authors.initials: V
authors.lastname: Massari
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
authors.forename: Lawrence
authors.initials: L
authors.lastname: Serfaty
authors.forename: Joël
authors.initials: J
authors.lastname: Gozlan
authors.forename: Gilles
authors.initials: G
authors.lastname: Pialoux
authors.forename: Patrick
authors.initials: P
authors.lastname: Mialhes
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.forename: Dominique
authors.initials: D
authors.lastname: Wendum
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.forename: Fabien
authors.initials: F
authors.lastname: Zoulim
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D019694:Hepatitis B, Chronic / Q000150:complications / Q000235:genetics*; D006801:Humans; D008103:Liver Cirrhosis / Q000235:genetics* / Q000821:virology; D008297:Male