Hepatitis B Virus Genotypes and Antiviral Resistance Mutations in Romanian HIV-HBV Co-Infected Patients

Abstract

Background and Objectives: Romania has one of the highest prevalence of hepatitis B virus (HBV) infection in human immunodeficiency virus (HIV) patients, mostly in those parenterally infected during childhood; nevertheless, there are scarce data on the virological profile of co-infection. The objective of this study was to assess the prevalence of HBV genotypes and antiviral resistance-associated mutations (RAMs) in these co-infected patients, in order to monitor the viral factors associated with the evolution of liver disease. Materials and Methods: HBV genotypes and RAMs were detected using nested PCR and line probe assays (INNO-LiPA HBV genotyping assay, and INNO-LiPA HBV DR v2, Innogenetics). Results: Out of 117 co-infected patients, 73.5% had detectable HBV-DNA, but only 38.5% presented an HBV viral load >1000 IU/mL. HBV genotype A was present in 66.7% of the cases and was dominant in patients parenterally infected during early childhood, who experienced multiple treatment regimens, with a mean therapy length of 15.25 years, and present numerous mutations associated with lamivudine (LAM) resistance, but very rarely active liver disease. HBV genotype D was detected in 33.3% of the cases, mostly in recently diagnosed injecting drug users who are treatment naïve, but, nevertheless, present RAMs in 63.5% of the cases, suggesting transmitted drug resistance, and display more frequently advanced liver fibrosis (36.1% vs. 12.3%; p = 0.033). The most frequently encountered RAMs are M204V/I: 48.8%, L180M: 33.3%, L80V: 28.8%, and V173L: 42.2%. There are no significant differences in the distribution of RAMs in patients infected with different HBV genotypes, except for the L80V and N236T mutations, which were more frequently found in HBV genotype A infections (p = 0.032 and p = 0.004, respectively). Conclusions: HBV genotypes A and D are the only genotypes present in HIV–HBV co-infected patients from Romania, with different distributions according to the infection route, and are frequently associated with multiple RAMs, conferring extensive resistance to LAM.

The Connection between MiR-122 and Lymphocytes in Patients Receiving Treatment for Chronic Hepatitis B Virus Infection

“…Although both miR-122 and the levels of lymphocytes are related to the response to therapy, these connections are not fully understood, and they might be different from what has been discovered until now. This might be because of the differences in the viral genotypes encountered in Romanians as opposed to the other populations already studied [29,30] since HBV genotypes are important in the response to therapy [28]. Therefore, our study sets a trend towards future research projects which have the potential to better define the effects of HBV treatment on all individuals at a molecular level.…”

“…On the other hand, recent studies have shown that the loss of HBsAg in chronic HBV patients receiving treatment is related to their viral genotype [28]. In Romania, the dominant viral genotypes are A and D [29], which are different from the dominant genotypes found in Asian subjects (who are mostly involved in HBV studies) [30]. Since microRNAs and lymphocytes are also involved in treatment response, the differences in viral genotypes might affect them as well.…”

Antimicrobial Properties of Capsaicin: Available Data and Future Research Perspectives

“…There have been many studies in the last few years documenting the extensive burden of disease from common viral pathogens [230][231][232][233]. Given that for many of the most common viral pathogens, there is a pattern of increasing resistance to antiviral drugs and recombinant strains emergence [234][235][236][237][238][239], and many viruses are associated with severe persistent pathological features [240][241][242][243][244][245], the research on natural antiviral substances is ever more important.…”