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Vo LT, Phan DQ, Nguyen PH, Gyan A, Vuong NM, Nguyen TNL, Vo LY, Huynh G. Clinical characteristics and treatment outcomes of opportunistic infections in advanced HIV disease patients among men who have sex with men in Vietnam: A prospective cross-sectional study. BMC Infect Dis 2025; 25:271. [PMID: 40001047 PMCID: PMC11863644 DOI: 10.1186/s12879-025-10679-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 02/18/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Opportunistic infections (OIs) in patients with advanced HIV disease remain a serious health issue, particularly in low-and middle-income countries. OBJECTIVES This study aims to describe the clinical characteristics and factors associated with mortality among hospitalized advanced HIV-infected men who have sex with men (MSM). METHODS A prospective cross-sectional study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City between March and June 2023. Data was collected through interviews and medical record reviews. A multivariate logistic regression model was employed to assess factors associated with hospitalization outcomes, with statistical significance set at p < 0.05. RESULTS The study included 121 participants, with 61.3% aged 25-34 years and 42.2% classified as underweight. Only 35.5% of patients received OI preventive treatment. Comorbidities were noted as follows: hepatitis B (12.4%), hepatitis C (2.5%), and syphilis (43.8%). A total of 41.3% of patients had at least one OI, with Mycobacterium tuberculosis being the most common (46.3%), followed by Pneumocystis jirovecii pneumonia (44.6%) and Cryptococcus neoformans (19%). Sepsis was present in 20.7% of patients. The in-hospital mortality rate was 19%. Factors significantly associated with mortality included being underweight, HBV coinfection, C. neoformans infection, lack of OI preventive treatment, and sepsis. CONCLUSION The study reveals a high inpatient mortality rate among advanced HIV-infected MSM, even among relatively young patients. Increased mortality was associated with being underweight, having sepsis, HBV coinfection, C. neoformans infection, and not receiving OI preventive treatment.
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Affiliation(s)
- Ly Trieu Vo
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dung Quoc Phan
- Faculty of Control Disease, Health Center District 8, Ho Chi Minh, Vietnam
| | - Phi Hoang Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam
| | - Araba Gyan
- University of Michigan School of Public Health, Michigan, USA
| | - Nhut Minh Vuong
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Lan Y Vo
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam
| | - Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam.
- Le Van Thinh Hospital, Ho Chi Minh City, Vietnam.
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Yang R, Chen Q, Jiao F, Yu X, Xiong Y. The sex differences in diseases progression and prognosis among persons with HIV and HBV coinfection. Sci Rep 2025; 15:4018. [PMID: 39893294 PMCID: PMC11787304 DOI: 10.1038/s41598-025-88530-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 01/29/2025] [Indexed: 02/04/2025] Open
Abstract
To investigate sex differences in liver disease development and prognosis in individuals with HIV and HBV co-infection. This study comprised 752 HIV/HBV co-infected people who were diagnosed with HIV and started on combination antiretroviral therapy (cART) between January 31st, 2015 and January 31st, 2023. Their clinical data, including CD4+ T lymphocyte counts, HBV-DNA, and FIB-4 scores, were tracked once a year. The prognosis was determined during the long-term surveillance period. Risk factors related with the progression of liver diseases were included in both univariable and multivariable logistic regression. Then, sex differences in CD4+ T lymphocyte counts, HBV-DNA, FIB-4 scores, changes in liver fibrosis levels, and prognosis were investigated. Multivariable logistic regression analysis identified male as an independent risk factor for liver disease progression. Compared to the male group, the female group had a significantly greater decline of HBV DNA levels at years 1, 2, 3, 3-5, and > 5 post-cART. At each assessment point, the female group showed a significantly greater rise in CD4+ T lymphocyte counts than the male group based on their respective baseline values. Furthermore, females had greater CD4+ T lymphocyte counts and a lower prevalence of liver cirrhosis than males throughout the study period. Compared to female, higher incidence of end-stage-liver disease (1.190/100 person-years vs 0.714/100 person-years), higher all-cause mortality (0.440/100 person-years vs 0.148/100 person-years) and higher mortality associated with end-stage-liver diseases (0.273/100 person-years vs 0.074/100 person-years) were found in male. Among individuals with HIV and HBV coinfection, males had a worse therapeutic effect of HBV-active therapy and poorer prognosis than females.
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Affiliation(s)
- Rongrong Yang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuchang District, Wuhan, 430071, Hubei, China
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China
| | - Qianhui Chen
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuchang District, Wuhan, 430071, Hubei, China
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China
| | - Fangzhou Jiao
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuchang District, Wuhan, 430071, Hubei, China
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China
| | - Xingxia Yu
- Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
| | - Yong Xiong
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuchang District, Wuhan, 430071, Hubei, China.
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China.
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Lungu GN, Diaconescu GI, Dumitrescu F, Docea AO, Mitrut R, Giubelan L, Zlatian O, Mitrut P. FibroScan ® versus Biochemical Scores: A Study of Liver Fibrosis in HIV with HBV Co-Infection. Microorganisms 2024; 12:1213. [PMID: 38930595 PMCID: PMC11205675 DOI: 10.3390/microorganisms12061213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
The study aimed to determine liver fibrosis in human immunodeficiency virus (HIV) positive individuals using transient elastography (FibroScan®), Fibrosis-4 (FIB-4) score, and aspartate aminotransferase (AST) to Platelet Ratio Index (APRI) in the HIV Department from Infectious Diseases Hospital "Victor Babeș" Craiova, Romania. Of the analyzed HIV-positive subjects (n = 161), 93 (57.76%) had HIV mono-infection, and 68 (42.24%) had Hepatitis B Virus (HBV) co-infection. The prevalence of advanced liver fibrosis was higher (F2: 11.76% and F3: 13.24%, F4: 4.41%) in the HIV-HBV co-infected group compared to the HIV mono-infected group. The univariate and multivariate analysis identified HBV co-infection (OR = 5.73) male sex (OR = 5.34), serum aspartate amino-transferase levels (Pearson's rho = 0.273), low platelet count (Pearson's rho = -0.149) and erythrocyte sedimentation rate (OR = 1.030) as risk factors for the presence of liver fibrosis. Body mass index (OR = 1.08), serum lipid levels (OR = 0.96), viral load at diagnosis (OR = 1.00005), and low CD4+ cell count (OR = 0.977) were also correlated with liver fibrosis. The FIB-4 and APRI scores were strongly correlated with each other. In conclusion, HBV co-infection seems to be a determinant factor for liver fibrosis development in people living with HIV, together with other risk factors.
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Affiliation(s)
- Giorgiana Nicoleta Lungu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (G.N.L.); (R.M.)
| | - Gheorghe Iulian Diaconescu
- “Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, 200515 Craiova, Romania; (G.I.D.); (F.D.); (L.G.)
| | - Florentina Dumitrescu
- “Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, 200515 Craiova, Romania; (G.I.D.); (F.D.); (L.G.)
- Department of Infectious diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Radu Mitrut
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (G.N.L.); (R.M.)
| | - Lucian Giubelan
- “Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, 200515 Craiova, Romania; (G.I.D.); (F.D.); (L.G.)
- Department of Infectious diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ovidiu Zlatian
- Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania
| | - Paul Mitrut
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Internal Medicine II, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
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Breen RW, Parmley LE, Mapingure MP, Chingombe I, Mugurungi O, Musuka G, Hakim AJ, Rogers JH, Moyo B, Samba C, Miller SS, Lamb MR, Harris TG. Hepatitis B virus infection (HBV) and HIV-HBV coinfection among men who have sex with men, transgender women, and genderqueer individuals in Harare and Bulawayo Zimbabwe, 2019. Heliyon 2024; 10:e25790. [PMID: 38352793 PMCID: PMC10862682 DOI: 10.1016/j.heliyon.2024.e25790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Objectives To measure HIV and Hepatitis B virus (HBV) prevalence and associated risk behaviors among men who have sex with men (MSM) and transgender women/genderqueer individuals (TGW/GQ) in Zimbabwe. Methods We conducted a biobehavioral survey using respondent-driven sampling (RDS) among adult MSM and TGW/GQ in Harare and Bulawayo, Zimbabwe in 2019. Participants completed a questionnaire and underwent testing for HIV and HBV. Results Overall, 1,510 (Harare: 694, Bulawayo 816) participants were enrolled and consented to testing; 3.8 % (58) tested positive for HBV, 22.5 % (339) tested positive for HIV, and 2.2 % (33) tested positive for both HIV and HBV. HBV prevalence was higher among participants with HIV compared to HIV-negative participants (9.7 % vs. 2.1 %, p < 0.0001). Overall, HBV prevalence was not statistically different between MSM and TGW/GQ (3.7 % vs 4.5 %, p = 0.49) nor between Harare and Bulawayo (3.3 % vs 4.3 %, p = 0.33). Conclusions Our survey demonstrates the prevalence of HBV among MSM and TGW/GQ is lower than other estimates of HBV among MSM in Africa but remains high among our survey population living with HIV highlighting the need to expand HBV testing and treatment services, especially among people with HIV in Zimbabwe.
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Affiliation(s)
- Robin W.B. Breen
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | | | - Owen Mugurungi
- Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - Avi J. Hakim
- Division of Global HIV & TB, Global Health Center, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John H. Rogers
- Division of Global HIV & TB, Global Health Center, U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - Brian Moyo
- Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe
| | | | | | - Matthew R. Lamb
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- ICAP at Columbia University, New York, NY, USA
| | - Tiffany G. Harris
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- ICAP at Columbia University, New York, NY, USA
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Baruti K, Phinius BB, Phakedi B, Mpebe G, Choga W, Bhebhe L, Mulenga G, Moraka NO, Ratsoma T, Pretorius-Holme M, Makhema J, Shapiro R, Lockman S, Moyo S, Jongman M, Anderson M, Gaseitsiwe S. High prevalence of hepatitis delta virus among people with hepatitis B virus and HIV coinfection in Botswana. J Infect Public Health 2023; 16:1736-1741. [PMID: 37734129 PMCID: PMC10589822 DOI: 10.1016/j.jiph.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/12/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Approximately 15-20 million people worldwide are infected with hepatitis delta virus (HDV), which is approximately 5 % of people with chronic hepatitis B virus (HBV). Sub-Saharan Africa has high HDV prevalence, leading to worse clinical outcomes among people who are HIV/HBV/HDV tri-infected. There are limited data on HDV prevalence among people with HIV (PWH) who are HBV-infected and uninfected in Botswana. We, therefore, determined HDV prevalence among PWH in Botswana. METHODS This was a retrospective cross-sectional study utilizing archived plasma samples from PWH with results for HBV markers such as hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) and hepatitis B e antigen (HBeAg). Samples were categorized according to their HBsAg status and screened for anti-HDV antibodies. Total nucleic acid was extracted from samples with a single positive anti-HDV result, and HDV ribonucleic acid (RNA) load was quantified using the Altona Diagnostic RealStar® HDV RT-PCR kit. Statistical analysis was performed using STATA version 14.0 where p-values < 0.05 were considered statistically significant. RESULTS The study cohort (n = 478) included both HBsAg positive (44 %) and negative (56 %) participants, with a median age of 42 [IQR; 41-43]. Anti-HDV prevalence of (15/211) [7.1 %, 95 % CI: 4.4 - 11.4] was recorded among HBsAg positive participants, all of whom were IgM anti-HBc negative, while 5/6 participants were HBeAg negative. HDV RNA load was detected in 11/12 (92 %) anti-HDV-positive participants. No HDV prevalence was recorded among participants who were HBsAg negative, therefore, the overall HDV prevalence was (15/478) [3.1 %, 95 % CI: 1.9 - 5.1]. HIV viral load suppression was statistically insignificant, irrespective of HDV status. CONCLUSIONS We report high HDV prevalence among HBsAg-positive PWH in Botswana. Most HDV-positive participants had active HDV infection, therefore, we recommend HDV screening in this cohort to guide their clinical care.
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Affiliation(s)
- Kabo Baruti
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Bonolo B Phinius
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Basetsana Phakedi
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Gorata Mpebe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Wonderful Choga
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Lynnette Bhebhe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Graceful Mulenga
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Natasha O Moraka
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Tsholofelo Ratsoma
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Molly Pretorius-Holme
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Joseph Makhema
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Roger Shapiro
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Shahin Lockman
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Sikhulile Moyo
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States
| | - Mosimanegape Jongman
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Motswedi Anderson
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Simani Gaseitsiwe
- Research laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston MA, United States.
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Bautista-Amorocho H, Silva-Sayago JA, Picón-Villamizar J. High frequency of Lamivudine and Telbivudine resistance mutations in hepatitis B virus isolates from human immunodeficiency virus co-infected patients on highly active antiretroviral therapy in Bucaramanga, Colombia. Front Microbiol 2023; 14:1202342. [PMID: 37555061 PMCID: PMC10405920 DOI: 10.3389/fmicb.2023.1202342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/07/2023] [Indexed: 08/10/2023] Open
Abstract
Hepatitis B virus (HBV) antiviral Resistance-Associated Mutations (RAMs) in human immunodeficiency virus (HIV) coinfected patients undergoing highly active antiretroviral therapy (HAART) are complex and incompletely understood. We aimed to determine the prevalence of HBV coinfection, HBV genotypes, and RAMs in a cohort of people living with HIV (PLWH) in the northeastern region of Colombia. This cross-sectional study was carried out between February 2013 and February 2014. Virological, immunological and HAART data were collected from clinical records. In-house nested PCR and Sanger sequencing of the HBV pol gene were used to identify coinfections, genotypes, RAMs and HBV s antigen (HBsAg) escape mutants. Among 275 PLWH, HBV coinfection was confirmed in 32 patients (11.6%), of whom nine (28.2%) were HBsAg positive (active hepatitis B), and 23 (71.8%) were occult hepatitis B infections (OBI). All HBV sequences (n = 23) belonged to the genotype F3. Among HIV/HBV coinfections, 71.9% had CD4+ T cell counts above 200 cells/mm3 and 37.5% had undetectable HIV viral loads. The RAMs rtL80I, rtL180M, and rtM204V, which confer resistance to Lamivudine/Telbivudine and partially resistant to Entecavir, were found in all HBV isolates. An unknown rt236Y mutation to Tenofovir was also identified. Most patients under HAART received first-generation HBV antiviral therapy with a low genetic barrier to resistance. Antiviral Drug-associated Potential Vaccine-escape Mutations (ADAPVEMs) in the S gene were observed in all isolates ranging from 1-20 amino acid substitutions. However, no vaccine escape mutants were detected. In Conclusion, these findings highlight the importance of HBV molecular screening, antiviral resistance monitoring and new guidelines for PLWH to overcome RAMs and prevent HBV-related liver disease.
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Ruta S, Grecu L, Iacob D, Cernescu C, Sultana C. HIV-HBV Coinfection-Current Challenges for Virologic Monitoring. Biomedicines 2023; 11:1306. [PMID: 37238976 PMCID: PMC10215721 DOI: 10.3390/biomedicines11051306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
HIV-HBV coinfected patients have higher rates of liver-related morbidity, hospitalizations, and mortality compared to HBV or HIV mono-infected ones. Clinical studies have shown an accelerated progression of liver fibrosis and an increased incidence of HCC, resulting from the combined action of HBV replication, immune-mediated hepatocytolysis, and HIV-induced immunosuppression and immunosenescence. Antiviral therapy based on dually active antiretrovirals is highly efficient, but late initiation, global disparities in accessibility, suboptimal regimens, and adherence issues may limit its impact on the development of end-stage liver disease. In this paper, we review the mechanisms of liver injuries in HIV-HBV coinfected patients and the novel biomarkers that can be used for treatment monitoring in HIV-HBV coinfected persons: markers that assess viral suppression, markers for liver fibrosis evaluation, and predictors of oncogenesis.
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Affiliation(s)
- Simona Ruta
- Virology Discipline, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania;
| | - Laura Grecu
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania;
| | - Diana Iacob
- Department for the Prevention and Control of Healthcare Associated Infections, Emergency University Hospital, 050098 Bucharest, Romania;
| | | | - Camelia Sultana
- Virology Discipline, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Emerging Viral Diseases, “Stefan S. Nicolau” Institute of Virology, 030304 Bucharest, Romania;
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Ward JW, Wanlapakorn N, Poovorawan Y, Shouval D. Hepatitis B Vaccines. PLOTKIN'S VACCINES 2023:389-432.e21. [DOI: 10.1016/b978-0-323-79058-1.00027-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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9
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Annison L, Hackman H, Eshun PF, Annison S, Forson P, Antwi-Baffour S. Seroprevalence and effect of HBV and HCV co-infections on the immuno-virologic responses of adult HIV-infected persons on anti-retroviral therapy. PLoS One 2022; 17:e0278037. [PMID: 36417469 PMCID: PMC9683579 DOI: 10.1371/journal.pone.0278037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Chronic hepatitis negatively affects persons living with HIV. While varying in their transmission efficiency, HIV, HBV, and HCV have shared routes of transmission. Available data suggest widely variable rates of HBV and HCV infections in HIV-infected populations across sub-Saharan Africa. With prolonged survival rates due to increased accessibility to antiretroviral drugs, HBV and HCV have the potential to complicate the prognosis of HIV co-infected patients by contributing significantly to continued morbidity and mortality. The study sought to determine the seroprevalence of HIV/HBV and HIV/HCV co-infections among HIV patients on antiretroviral therapy and to evaluate the effect of HIV/HBV and HIV/HCV co-infections on the immunologic and virologic responses of patients. A cross-sectional study in which samples were taken from 500 people living with HIV and attending ART clinic at the Fevers unit of the Korle Bu Teaching Hospital and tested for Hepatitis B Surface Antigen (HBsAg) and Hepatitis C virus antibody (HCV). CD4 cell counts and HIV-1 RNA levels were estimated as well. Data generated were analysed using IBM SPSS version 22. The seroprevalence of HIV/HBV and HIV/HCV co-infections among people living with HIV was 8.4% and 0.2% respectively. HIV/HBV coinfection included 15/42 (35.7%) males and 27/42 (64.3%) females out of which the majority (97.6%) were in the 21-60 years old bracket. HIV/HBV and HIV/HCV co-infections have varied effects on the immunological and virological response of HIV patients on ART. The mean CD cell count was 361.0 ± 284.0 in HIV/HBV co-infected patients and 473.8 ± 326.7 in HIV mono-infected patients. The mean HIV-1 RNA level was not significantly different (X2 [df] = .057 [1]; P = .811) among HIV/HBV co-infected patients (Log102.9±2.0 copies/mL), compared to that of HIV mono-infected patients (Log102.8±2.1 copies/mL) although HIV mono-infected patients had lower viral load levels. One-third (14/42) of HIV/HBV co-infected patients had virologic failure and the only HIV/HCV co-infected patient showed viral suppression. 336/500 (67.2%) patients had HIV-1 viral suppression (females [66.1%]; males [33.9%]) while 164/500 (32.8%) had virologic failure (females [67.7%]; males [32.3%]). The mean CD4 count of patients with viral suppression and patients with virologic failure was 541.2 cells/μL (95% CI 508.5-573.8) and 309.9 cell/μL (95% CI 261.9-357.9) respectively.The study concludes that, HIV/HBV and HIV/HCV coinfections do not significantly affect the immunologic and virologic responses of patients who have initiated highly active antiretroviral therapy, and treatment outcomes were better in females than in males. There was no HBV/HCV co-infection among patients.
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Affiliation(s)
- Lawrence Annison
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
- * E-mail:
| | - Henry Hackman
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Paulina Franklin Eshun
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Sharon Annison
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Peter Forson
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
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10
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Li C, Zhou Y, Wang Y, Liu S, Wang W, Lu X, Sun C, Liu P, Wen Y. The Screening of Hepatitis B and Hepatitis C Virus Infection among HIV-Infected Inpatients and Evaluation of Correlated Characteristics in a General Hospital in Shenyang, Liaoning, China. J Clin Med 2022; 11:jcm11226620. [PMID: 36431096 PMCID: PMC9692379 DOI: 10.3390/jcm11226620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Background: In this study, we surveyed the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) and hepatitis C virus (HCV) antibody (anti-HCV) among inpatients with human immunodeficiency virus (HIV) infection and analyzed the correlated factors. Methods: We conducted a retrospective data collection of the HIV-infected inpatients in our hospital from January 2010 to December 2020. We utilized multivariate logistic regression to identify the correlated factors. Results: The proportion of patients screened for HBsAg was 81.8%, which increased from 66.7% in 2010 to 85.7% in 2020. The proportion of patients with anti-HCV screening was 73.9%, which increased from 58.3% in 2010 to 86.7% in 2020. The prevalence of HBsAg positivity was 10.9%, which decreased from 15.0% in the period of 2010−2015 to 9.0% during 2016−2020. Positive anti-HCV was identified in 4.1% of cases. Compared to 4.8% in the period of 2010−2015, there was a similar prevalence of anti-HCV at 3.1% during 2016−2020. Among the HBsAg-positive cases, HBV deoxyribonucleic acid was screened in 70.8% of cases. Among the anti-HCV positive cases, HCV ribonucleic acid (RNA) was screened in 90% of cases. Albumin < 30 g/L, thrombocytopenia and aspartate aminotransferase (AST) > 40 U/L were associated with HBsAg positivity. AST > 40 U/L and higher CD4-positive T lymphocyte counts were associated with HIV/HCV coinfection. Conclusions: The routine screening for both HBV and HCV among HIV-positive inpatients has been greatly improved in the past decade. However, screening for the complete HBV serological markers in HIV-positive inpatients and HCV genotyping among HCV RNA-positive cases leaves much to be desired. A concerted effort should be made to improve HBV vaccine compliance in the HIV-positive population and provide direct-acting antiviral therapies to HCV RNA-positive patients.
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11
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Markers of Immune Activation and Inflammation Are Associated with Higher Levels of Genetically-Intact HIV in HIV-HBV Co-Infected Individuals. J Virol 2022; 96:e0058822. [PMID: 35916523 PMCID: PMC9400477 DOI: 10.1128/jvi.00588-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Co-infection with hepatitis B (HBV) and human immunodeficiency virus (HIV) increases overall and liver-related mortality. In order to identify interactions between these two viruses in vivo, full-length HIV proviruses were sequenced from a cohort of HIV-HBV co-infected participants and from a cohort of HIV mono-infected participants recruited from Bangkok, Thailand, both before the initiation of antiretroviral therapy (ART) and after at least 2 years of ART. The co-infected individuals were found to have higher levels of genetically-intact HIV proviruses than did mono-infected individuals pre-therapy. In these co-infected individuals, higher levels of genetically-intact HIV proviruses or proviral genetic-diversity were also associated with higher levels of sCD14 and CXCL10, suggesting that immune activation is linked to more genetically-intact HIV proviruses. Three years of ART decreased the overall level of HIV proviruses, with fewer genetically-intact proviruses being identified in co-infected versus mono-infected individuals. However, ART increased the frequency of certain genetic defects within proviruses and the expansion of identical HIV sequences. IMPORTANCE With the increased availability and efficacy of ART, co-morbidities are now one of the leading causes of death in HIV-positive individuals. One of these co-morbidities is co-infection with HBV. However, co-infections are still relatively understudied, especially in countries where such co-infections are endemic. Furthermore, these countries have different subtypes of HIV circulating than the commonly studied HIV subtype B. We believe that our study serves this understudied niche and provides a novel approach to investigating the impact of HBV co-infection on HIV infection. We examine co-infection at the molecular level in order to investigate indirect associations between the two viruses through their interactions with the immune system. We demonstrate that increased immune inflammation and activation in HBV co-infected individuals is associated with higher HIV viremia and an increased number of genetically-intact HIV proviruses in peripheral blood cells. This leads us to hypothesize that inflammation could be a driver in the increased mortality rate of HIV-HBV co-infected individuals.
