title: Human immunodeficiency virus and hepatitis B genotype G/A2 recombinant co-infection: a case study.
abstract: BACKGROUND
  Hepatitis B virus (HBV) genotypes have distinct geographical distributions and are associated with different clinical courses. HBV genotype G (HBV/G) is extremely rare among Human immunodeficiency virus (HIV) infected populations in Japan. Genetic analysis and clinical course of recombinant forms with HBV/G infection are seldom reported in the literature.
  
  
  METHODS
  A 36-year old homosexual man with HIV infection was referred to a general hospital for assessment of chronic HBV infection. We cloned full-length HBV isolates and determined the complete genome sequences of 2 obtained clones, although mixture of multiple variant with different length is detected by HBV-DNA genotyping. The Bootscaning analysis using a full-length HBV genome revealed the clones represented as the HBV/A2 and the HBV/G/A2 recombinant strain. The HBV-DNA decreased from >9.1 to 2.5 log copies/mL after 24 months of antiretroviral therapy.
  
  
  CONCLUSIONS
  This patient was co-infected with HBV/A2 and HBV/G/A2 recombinant strain. This recombinant strain was not identical to HBV/G/A2 strains previously reported from Japan. Recombination with other genotypes could alter the clinical manifestations of chronic hepatitis B in people living with HIV.
authors.affiliation: Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
authors.forename: Eisuke
authors.identifier: 0000-0002-1623-873X
authors.initials: E
authors.lastname: Adachi
authors.affiliation: Genome Medical Science Project, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa-shi, Chiba 272-8516 Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Sugiyama
authors.affiliation: Department of Hepatology Center, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642 Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa 252-0375 Japan.
authors.forename: Kako
authors.initials: K
authors.lastname: Kodama
authors.affiliation: Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Koga
authors.affiliation: Genome Medical Science Project, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa-shi, Chiba 272-8516 Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.affiliation: Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Koibuchi
keywords: Antiretroviral therapy; Hepatitis B virus; Human immunodeficiency virus; Recombinants with HBV genotype G