title: High Burden of HBV-Infection and Atypical HBV Strains among HIV-infected Cameroonians.
abstract: OBJECTIVE
  To investigate the prevalence and genotypic profile of overt and occult hepatitis-B infection (OBI) among HIV-infected individuals in Cameroon.
  
  
  METHODS
  212 HIV-infected Cameroonians, aged 37.6 [IQR: 32.6-46.6] followed-up at the University Health Centre in Yaoundé, were tested for HBsAg, anti-HBs, anti-HBc IgG/IgM, HBV-DNA and anti-HCV IgG. HBV positive cases were tested for Hepatitis Delta virus (HDV) using anti-HDV IgG and HDV-RNA. Liver function was assessed by alanine and aspartate aminotransaminases. OBI was defined as negative-HBsAg and detectable HBV-DNA. In occult or overt HBVinfected participants, HBV reverse transcriptase (RT)/surface (S) sequences were analyzed for drug resistance, immuneescape mutants, and phylogeny.
  
  
  RESULTS
  Overall, 78.3% (166/212) participants had past/ongoing HBV-exposure, with 39.1% (83/212) carrying "HBcAbpositive alone". Prevalence of overt HBV (positive-HBsAg) was 11.8% (25/212), prevalence of HBV and HDV was respectively 6.9% (12/175) and 12% (3/25). Phylogeny of HBV-RT/S revealed the co-circulation of genotypes A and E. All HBV-coinfected participants harbored HBV strains with at least one immune-escape mutation. Of note, one HBV variant carried the vaccine-escape mutation G145R that hinders HBsAg neutralization by antibodies. For the first time, a novel 9 aa-deletion (s115-s123), located in the HBsAg "a" determinant, was found concomitantly with OBI. A stop codon in the S region (associated with increased risk of hepatocellular carcinoma) was found in six cases.
  
  
  CONCLUSIONS
  High prevalence of overt/occult HBV-infection and circulating atypical strains highlight the importance of HBV-surveillance among HIV-infected Cameroonians and strategies to detect OBI in highly endemic countries.
authors.affiliation: Department of Experimental Medicine and Surgery University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy. rsalpini@yahoo.it.
authors.forename: Romina
authors.initials: R
authors.lastname: Salpini
authors.affiliation: Department of Experimental Medicine and Surgery University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy. josephfokam@gmail.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Fokam
authors.forename: Laura
authors.initials: L
authors.lastname: Ceccarelli
authors.forename: Maria-Mercedes
authors.initials: MM
authors.lastname: Santoro
authors.forename: Aubin
authors.initials: A
authors.lastname: Nanfack
authors.forename: Samuel Martin
authors.initials: SM
authors.lastname: Sosso
authors.forename: Mathurin
authors.initials: M
authors.lastname: Kowo
authors.forename: Valeria
authors.initials: V
authors.lastname: Cento
authors.forename: Judith
authors.initials: J
authors.lastname: Torimiro
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
authors.forename: Massimo
authors.initials: M
authors.lastname: Andreoni
authors.forename: Vittorio
authors.initials: V
authors.lastname: Colizzi
authors.forename: Carlo Federico
authors.initials: CF
authors.lastname: Perno
authors.forename: Oudou
authors.initials: O
authors.lastname: Njoya
mesh_terms: D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D060085:Coinfection; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens