title: Overt and occult hepatitis B virus infection among treatment-naïve HIV-infected patients in Brazil.
abstract: Although hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection is common, only few data are available on HBV among HIV patients including occult hepatitis B infection (OBI), regardless of serological markers. This study aims to determine the prevalence of OBI and overall HBV infection, associated factors, HBV genotypes, and surface (S) gene mutations in a population of treatment-naïve HIV-infected patients in Brazil. A cross-sectional study was conducted in treatment-naïve HIV-infected patients in Central Brazil. All samples were tested for HBV serological markers and HBV DNA. Sequence analysis of the S gene and overlapping polymerase gene was preformed. Overall, 25.1% (127/505) of the patients had markers of current or previous HBV infection, which was associated with age over 40 years, history of injection drug use, and homosexual sex. The hepatitis B surface antigen (HBsAg) seroprevalence was 4.9% (25/505). HBV DNA was detected in 39 out of 505 patients: 20 of them were HBsAg-positive and 19 were HBsAg-negative, resulting in an OBI prevalence of 3.8%. Patients with OBI had significantly higher HCV seropositivity rate compared to HBsAg-positive patients. Sequencing of the S gene revealed Y100C, T131N, and D144A mutations. One patient had the M204I and L180M drug-resistance mutations (polymerase). HBV genotypes A (A1, A2), D (D2, D3), and F (F2) were identified. In conclusion, OBI represented almost half of all HBV infections with detectable HBV DNA, suggesting that hepatitis B diagnosis in HIV patients should include in addition to serological markers the detection of HBV DNA.
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Marina Pedroso
authors.initials: MP
authors.lastname: Oliveira
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Pollyanne Sousa
authors.initials: PS
authors.lastname: Lemes
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Márcia Alves Dias
authors.initials: MA
authors.lastname: Matos
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Nativa Helena Alves
authors.initials: NH
authors.lastname: Del-Rios
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Megmar Aparecida Santos
authors.initials: MA
authors.lastname: Carneiro
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Ágabo Macedo Costa
authors.initials: ÁM
authors.lastname: Silva
authors.affiliation: Faculty of Nursing, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Carmen Luci Rodrigues
authors.initials: CL
authors.lastname: Lopes
authors.affiliation: Faculty of Nursing, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Sheila Araújo
authors.initials: SA
authors.lastname: Teles
authors.affiliation: Hospital of Tropical Diseases Dr. Anuar Auad, Goiás, Brazil.
authors.forename: Rodrigo Sebba
authors.initials: RS
authors.lastname: Aires
authors.affiliation: Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: Bárbara Vieira
authors.initials: BV
authors.lastname: Lago
authors.affiliation: Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: Natalia Motta
authors.initials: NM
authors.lastname: Araujo
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiás, Brazil.
authors.forename: Regina Maria Bringel
authors.initials: RM
authors.lastname: Martins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D055030:Drug Users; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000235:genetics / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests; D015995:Prevalence; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens
keywords: HBV DNA; HIV; hepatitis B; occult infection