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12
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Lee TH, Hunt CM, Maier MM, Lowy E, Beste LA. Hepatitis B Virus-Related Care Quality In Patients With Hepatitis B/Hiv Coinfection Versus Hepatitis B Monoinfection: A National Cohort Study. Clin Infect Dis 2022; 75:1529-1536. [PMID: 35349635 DOI: 10.1093/cid/ciac227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Guideline-adherent hepatitis B virus (HBV) care is critical for patients with HBV, particularly HBV-HIV co-infected patients given increased risks of liver-related complications. However, a comprehensive assessment of HBV-related care in HBV-HIV coinfected patients is lacking. METHODS We retrospectively assessed adherence to HBV-related care guidelines in all patients with HBV-HIV co-infection and HBV monoinfection (HBV-M) in the national Veterans Health Administration healthcare system in 2019. RESULTS We identified 1,021 patients with HBV-HIV among 8,323 veterans with chronic HBV. Adherence to HBV guidelines was similar or better in HBV-HIV versus HBV-M, including HBV treatment (97% vs. 71%), biannual hepatocellular carcinoma (HCC) surveillance (55% vs. 55%) for patients with cirrhosis, HAV screening (69% vs. 56%), HCV screening (100% vs. 99%), and on-therapy ALT monitoring (95% vs. 96%).Compared to those seeing gastroenterology (GI) or infectious diseases (ID) providers, patients without specialty care were less likely to receive antiviral treatment (None:39%, GI:80%, ID:84%) or HCC surveillance (None: 16%, GI: 66%, ID:47%). These findings persisted in multivariable analysis. Compared with ID care alone, a higher proportion of HBV-HIV patients seen dually by GI and ID received HCC surveillance (GI+ID:73% vs. ID:31%) and on-therapy HBV-DNA monitoring (GI+ID: 82%, ID: 68%). CONCLUSIONS HBV-HIV patients received similar or higher rates of guideline-adherent HBV-related care than HBV-M patients. HBV-HIV patients under dual GI and ID care achieved higher quality care compared to ID care alone. Specialty care was independently associated with higher quality HBV care in HBV-HIV and HBV-M patients.
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Affiliation(s)
- Tzu-Hao Lee
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Division of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Christine M Hunt
- Division of Gastroenterology, Duke University Medical Center, Durham, NC, USA.,VA Cooperative Studies Program Epidemiology Center-Durham and Durham VA Health Care System, Durham, NC, USA
| | - Marissa M Maier
- Division of Infectious Diseases, Department of Medicine, Oregon Health and Science University, Portland, OR, USA.,VA Portland Health Care System, Portland, OR, USA
| | - Elliott Lowy
- VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Lauren A Beste
- VA Puget Sound Health Care System, Seattle, WA, USA.,Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
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13
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Deng H, Feng Q, Wu Y, Lin H, Cao X, Xiang F, Li L, Yu W. Immune response to hepatitis B vaccination in human immunodeficiency virus-positive patients in China: A 2-year retrospective study. J Med Virol 2021; 94:2684-2693. [PMID: 34905230 DOI: 10.1002/jmv.27523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/15/2021] [Accepted: 12/11/2021] [Indexed: 11/08/2022]
Abstract
Currently, the studies focused on the immune response to hepatitis B vaccination in Chinese human immunodeficiency virus (HIV)-positive patients are limited. In this study, the participants with an initial hepatitis B surface antibody (HBsAb) titer <10 mIU/ml were assigned to Cohort 1 to receive a standard dose of recombinant hepatitis B vaccine, and participants with an initial HBsAb titer between 10 and 100 mIU/ml were assigned to Cohort 2 to receive a single reinforced recombinant vaccine. In Cohort 1, the immune and high response rates in HIV-positive patients were 93.4%/81.4%, 87.4%/51.5%, and 83.2%/40.7% at 1-3 months, 1 year, and 2 years postvaccination. Multivariate analysis showed that only age and HIV RNA status at baseline were independent factors related to sustained immune response at 2 years postvaccination. In Cohort 2, the high immune response rates in HIV-positive patients were 78.8%, 60.6%, and 51.5% at 1-3 months, 1 year, and 2 years postvaccination. The immune or high response rates did not differ between HIV-positive patients and healthy controls at 1-3 months postvaccination in these two cohorts; however, HBsAb titers were significantly lower in HIV-positive patients. This study summarized the 2-year data of immune response to hepatitis B vaccination and analyzed the factors related to sustained immune response at 2 years postvaccination in Chinese HIV-positive patients.
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Affiliation(s)
- Haohui Deng
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qianchang Feng
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yue Wu
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Haowei Lin
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xin Cao
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fangfei Xiang
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Weihua Yu
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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14
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Rana U, Driedger M, Sereda P, Pan S, Ding E, Wong A, Walmsley S, Klein M, Kelly D, Loutfy M, Thomas R, Sanche S, Kroch A, Machouf N, Roy-Gagnon MH, Hogg R, Cooper CL. Clinical and demographic predictors of antiretroviral efficacy in HIV-HBV co-infected patients. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:137-148. [PMID: 36341035 PMCID: PMC9608701 DOI: 10.3138/jammi-2020-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/22/2020] [Indexed: 06/16/2023]
Abstract
BACKGROUND The clinical and demographic characteristics that predict antiretroviral efficacy among patients co-infected with HIV and hepatitis B virus (HBV) remain poorly defined. We evaluated HIV virological suppression and rebound in a cohort of HIV-HBV co-infected patients initiated on antiretroviral therapy. METHODS A retrospective cohort analysis was performed with Canadian Observation Cohort Collaboration data. Cox proportional hazards models were used to determine the factors associated with time to virological suppression and time to virological rebound. RESULTS HBV status was available for 2,419 participants. A total of 8% were HBV co-infected, of whom 95% achieved virological suppression. After virological suppression, 29% of HIV-HBV co-infected participants experienced HIV virological rebound. HBV co-infection itself did not predict virological suppression or rebound risk. The rate of virological suppression was lower among patients with a history of injection drug use or baseline CD4 cell counts of <199 cells per cubic millimetre. Low baseline HIV RNA and men-who-have-sex-with-men status were significantly associated with a higher rate of virological suppression. Injection drug use and non-White race predicted viral rebound. CONCLUSIONS HBV co-infected HIV patients achieve similar antiretroviral outcomes as those living with HIV mono-infection. Equitable treatment outcomes may be approached by targeting resources to key subpopulations living with HIV-HBV co-infection.
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Affiliation(s)
- Urvi Rana
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States
| | - Matt Driedger
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Paul Sereda
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Shenyi Pan
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Erin Ding
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Alex Wong
- Regina Qu’Appelle Health Region, Regina, Saskatchewan, Canada
| | | | - Marina Klein
- Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Deborah Kelly
- Memorial University of Newfoundland, Saint John’s, Newfoundland, Canada
| | - Mona Loutfy
- Maple Leaf Medical Clinic, Toronto, Ontario, Canada
| | - Rejean Thomas
- Clinique Medicale l’Actuel, Montreal, Quebec, Canada
| | - Stephen Sanche
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Abigail Kroch
- Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Nima Machouf
- Clinique de Médicine Urbaine du Quartier Latin, Montreal, Quebec, Canada
| | | | - Robert Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Curtis L Cooper
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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15
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Weldemhret L. Epidemiology and Challenges of HBV/HIV Co-Infection Amongst HIV-Infected Patients in Endemic Areas: Review. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:485-490. [PMID: 33981165 PMCID: PMC8107003 DOI: 10.2147/hiv.s273649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022]
Abstract
With the introduction of highly active antiretroviral treatment, HIV-related morbidity and mortality have declined. But underlying hepatitis B virus infection remains the major cause of AIDS-defined illness and liver-related disease progression mainly in endemic settings. Moreover, HBV-HIV co-infection is the leading cause of cirrhosis, hepatocellular carcinoma, and liver-related death. This review paper emphasizes reviewing the burden and impact of HBV-HIV co-infection in liver-related disease progression, immune recovery, and therapeutic management of HIV-infected individuals on ART regimen.
