title: Broad Range of Hepatitis B Virus (HBV) Patterns, Dual Circulation of Quasi-Subgenotype A3 and HBV/E and Heterogeneous HBV Mutations in HIV-Positive Patients in Gabon.
abstract: Integrated data on hepatitis B virus (HBV) patterns, HBV genotypes and mutations are lacking in human immunodeficiency virus type 1 (HIV-1) co-infected patients from Africa. This survey was conducted in 2010-2013 among 762 HIV-1-positive adults from Gabon who were predominantly treated with 3TC-based antiretroviral treatment. HBV patterns were identified using immunoassays detecting total antibody to hepatitis B core antigen (HBcAb), hepatitis B surface antigen (HBsAg), IgM HBcAb, hepatitis B e antigen (HBeAg), antibody to HBsAg (HBsAb) and an in-house real-time PCR test for HBV DNA quantification. Occult hepatitis B (OBI) was defined by the presence of isolated anti-HBc with detectable serum HBV DNA. HBV genotypes and HBV mutations were analyzed by PCR-direct sequencing method. Seventy-one (9.3%) patients tested positive for HBsAg, including one with acute hepatitis B (0.1%; 95% CI, 0.0%-0.2%), nine with HBeAg-positive chronic hepatitis B (CHB) (1.2%; 95% CI, 0.6%-2.2%), 16 with HBeAg-negative CHB (2.1%; 95% CI, 1.2%-3.3%) and 45 inactive HBV carriers (5.9%; 95% CI, 4.4%-7.8%). Sixty-one (8.0%; 95% CI, 6.2%-10.1%) patients showed OBI. Treated patients showed similar HBV DNA levels to those obtained in untreated patients, regardless of HBV patterns. Around 15.0% of OBI patients showed high (>1,000 UI/mL) viremia. The mutation M204V/I conferring resistance to 3TC was more common in HBV/A (47.4%) than in HBV/E isolates (0%) (P = .04). Our findings encouraged clinicians to promote HBV vaccination in patients with no exposure to HBV and to switch 3TC to universal TDF in those with CHB.
authors.affiliation: Laboratoire de Rétrovirologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.|Unité Mixte de Recherche VIH et Maladies Infectieuses Associées (UMR-VIH-MIA), CIRMF, Libreville, Gabon.
authors.forename: Berthold
authors.initials: B
authors.lastname: Bivigou-Mboumba
authors.affiliation: Unité Mixte de Recherche VIH et Maladies Infectieuses Associées (UMR-VIH-MIA), CIRMF, Libreville, Gabon.
authors.forename: Sandrine
authors.initials: S
authors.lastname: François-Souquière
authors.affiliation: Laboratoire de Rétrovirologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
authors.forename: Luc
authors.initials: L
authors.lastname: Deleplancque
authors.affiliation: Centre de Traitement Ambulatoire (CTA), Franceville, Gabon.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Sica
authors.affiliation: Laboratoire de Rétrovirologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
authors.forename: Augustin
authors.initials: A
authors.lastname: Mouinga-Ondémé
authors.affiliation: Service de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun.
authors.forename: Marie
authors.initials: M
authors.lastname: Amougou-Atsama
authors.affiliation: Laboratoire de Virologie, AP-HP, Hôpital Saint Louis; INSERM U941, Université Paris Diderot; Laboratoire associé au Centre national de Référence du VIH, Paris, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Chaix
authors.affiliation: Service de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun.
authors.forename: Richard
authors.initials: R
authors.lastname: Njouom
authors.affiliation: Laboratoire de Rétrovirologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
authors.forename: François
authors.initials: F
authors.lastname: Rouet
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D003430:Cross-Sectional Studies; D005260:Female; D005681:Gabon / Q000453:epidemiology; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000276:immunology; D006511:Hepatitis B Antigens / Q000235:genetics / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D015995:Prevalence; D017422:Sequence Analysis, DNA; D019562:Viral Load
chemical_list: D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens