Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg‐positive and HBsAg‐negative HIV‐positive South African adults

Abstract

Both hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection are highly endemic in sub‐Saharan Africa. This study examined serological and clinical follow‐up data from 39 HBV DNA‐positive, HIV‐positive black South African adults, who returned for follow‐up at 3, 6, 12, and 18 months post‐initiation of antiretroviral therapy (ART). Of the 39 participants, 10 experienced full suppression of HBV and 29 experienced no suppression, with 10 of these showing a virological breakthrough. All 10 patients who fully suppressed were HBsAg‐negative, with 16 of the 29 who did not suppress being HBsAg‐positive and 13 HBsAg‐negative (P < 0.05). Participants fully suppressing the virus had significantly lower aminotransferase levels and were all HBsAg‐negative compared to those who did not suppress (P < 0.05). HBV viral loads between HBsAg‐positive and HBsAg‐negative samples were similar at baseline and at the final time‐point. In these South African patients with HBV/HIV coinfection, HBsAg‐negative status at baseline was a predictor of the outcome of HBV suppression in response to ART containing lamivudine.

Hepatitis B Virus Research in South Africa

“…Studies using samples from lamivudine-treated or -naïve SA patients with CHB reported reverse transcriptase gene mutations in 75.6% of isolates from patients receiving lamivudine, and 38% of cases were associated with drug resistance and treatment failure [28]. Interestingly, lamivudine resistance mutations were also detected in 37% of lamivudine-naïve patients [28,29] and in HIV/HBV co-infected individuals [30,31]. The resistance-associated mutations detected from lamivudine-naïve patients were likely to be polymorphisms of the wild-type viral sequence [32].…”

Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana

“…Most of the studies on the impact of HBV/HIV coinfection in natural disease progression were carried out in the HBsAg-positive individuals as in the studies described above. In contrast, there is a paucity of data on OBI natural disease progression owing to the few longitudinal studies on OBI, especially in Africa, where different genotypes/subgenotypes of HBV and subtypes of HIV circulate ( Amponsah-Dacosta et al, 2018 ; Singh et al, 2019 ). A study in China followed seven OBI-positive blood donors, and all were HBV DNA negative at 1-year follow-up, without an intervention ( Ye et al, 2016 ).…”