The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa
The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa
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DOI：
10.1016/j.vaccine.2013.08.028
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发表时间：
2013-11-12
期刊：
影响因子：
5.5
通讯作者：
Tedder, R. S.
中科院分区：
文献类型：
--
作者：
Andersson, M. I.;Maponga, T. G.;Tedder, R. S.
目的：持续的乙肝病毒感染是撒哈拉以南非洲地区发病率和死亡率的主要原因。艾滋病毒的流行有可能影响其生物学特性。在前艾滋病毒时代建立的免疫接种方案是基于显示主要是婴儿水平传播的数据。这项研究旨在确定HIV混合感染是否会通过增加传染性和有利于携带表型改变的乙肝表面抗原的病毒逃逸来改变乙肝病毒的流行病学。方法：这项回顾性横断面研究使用了2008年南非西开普省产前哨兵艾滋病毒和梅毒流行调查的产前样本。所有感染艾滋病毒的妇女的年龄和种族都与未感染艾滋病毒的妇女匹配。对样本进行乙肝病毒和丁型肝炎病毒感染的血清标志物检测。进行乙肝病毒载量、一致测序和基因分型。采用Luminex技术检测乙肝表面抗原表型。对所有HIV感染妇女样本进行抗逆转录病毒药物检测。结果：本次研究显示HIV感染妇女有失去对HBV病毒免疫控制的趋势，有3.4%的样本含有HBs Ag，18.9%的样本含有HBeAg。相比之下，来自未感染艾滋病毒的妇女的样本中，2.9%的样本含有乙肝表面抗原，17.1%的样本含有HBeAg。HIV感染者组和非感染者组的病毒载量中位数分别为9.72×10(7)IU/ml和1.19×10(6)IU/ml，基因分型显示63/68例样本为A型，其余为D型。虽然没有发现主要的表位消融，但在HIV感染组中，HBs Ag图谱显示出显著的变化。未检出HDV感染。结论：HIV-HBV混合感染妇女存在一定程度的免疫逃逸。每六名感染乙肝病毒的孕妇中，就有一名HBeAg血清阳性，无论艾滋病毒状态如何。应对撒哈拉以南非洲的新生儿实施乙肝疫苗接种。(C)2013年提交人。爱思唯尔有限公司出版。保留所有权利。
Objectives: Persistent hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in sub-Saharan Africa. The HIV epidemic has the potential to affect its biology. Immunisation protocols established in the pre-HIV era are based upon data showing predominantly horizontal infant transmission. This study aimed to determine whether HIV co-infection will change the epidemiology of HBV both by increasing infectivity and by favouring the escape of viruses bearing phenotypically altered HBsAg.Methods: This retrospective cross-sectional study used antenatal samples from the 2008 Antenatal Sentinel HIV and Syphilis Prevalence Survey in the Western Cape, South Africa. All HIV-infected women were age and race-matched to HIV-uninfected women. Samples were tested for serological markers of HBV and HDV infection. HBV viral load, consensus sequencing and genotyping were performed. Luminex technology was used to determine HBsAg phenotype. All samples from HIV-infected women were tested for traces of antiretroviral drugs by mass spectrometry.Results: This study showed a trend toward loss of immune control of HBV in HIV-infected women with 3.4% of samples containing HBsAg, 18.9% contained HBeAg. In contrast, 2.9% of samples from HIV-uninfected women contained HBsAg and 17.1% of these HBeAg. The median HBV load in the HIV-infected group was 9.72 x 10(7) IU/ml and in the HIV-uninfected group 1.19 x 10(6) IU/ml. Genotyping showed 63/68 samples belonged to genotype A and the remainder genotype D. Mutations in the precore region were found in 35% and 33% of samples from HIV-infected and HIV-uninfected respectively. Although no major epitope ablation was found, marked variation in HBsAg profiles in HIV-infected group was demonstrated. No HDV infection was detected.Conclusion: HIV-HBV co-infected women exhibit a degree of immune escape. One in six HBV-infected pregnant women, irrespective of HIV status is HBeAg seropositive. HBV immunization of newborns in sub-Saharan Africa should be implemented. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.