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16
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A Noninvasive Prediction Model for Hepatitis B Virus Disease in Patients with HIV: Based on the Population of Jiangsu, China. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6696041. [PMID: 33860053 PMCID: PMC8024075 DOI: 10.1155/2021/6696041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
Abstract
Objective To establish a machine learning model for identifying patients coinfected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) through two sexual transmission routes in Jiangsu, China. Methods A total of 14197 HIV cases transmitted by homosexual and heterosexual routes were recruited. After data processing, 12469 cases (HIV and HBV, 1033; HIV, 11436) were left for further analysis, including 7849 cases with homosexual transmission and 4620 cases with heterosexual transmission. Univariate logistic regression was used to select variables with significant P value and odds ratio for multivariable analysis. In homosexual transmission and heterosexual transmission groups, 10 and 6 variables were selected, respectively. For identifying HIV individuals coinfected with HBV, a machine learning model was constructed with four algorithms, including Decision Tree, Random Forest, AdaBoost with decision tree (AdaBoost), and extreme gradient boosting decision tree (XGBoost). The detective value of each variable was calculated using the optimal machine learning algorithm. Results AdaBoost algorithm showed the highest efficiency in both transmission groups (homosexual transmission group: accuracy = 0.928, precision = 0.915, recall = 0.944, F − 1 = 0.930, and AUC = 0.96; heterosexual transmission group: accuracy = 0.892, precision = 0.881, recall = 0.905, F − 1 = 0.893, and AUC = 0.98). Calculated by AdaBoost algorithm, the detective value of PLA was the highest in homosexual transmission group, followed by CR, AST, HB, ALT, TBIL, leucocyte, age, marital status, and treatment condition; in the heterosexual transmission group, the detective value of PLA was the highest (consistent with the condition in the homosexual group), followed by ALT, AST, TBIL, leucocyte, and symptom severity. Conclusions The univariate logistics regression combined with the AdaBoost algorithm could accurately screen the risk factors of HBV in HIV coinfection without invasive testing. Further studies are needed to evaluate the utility and feasibility of this model in various settings.
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17
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Attiku K, Bonney J, Agbosu E, Bonney E, Puplampu P, Ganu V, Odoom J, Aboagye J, Mensah J, Agyemang S, Awuku-Larbi Y, Arjarquah A, Mawuli G, Quaye O. Circulation of hepatitis delta virus and occult hepatitis B virus infection amongst HIV/HBV co-infected patients in Korle-Bu, Ghana. PLoS One 2021; 16:e0244507. [PMID: 33411715 PMCID: PMC7790253 DOI: 10.1371/journal.pone.0244507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Within HIV/HBV infected patients, an increase in HDV infection has been observed; there is inadequate information on HDV prevalence as well as virologic profile in Ghana. This study sought to determine the presence of HDV in HIV/HBV co-infected patients in Ghana. METHODS This was a longitudinal purposive study which enrolled 113 HIV/HBV co-infected patients attending clinic at Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. After consenting, 5 mL whole blood was collected at two-time points (baseline and 4-6 months afterwards). The sera obtained were tested to confirm the presence of HIV, HBV antibodies and/or antigens, and HBV DNA. Antibodies and viral RNA were also determined for HDV. Amplified HBV DNA and HDV RNA were sequenced and phylogenetic analysis carried out with reference sequences from the GenBank to establish the genotypes. RESULTS Of the 113 samples tested 63 (55.7%) were females and 50 (44.25%) were males with a median age of 45 years. A total of 100 (88.5%) samples had detectable HBV surface antigen (HBsAg), and 32 out of the 113 had detectable HBV DNA. Nucleotide sequences were obtained for 15 and 2 samples of HBV and HDV, respectively. Phylogenetic analysis was predominantly genotype E for the HBVs and genotype 1 for the HDVs. Of the 13 samples that were HBsAg unreactive, 4 (30.8%) had detectable HBV DNA suggesting the incidence of occult HBV infections. The percentage occurrence of HDV in this study was observed to be 3.54. CONCLUSION Our data suggest the presence and circulation of HDV and incidence of occult HBV infection in HIV/HBV co-infected patients in Ghana. This informs health staff and makes it imperative to look out for the presence of HDV and occult HBV in HIV/HBV co-infected patients presenting with potential risk of liver cancers and HBV transmission through haemodialysis and blood transfusions.
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Affiliation(s)
- Keren Attiku
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joseph Bonney
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Esinam Agbosu
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Evelyn Bonney
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Vincent Ganu
- Fevers Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - John Odoom
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - James Aboagye
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - John Mensah
- Fevers Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Seth Agyemang
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Fevers Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Yaw Awuku-Larbi
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Augustina Arjarquah
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gifty Mawuli
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
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18
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Bharti AR, McCutchan JA, Umlauf A, Okwuegbuna OK, Letendre S, Cherner M, Burdo T, Jumare J, Williams K, Blattner W, Royal W. Asymptomatic Malaria Co-infection of HIV-Infected Adults in Nigeria: Prevalence of and Impact on Cognition, Mood, and Biomarkers of Systemic Inflammation. J Acquir Immune Defic Syndr 2021; 86:91-97. [PMID: 33021552 PMCID: PMC10742372 DOI: 10.1097/qai.0000000000002516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND HIV and malaria are associated with immunological perturbations and neurocognitive disorders even when asymptomatic. However, the effect of asymptomatic malaria (AM) in HIV-infected adults on neurocognitive impairment (NCI) is not well understood. This study investigated the biomarkers of systemic inflammation and neurocognition in dually infected Nigerian adults. METHODS We assessed the HIV and AM status of 269 adults and measured their global and domain-specific neurocognition and depression using standardized measures. Blood levels of sCD14 and sCD163 were also measured. RESULTS The mean age of the participants (n = 269) was 33 years, 62% were women, and AM among HIV+ and HIV- was similar (36% versus 37%). NCI was found in 23% (62/269) of participants. HIV+/AM+ had a higher prevalence of impaired learning and executive functions and were more depressed than HIV-/AM- or HIV+/AM-. HIV+ with CD4 T-cell counts ≤200/µL were more impaired in the learning domain than those with >200/µL. HIV+/AM+ group had higher levels of sCD14 compared to the other 3 groups and higher levels of sCD163 than the HIV-/AM- group. Higher levels of sCD14 and sCD163 were each associated with NCI. The sCD163 (log10) levels were higher for those with 1+ versus 2+ parasitemia level. CONCLUSIONS HIV and AM coinfection was associated with an increased risk of reduced learning and executive functions, and elevated systemic inflammation. Mood was more depressed in HIV patients with than those without AM. The mechanisms and long-term effects on neurocognition and depression among HIV+/AM+ individuals should be studied because this coinfection is common globally.
