title: Lamivudine-resistant HBV infection in HIV-positive patients receiving antiretroviral therapy in a public routine clinic in Cameroon.
abstract: BACKGROUND
  In Africa, most HIV-HBV-coinfected patients on antiretroviral therapy (ART) receive an anti-HBV lamivudine monotherapy that has been shown in northern countries to lead to frequent emergence of drug resistance. We assessed the HBV prevalence and the rate and pattern of lamivudine-resistant HBV mutations in Cameroonian HIV-infected, ART-treated patients.
  
  
  METHODS
  A cross-sectional survey was performed in 2006-2007 at the HIV/AIDS outpatient clinic of the Central Hospital in Yaoundé, Cameroon. Plasma samples were tested as appropriate for hepatitis B surface antigens, antibodies to hepatitis B core, HBV DNA, genotypes and lamivudine-resistant polymerase mutations.
  
  
  RESULTS
  Of 552 adult patients (71% women, median age 38 years), 290 had received lamivudine-based ART for 12 months and 262 for 24 months. No patient had received tenofovir. The prevalence of hepatitis B surface antigen was 9.8%. Overall, 26% of seropositive patients had an HBV DNA level >40 IU/ml. Genotypes A and E were identified. Polymerase resistance mutations were detected in 14% and 60% of patients at months 12 and 24, respectively.
  
  
  CONCLUSIONS
  This study supports both WHO recommendations of screening for HBV before initiation of ART and of using ART containing tenofovir and either lamivudine or emtricitabine in HIV-HBV-coinfected patients in Africa.
authors.affiliation: Central Hospital, UMI 233, Yaoundé, Cameroon.
authors.forename: Charles
authors.initials: C
authors.lastname: Kouanfack
authors.forename: Avelin F
authors.initials: AF
authors.lastname: Aghokeng
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Mondain
authors.forename: Anke
authors.initials: A
authors.lastname: Bourgeois
authors.forename: Alain
authors.initials: A
authors.lastname: Kenfack
authors.forename: Eitel
authors.initials: E
authors.lastname: Mpoudi-Ngolé
authors.forename: Jacques
authors.initials: J
authors.lastname: Ducos
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.forename: Christian
authors.initials: C
authors.lastname: Laurent
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D001483:Base Sequence; D002163:Cameroon; D060085:Coinfection / Q000188:drug therapy / Q000821:virology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D015684:Gene Products, pol / Q000235:genetics; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017422:Sequence Analysis, DNA
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D015684:Gene Products, pol; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine