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.

HBsAg mutations related to occult hepatitis B virus infection in HIV‐positive patients result in a reduced secretion and conformational changes of HBsAg

“…Instead, some other “a” determinant mutations were found. Previous investigations had shown P127T, Y134I, E164D, I195M, P120S [Taffon et al, ], Y100C, T131N, and D144A mutations [Oliveira et al, ] in OBI‐HIV coinfection. Moreover, in the present study, other unreported new mutations among these OBI‐HIV‐1‐positive patients were found.…”

Emergence of New Epidemiological Hepatitis B and C Profiles in High Risk Groups in Latin America

“…Tengan et al [15] reported HBsAg prevalence in HIV of 3.3% in [20,21]. HBV genotype A was the most detected in studies from Brazil and Argentina while genotype F was most found in Colombia [17,[19][20][21][22].…”

“…In Brazil, HBsAg prevalence in HIV infected individuals ranges from 1.9 to 10.3% according geographical regions [15][16][17][18]. Tengan et al [15] reported HBsAg prevalence in HIV of 3.3% in [20,21]. HBV genotype A was the most detected in studies from Brazil and Argentina while genotype F was most found in Colombia [17,[19][20][21][22].…”

Detection of Occult Hepatitis B Virus Among Iranian HCV-Infected Patients with Hemophilia Treated with Direct-Acting Antiviral Agents

“…HBV activation could be associated with severe hepatitis and liver failure (6)(7)(8)(9)(10)(11)(12)(13). There are conflicting data whether HBV replication may be inhibited by coinfection with other agents, especially HCV or HIV (14)(15)(16)(17)(18)(19)(20). Although HBV replication is commonly inhibited in the presence of HCV coinfection, a total HBV activation rate of 14.5% is reported following interferon (IFN)-induced HCV eradication (21) .Thus, the individuals with active HBV and HCV infections likely show a high HCV viral load, and low or undetectable HBV DNA levels.…”