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Affiliation(s)
- Ajay R. Bharti
- University of California San Diego, School of Medicine, San Diego, CA
| | | | - Anya Umlauf
- University of California San Diego, School of Medicine, San Diego, CA
| | | | - Scott Letendre
- University of California San Diego, School of Medicine, San Diego, CA
| | - Mariana Cherner
- University of California San Diego, School of Medicine, San Diego, CA
| | - Tricia Burdo
- Temple University, Lewis Katz School of Medicine, Philadelphia, PA
| | - Jibreel Jumare
- University of Maryland, School of Medicine, Baltimore, MD
| | | | | | - Walter Royal
- University of Maryland, School of Medicine, Baltimore, MD
- Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA
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19
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Jiang TY, Hou JH, Su B, Zhang T, Yang Y, Liu ZY, Wang W, Guo CP, Dai LL, Sun LJ, Wu H. Demographic and clinical factors associated with immune reconstitution in HIV/HBV co-infected and HIV mono-infected patients: a retrospective cohort study. HIV Med 2020; 21:722-728. [PMID: 33369028 DOI: 10.1111/hiv.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the clinical characteristics and factors associated with CD4 T-cell count and CD4/CD8 ratio restoration in HIV mono-infected and HIV/HBV co-infected individuals, and to explore liver and renal functional changes in both groups. METHODS A retrospective cohort study was performed including 356 HIV/HBV co-infected and 716 HIV mono-infected participants who initiated antiretroviral therapy (ART) during 2013-2017 in Beijing Youan Hospital, China. Demographic and clinical characteristics were compared between the two groups, using χ2 and Mann-Whitney non-parametric tests. Bivariate and multivariate Cox regression models were used to test their association. RESULTS Baseline HIV viral load and ART regimen were found to be significantly associated with CD4 T-cell restoration among HIV-infected participants, whereas baseline HIV viral load was the only significant factor associated with CD4 T-cell restoration in HIV/HBV co-infected participants. The final model showed that baseline HIV viral load and ART regimen were significantly associated with CD4/CD8 ratio restoration among HIV-infected participants, while baseline HIV viral load was the significant factor. Liver and renal functions were similar at the endpoint (P > 0.05). CONCLUSIONS Baseline HIV viral load count was found to be the key factor affecting immune restoration in both HIV and HIV/HBV individuals. Future multi-wave prospective studies are needed to clarify the potential biological mechanism.
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Affiliation(s)
- T Y Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - J H Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - B Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - T Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Y Yang
- Network Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Z Y Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - C P Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - L L Dai
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - L J Sun
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - H Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
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20
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Ferrante ND, Lo Re V. Epidemiology, Natural History, and Treatment of Hepatitis Delta Virus Infection in HIV/Hepatitis B Virus Coinfection. Curr HIV/AIDS Rep 2020; 17:405-414. [PMID: 32607773 DOI: 10.1007/s11904-020-00508-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Limited data exist on the prevalence, determinants, and outcomes of hepatitis delta virus (HDV) infection among HIV/hepatitis B virus (HBV)-coinfected persons. This review provides current evidence on the epidemiology, natural history, and treatment of HDV infection in patients with HIV/HBV coinfection and highlights future research needs. RECENT FINDINGS Cross-sectional studies in Europe, Africa, South America, and Asia show that the prevalence of HDV among HIV/HBV-coinfected patients ranges from 1.2 to 25%. No studies have evaluated the prevalence of HDV infection among HIV/HBV-coinfected patients in the USA. HDV infection increases the risk of hepatic decompensation and hepatocellular carcinoma among HIV/HBV-coinfected patients. HDV treatment remains limited to pegylated interferon-alpha, which results in sustained virologic response in fewer than 25%. Data on the epidemiology, natural history, and treatment of HDV among HIV/HBV-coinfected persons remain limited. More research is needed to address these knowledge gaps in order to better manage HDV coinfection in HIV/HBV-coinfected patients.
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Affiliation(s)
- Nicole D Ferrante
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA.
- Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Population attributable fractions of mortality in people living with HIV: roles of delayed antiretroviral therapy, hepatitis coinfections and social factors. AIDS 2020; 34:1843-1854. [PMID: 32889854 DOI: 10.1097/qad.0000000000002621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Despite free access to antiretroviral therapy (ART) from 1996 onward, and treatment for all people living with HIV (PLWHIV) from 2013, mortality in Brazil has not homogeneously decreased. We investigated to what extent delayed ART, hepatitis coinfections and sociodemographic factors predict all-cause mortality in Brazilian PLWHIV. DESIGN We included PLWHIV at least 18 years, with complete CD4 cell count data, followed up between 2007 and 2015 in Brazil. METHODS After multiple imputation, an extended Cox model helped estimate the effects of fixed and time-varying covariates on mortality. RESULTS The study population (n = 411 028) were mainly male (61%), white (55%), 40 years or less (61%), heterosexually HIV infected (71%), living in the Southeast region (48%) and had basic education (79%). Hepatitis C virus and hepatitis B virus coinfection prevalences were 2.5 and 1.4%, respectively. During a 4-year median follow-up, 61 630 deaths occurred and the mortality rate was 3.45 (95% confidence interval: 3.42-3.47) per 100 person-years. Older age, male sex, non-white ethnicity, illiteracy/basic education and living outside the Southeast and Central-West regions were independently associated with increased mortality. The main modifiable predictors of mortality were delayed ART (i.e. CD4 cell count <200 cells/μl at ART initiation) (adjusted population attributable fraction: 14.20% [95% confidence interval: 13.81-14.59]), being ART-untreated (14.06% [13.54-14.59]) and ART-treated with unrecorded CD4 at ART initiation (5.74% [5.26-6.21]). Hepatitis C virus and hepatitis B virus coinfections accounted for 2.44 [2.26-2.62] and 0.42% [0.31-0.53] of mortality, respectively. CONCLUSION The current study demonstrates that besides early ART and coinfection control, actions targeting males, non-whites and illiterate people and those with basic education are important to reduce avoidable deaths among Brazilian PLWHIV.
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Prevalence of hepatitis B surface antigen and serological markers of other endemic infections in HIV-infected children, adolescents and pregnant women in Sierra Leone: A cross-sectional study. Int J Infect Dis 2020; 102:45-52. [PMID: 33002619 DOI: 10.1016/j.ijid.2020.09.1459] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To assess the prevalence of serological markers of HBV and endemic acute and chronic infections (HAV, HCV, CMV, HTLV-1/2 and syphilis) in HIV-infected children, adolescents and pregnant women in Sierra Leone. METHOD We conducted a cross-sectional study at the national children's and women's hospitals in Freetown. Logistic regression was used to assess predictors of HBsAg positivity. RESULTS 183 HIV-infected participants were enrolled, comprising children (n = 88), adolescents (n = 47) and pregnant women (n = 48). All participants (100%) were CMV IgG-positive, while 56.8%, 93.6% and 100% of children, adolescents and pregnant women, respectively, were HAV IgG-positive. The prevalence of HCV, HTLV-1/2 and syphilis were <4%. HBV markers were distributed as follows-children: HBsAg (2.3%), HBeAg (0%), anti-HBc (5.7%); adolescents: HBsAg (17.0%), HBeAg (6.4%), anti-HBc (27.7%); and pregnant women: HBsAg (18.8%), HBeAg (4.2%), anti-HBc (77.1%). Age >10 years, i.e., being born pre-2009 before implementation of routine hepatitis B immunization (aOR 5.05 [1.18-21.28]; p = 0.029) and CD4 count <350 cells/mm3 (aOR 3.97 [1.07-14.71]; p = 0.039) predicted HBsAg positivity. CONCLUSION A high burden of chronic HBV and other endemic infections was observed among HIV-infected patients born pre-2009 before implementation of routine HBV immunization in Sierra Leone, warranting targeted screening and immunization of this high-risk population.
