title: HBV genotypes and drug resistance mutations in antiretroviral treatment-naive and treatment-experienced HBV-HIV-coinfected patients.
abstract: The presence of HBV resistance mutations upon initiation or during antiretroviral therapy (ART) in HIV-coinfected patients is an important determinant of treatment response. The main objective of the study was to determine the prevalence of HBV resistance mutations in antiretroviral treatment-naive and treatment-experienced HBV-HIV-coinfected Ghanaian patients with detectable HBV viraemia.
  
  
  
  HBV-HIV-coinfected patients who were ART-naive or had received at least 9 months of lamivudine (3TC)-containing ART were enrolled in a cross-sectional study. Demographic and clinical data were collected and HBV DNA quantified. Partial HBV sequences were amplified by PCR and sequenced bi-directionally to obtain a 2.1-2.2 kb fragment for phylogenetic analysis of HBV genotypes and evaluation of drug resistance mutations.
  
  
  
  Of the 100 HBV-HIV-coinfected study patients, 75 were successfully PCR-amplified, and 63 were successfully sequenced. Of these 63 patients, 27 (42.9%) were ART-experienced and 58 (92.1%) had HBV genotype E. No resistance mutations were observed in the 36 ART-naive patients, while 21 (77.8%) of 27 treatment-experienced patients had resistance mutations. All patients with resistance mutations had no tenofovir in their regimens, and 80% of them had HIV RNA <40 copies/ml. The 3TC resistance mutations rtL180M and rtM204V were observed in 10 (47.6%) of the 21 patients, while 5 patients (23.8%) had rtV173L, rtL180M and rtM204V mutations.
  
  
  
  A high proportion of HBV-HIV-coinfected patients with detectable viraemia on 3TC-containing ART had resistance mutations despite good ART adherence as determined by HIV RNA suppression. This study emphasizes the need for dual therapy as part of a fully suppressive ART in all HBV-HIV-coinfected patients in Ghana.
authors.affiliation: Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana.|Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: Timothy Na
authors.initials: TN
authors.lastname: Archampong
authors.affiliation: Division of Digestive Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Ceejay L
authors.initials: CL
authors.lastname: Boyce
authors.affiliation: Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana.|Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.affiliation: Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: Kwamena W
authors.initials: KW
authors.lastname: Sagoe
authors.affiliation: Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: Adjoa
authors.initials: A
authors.lastname: Obo-Akwa
authors.affiliation: Korle-Bu Teaching Hospital, Accra, Ghana.|School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: Ernest
authors.initials: E
authors.lastname: Kenu
authors.affiliation: Division of Digestive Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Blackard
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, RI, USA.|The Miriam Hospital, Providence, RI, USA.
authors.forename: Awewura
authors.initials: A
authors.lastname: Kwara
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy* / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D024882:Drug Resistance, Viral / Q000235:genetics; D005838:Genotype; D005869:Ghana; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology*; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000821:virology*; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D009154:Mutation; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine