Broad Range of Hepatitis B Virus (HBV) Patterns, Dual Circulation of Quasi-Subgenotype A3 and HBV/E and Heterogeneous HBV Mutations in HIV-Positive Patients in Gabon
Broad Range of Hepatitis B Virus (HBV) Patterns, Dual Circulation of Quasi-Subgenotype A3 and HBV/E and Heterogeneous HBV Mutations in HIV-Positive Patients in Gabon
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DOI：
10.1371/journal.pone.0143869
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发表时间：
2016-01-14
期刊：
影响因子：
3.7
通讯作者：
Rouet, Francois
中科院分区：
文献类型：
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作者：
Bivigou-Mboumba, Berthold;Francois-Souquiere, Sandrine;Rouet, Francois
在非洲合并感染人类免疫缺陷病毒1型（HIV-1）的患者中缺乏关于B肝炎病毒（HBV）模式、HBV基因型和突变的综合数据。这项调查于2010-2013年在加蓬的762名艾滋病毒-1阳性成年人中进行，他们主要接受基于3 TC的抗逆转录病毒治疗。采用免疫测定法检测乙型肝炎B核心抗原（HBcAb）、乙型肝炎B表面抗原（HBsAg）、IgM HBcAb、乙型肝炎B e抗原（HBeAg）、乙型肝炎表面抗原抗体（HBsAg）的总抗体，并采用内部实时PCR检测HBV DNA定量，确定HBV模式。隐匿性B型肝炎（OBI）的定义是存在分离的抗-HBc和可检测的血清HBV DNA。采用PCR-直接测序法分析HBV基因型和HBV变异。七十一（9.3%）例患者HBsAg检测阳性，包括1例急性B型肝炎（0.1%; 95% CI，0.0%-0.2%），9例HBeAg阳性慢性B型肝炎（CH B）（1.2%; 95%CI，0.6%-2.2%），16例HBeAg阴性CHB（2.1%; 95%CI，1.2%-3.3%）和45例非活动性HBV携带者（5.9%; 95%CI，4.4%-7.8%）。61例（8.0%; 95% CI，6.2%-10.1%）患者出现OBI。无论HBV模式如何，治疗患者的HBV DNA水平与未治疗患者相似。约15.0%的OBI患者显示高（> 1，000 UI/mL）病毒血症。M204 V/I突变导致3 TC耐药在HBV/A（47.4%）中比在HBV/E分离株（0%）中更常见（P =.04）。我们的研究结果鼓励临床医生在没有暴露于HBV的患者中推广HBV疫苗接种，并在CHB患者中将3 TC转换为通用TDF。
Integrated data on hepatitis B virus (HBV) patterns, HBV genotypes and mutations are lacking in human immunodeficiency virus type 1 (HIV-1) co-infected patients from Africa. This survey was conducted in 2010-2013 among 762 HIV-1-positive adults from Gabon who were predominantly treated with 3TC-based antiretroviral treatment. HBV patterns were identified using immunoassays detecting total antibody to hepatitis B core antigen (HBcAb), hepatitis B surface antigen (HBsAg), IgM HBcAb, hepatitis B e antigen (HBeAg), antibody to HBsAg (HBsAb) and an in-house real-time PCR test for HBV DNA quantification. Occult hepatitis B (OBI) was defined by the presence of isolated anti-HBc with detectable serum HBV DNA. HBV genotypes and HBV mutations were analyzed by PCR-direct sequencing method. Seventy-one (9.3%) patients tested positive for HBsAg, including one with acute hepatitis B (0.1%; 95% CI, 0.0%-0.2%), nine with HBeAg-positive chronic hepatitis B (CHB) (1.2%; 95% CI, 0.6%-2.2%), 16 with HBeAg-negative CHB (2.1%; 95% CI, 1.2%-3.3%) and 45 inactive HBV carriers (5.9%; 95% CI, 4.4%-7.8%). Sixty-one (8.0%; 95% CI, 6.2%-10.1%) patients showed OBI. Treated patients showed similar HBV DNA levels to those obtained in untreated patients, regardless of HBV patterns. Around 15.0% of OBI patients showed high (> 1,000 UI/mL) viremia. The mutation M204V/I conferring resistance to 3TC was more common in HBV/A (47.4%) than in HBV/E isolates (0%) (P =.04). Our findings encouraged clinicians to promote HBV vaccination in patients with no exposure to HBV and to switch 3TC to universal TDF in those with CHB.