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Boyd A, Kouamé MG, Houghtaling L, Moh R, Gabillard D, Maylin S, Abdou Chekaraou M, Delaugerre C, Anglaret X, Eholié SP, Danel C, Zoulim F, Lacombe K. Hepatitis B virus activity in untreated hepatitis B e antigen-negative human immunodeficiency virus-hepatitis B virus co-infected patients from sub-Saharan Africa. Trans R Soc Trop Med Hyg 2020; 113:437-445. [PMID: 31574151 DOI: 10.1093/trstmh/trz021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/04/2019] [Accepted: 03/13/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients from sub-Saharan Africa with hepatitis B e antigen (HBeAg)-negative status, data are limited on the evolution of HBV activity when antiretroviral treatment (ART) is absent. METHODS A total of 43 HBeAg-negative co-infected patients not indicated for ART (per concomitant World Health Organization recommendations) were followed during participation in a randomized controlled trial in Côte d'Ivoire. Chronic HBeAg-negative phases were classified at yearly visits and defined as 'infection' (HBV DNA ≤10 000 copies/mL and normal alanine aminotransferase [ALT]) or 'hepatitis' (HBV DNA >10 000 copies/mL and/or above normal ALT). Dispersion in HBV DNA and ALT levels during follow-up was assessed using interquartile range (IQR) regression. RESULTS During a median 25 months (IQR 19-31), 17 (40%) patients consistently had 'infection', 5 (12%) consistently had 'hepatitis' and 21 (48%) fluctuated between phases. Wider dispersion in HBV DNA over time was associated with higher baseline HIV RNA (p=0.02) and higher baseline HBV DNA levels (p=0.008), while wider dispersion in ALT was associated with higher baseline HIV RNA (p<0.001), higher baseline ALT levels (p=0.02) and baseline hepatitis surface antigen >4.0 log10 IU/mL (p=0.02). CONCLUSIONS HBV activity is common with HBeAg-negative status, whose variation is partly linked to HIV replication. Fluctuations in disease phase make it difficult to assess the risk of morbidity and mortality after ART initiation.
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Affiliation(s)
- Anders Boyd
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Menan Gerard Kouamé
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - Laura Houghtaling
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Raoul Moh
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,Department of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Medical School, University Felix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | - Delphine Gabillard
- INSERM, U1219, Epidémiologie-Biostatistique, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Sarah Maylin
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France
| | | | - Constance Delaugerre
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France.,INSERM U941, Paris, France
| | - Xavier Anglaret
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,INSERM, U1219, Epidémiologie-Biostatistique, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Serge Paul Eholié
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,Department of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Medical School, University Felix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | - Christine Danel
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,INSERM, U1219, Epidémiologie-Biostatistique, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Fabien Zoulim
- Centre de Recherche sur le Cancer de Lyon, INSERM, Unité 1052, CNRS, UMR 5286, Lyon, France
| | - Karine Lacombe
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.,Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, AP-HP, Paris, France
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Lukhwareni A, Gededzha MP, Amponsah-Dacosta E, Blackard JT, Burnett RJ, Selabe SG, Kyaw T, Mphahlele MJ. Impact of Lamivudine-Based Antiretroviral Treatment on Hepatitis B Viremia in HIV-Coinfected South Africans. Viruses 2020; 12:v12060634. [PMID: 32545313 PMCID: PMC7354521 DOI: 10.3390/v12060634] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/28/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
This prospective study investigated the impact of lamivudine-containing antiretroviral therapy (ART) on HIV-positive patients in South Africa with baseline hepatitis B virus (HBV) infection. Follow-up samples from 56 HBV/HIV co-infected patients, 25 with occult HBV infection (OBI) and 31 with chronic HBV infection (CHB), were available for analysis. HBV viral loads were quantified at 6, 12, 18, and 24 months post-ART initiation by the COBAS TaqMan HBV Test 48 assay, and the HBV polymerase gene was amplified with an in-house nested polymerase chain reaction assay. During 24 months of lamivudine-based ART, 6 of 8 (75%) OBI and 4 of 6 (67%) CHB patients achieved undetectable levels of HBV DNA, while 2 patients had persistent HBV DNA levels ≥ 2 × 105 despite lamivudine-based ART for 24 months. HIV viremia was undetectable in all patients at 12 months, suggesting high adherence to ART. Several lamivudine-associated HBV resistance mutations, including L180M, A181T, M204I, and M204V, were observed. Sequence analysis also revealed a rare genotype G infection. While resource-limited settings may use lamivudine-based ART because of availability and low cost, antivirals with dual therapy against HBV and HIV (e.g., lamivudine and tenofovir) should always be recommended with the regular monitoring of HBV viremia levels.
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Affiliation(s)
- Azwidowi Lukhwareni
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
- National Health Laboratory Service, Tshwane Academic Division, Department of Medical Virology, University of Pretoria, Pretoria 0002, South Africa
- Correspondence: ; Tel.: +27 12 319 2954; Fax: +27 12 325 5550
| | - Maemu Petronella Gededzha
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of Witwatersrand and National Health Laboratory Service, Johannesburg 2193, South Africa
| | - Edina Amponsah-Dacosta
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7700, South Africa
| | - Jason T. Blackard
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Rosemary J. Burnett
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
| | - Selokela Gloria Selabe
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
| | - Thanda Kyaw
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
| | - M. Jeffrey Mphahlele
- HIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, MEDUNSA, Pretoria 0204, South Africa; (M.P.G.); (E.A.-D.); (J.T.B.); (R.J.B.); (S.G.S.); (T.K.); (M.J.M.)
- South African Medical Research Council, Soutpansberg Road, Pretoria 0118, South Africa
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Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061990. [PMID: 32197326 PMCID: PMC7143838 DOI: 10.3390/ijerph17061990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 01/01/2023]
Abstract
Human immunodeficiency virus (HIV)-infected patients are at a higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis) than the general population. The prevalence of HBV, HCV, and syphilis has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV–HBV, HIV–HCV, and HIV–syphilis co-infection. HBV–HCV, HCV–syphilis, HBV–syphilis, and HBV–HCV–syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643–82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328–1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382–0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.
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Calux SJ, Silva VCM, Compri AP, Lemos MF, Santos APDT, Oba IT, Mendes-Correa MCJ, Moreira RC. Hepatitis B: Prevalence and occult infection in HIV-infected patients. Rev Soc Bras Med Trop 2020; 53:e20180533. [PMID: 31994654 PMCID: PMC7083387 DOI: 10.1590/0037-8682-0533-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 09/05/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION HBV and HIV have identical transmission routes. The aim of this study was to determine the prevalence of HBV in HIV patients and to detect the presence of occult HBV infection. METHODS All samples were tested for serology markers and using qPCR. RESULTS This study included 232 individuals, out of which 36.6% presented with HBV markers and 11.8% presented with HBsAg or HBV-DNA, including 3 patients that showed OBI. CONCLUSIONS We observed a high prevalence of HBV among HIV patients. In addition, the results suggest that OBI can occur in patients with serological profiles that are indicative of past infection. Therefore, the application of molecular tests may enable the identification of infections that are not evident solely based on serology.
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Affiliation(s)
- Samira Julien Calux
- Laboratório de Hepatites Virais, Centro de Virologia, Instituto Adolfo Lutz, São Paulo, SP, Brasil
| | | | - Adriana Parise Compri
- Laboratório de Hepatites Virais, Centro de Virologia, Instituto Adolfo Lutz, São Paulo, SP, Brasil
| | | | | | - Isabel Takano Oba
- Laboratório de Hepatites Virais, Centro de Virologia, Instituto Adolfo Lutz, São Paulo, SP, Brasil
| | | | - Regina Célia Moreira
- Laboratório de Hepatites Virais, Centro de Virologia, Instituto Adolfo Lutz, São Paulo, SP, Brasil
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Silva CMD, Peder LDD, Thomazella MV, Teixeira JJV, Bertolini DA. PROFILE OF HCV GENOTYPES AND HIV-SUBTYPES AMONG HIV-COINFECTED PATIENTS IN SOUTHERN BRAZIL. ARQUIVOS DE GASTROENTEROLOGIA 2020; 56:344-350. [PMID: 31800733 DOI: 10.1590/s0004-2803.201900000-68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/07/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatitis B and C virus (HBV and HCV) are the two most common infections among human immunodeficiency virus (HIV)-infected patients. OBJECTIVE To identify the frequency of HIV subtypes and HCV genotypes in HIV-coinfected patients. METHODS A cross-sectional and retrospective study was carried out into two reference centers in Southern Brazil between January 1, 2002 and June 30, 2016. The Abbott Real Time HCV Genotype II system was used for routine diagnostics to determine the HCV genotype based on dual-target real-time PCR. Proviral HIV-1 RNA was extracted from serum samples and fragments of the pol gene were generated by PCR. The HIV-1 PT and RT gene sequences were submitted to Maximum Likelihood Phylogenetic analysis by collecting reference sequences from the HIV-1 group M subtype of the Los Alamos database. RESULTS During the study period, 3340 patients with HIV were diagnosed at both referral centers, of which 4.97% (166/3340) had HBV and/or HCV coinfection. Seroprevalence of HIV-HBV, HIV-HCV and HIV-HBV-HCV was 37.4%, 58.4%, and 4.2%, respectively. HIV-HCV-coinfected patients had a lower median nadir CD4+ T-cell count when compared to HIV-HBV-coinfected patients (P=0.01). Among those coinfected with HCV, HCV-1 (HCV-1) and HCV-3 (HCV-3) genotypes were the most prevalent, being detected in 73.8% and 21.4%, respectively. Among the HCV-1 coinfected patients, 79.3% and 20.1% had subtypes 1a and 1b, respectively. HIV subtype B was the most prevalent in HIV-coinfected patients. There was no significant difference regarding nadir CD4+ T-cell count and HIV viral load when compared to coinfected with HCV-1 with HCV-3, as well as those co-infected with HCV-1a with HCV-1b. CONCLUSION In the present study, a higher frequency of subtype B of HIV and HCV-1 were found in HIV-coinfected patients. Further larger-scale and long-term studies are needed to better understand the effect of HCV genotypes in HIV-infected patients.
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Affiliation(s)
| | - Leyde Daiane de Peder
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, PR, Brasil
| | - Mateus Vailant Thomazella
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, PR, Brasil
| | | | - Dennis Armando Bertolini
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, PR, Brasil
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Rana U, Driedger M, Sereda P, Pan S, Ding E, Wong A, Walmsley S, Klein M, Kelly D, Loutfy M, Thomas R, Sanche S, Kroch A, Machouf N, Roy-Gagnon MH, Hogg R, Cooper CL. Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada? BMC Infect Dis 2019; 19:982. [PMID: 31752729 PMCID: PMC6873547 DOI: 10.1186/s12879-019-4617-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 11/04/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV) share common risk factors for exposure. Co-infected patients have an increased liver-related mortality risk and may have accelerated HIV progression. The epidemiology and demographic characteristics of HIV-HBV co-infection in Canada remain poorly defined. We compared the demographic and clinical characteristics and factors associated with advanced hepatic fibrosis between HIV and HIV-HBV co-infected patients. METHODS A retrospective cohort analysis was conducted using data from the Canadian Observational Cohort (CANOC) Collaboration, including eight sites from British Columbia, Quebec, and Ontario. Eligible participants were HIV-infected patients who initiated combination ARV between January 1, 2000 and December 14, 2014. Demographic and clinical characteristics were compared between HIV-HBV co-infected and HIV-infected groups using chi-square or Fisher exact tests for categorical variables, and Wilcoxon's Rank Sum test for continuous variables. Liver fibrosis was estimated by the AST to Platelet Ratio Index (APRI). RESULTS HBV status and APRI values were available for 2419 cohort participants. 199 (8%) were HBV co-infected. Compared to HIV-infected participants, HIV-HBV co-infected participants were more likely to use injection drugs (28% vs. 21%, p = 0.03) and be HCV-positive (31%, vs. 23%, p = 0.02). HIV-HBV co-infected participants had lower baseline CD4 T cell counts (188 cells/mm3, IQR: 120-360) compared to 235 cells/mm3 in HIV-infected participants (IQR: 85-294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37, p < 0.0001). This difference in APRI was no longer clinically significant at follow-up (0.32 vs. 0.30, p = 0.03). HIV-HBV co-infected participants had a higher mortality rate compared to HIV-infected participants (11% vs. 7%, p = 0.02). CONCLUSION The prevalence, demographic and clinical characteristics of the HIV-HBV co-infected population in Canada is described. HIV-HBV co-infected patients have higher mortality, more advanced CD4 T cell depletion, and liver fibrosis that improves in conjunction with ARV therapy. The high prevalence of unknown HBV status demonstrates a need for increased screening among HIV-infected patients in Canada.
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Affiliation(s)
- Urvi Rana
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3 Canada
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824 USA
| | - Matt Driedger
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5 Canada
| | - Paul Sereda
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6 Canada
| | - Shenyi Pan
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6 Canada
| | - Erin Ding
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6 Canada
| | - Alex Wong
- Regina Qu’Appelle Health Region, Regina, SK Canada
| | | | - Marina Klein
- Research Institute of McGill University Health Centre, Montreal, QC H3H 2L9 Canada
| | - Deborah Kelly
- Memorial University of Newfoundland, Saint John’s, NL A1C 5S7 Canada
| | - Mona Loutfy
- Maple Leaf Medical Clinic, Toronto, ON M5G 1K2 Canada
| | - Rejean Thomas
- Clinique Medicale l’Actuel, Montreal, QC H2L 4P9 Canada
| | - Stephen Sanche
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5 Canada
| | - Abigail Kroch
- The Ontario HIV Treatment Network, Toronto, ON M4T 1X3 Canada
| | - Nima Machouf
- Clinique de Médicine Urbaine du Quartier Latin, Montreal, QC H2L 4E9 Canada
| | | | - Robert Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6 Canada
| | - Curtis L. Cooper
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3 Canada
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5 Canada
| | - The Canadian Observational Cohort (CANOC) Collaboration
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3 Canada
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824 USA
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5 Canada
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6 Canada
- Regina Qu’Appelle Health Region, Regina, SK Canada
- University Health Network, Toronto, ON M5G 2C4 Canada
- Research Institute of McGill University Health Centre, Montreal, QC H3H 2L9 Canada
- Memorial University of Newfoundland, Saint John’s, NL A1C 5S7 Canada
- Maple Leaf Medical Clinic, Toronto, ON M5G 1K2 Canada
- Clinique Medicale l’Actuel, Montreal, QC H2L 4P9 Canada
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5 Canada
- The Ontario HIV Treatment Network, Toronto, ON M4T 1X3 Canada
- Clinique de Médicine Urbaine du Quartier Latin, Montreal, QC H2L 4E9 Canada
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O’Connor SM, Mixson-Hayden T, Ganova-Raeva L, Djibo DA, Brown M, Xia GL, Kamili S, Jacobs M, Dong M, Thomas AG, Bulterys M, Hale B. Integrated HIV surveillance finds recent adult hepatitis B virus (HBV) transmission and intermediate HBV prevalence among military in uncharacterized Caribbean country. PLoS One 2019; 14:e0222835. [PMID: 31574098 PMCID: PMC6772055 DOI: 10.1371/journal.pone.0222835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/09/2019] [Indexed: 12/18/2022] Open
Abstract
Background Guyana expanded its HIV response in 2005 but the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections has not been characterized. Methods The 2011 Seroprevalence and Behavioral Epidemiology Risk Survey for HIV and STIs collected biologic specimens with demographic and behavioral data from a representative sample of Guyana military personnel. Diagnostics included commercial serum: HIV antibody; total antibody to hepatitis B core (anti-HBc); IgM anti-HBc; hepatitis B surface antigen (HBsAg); anti-HBs; antibody to HCV with confirmatory testing; and HBV DNA sequencing with S gene fragment phylogenetic analysis. Chi-square, p-values and prevalence ratios determined statistical significance. Results Among 480 participants providing serologic specimens, 176 (36.7%) tested anti-HBc-positive. Overall, 19 (4.0%) participants tested HBsAg-positive; 17 (89.5%) of the HBsAg-positive participants also had detectable anti-HBc, including 1 (5.3%) IgM anti-HBc-positive male. Four (6.8%) females with available HBV testing were HBsAg-positive, all aged 23–29 years. Sixteen (16, 84.2%) HBsAg-positive participants had sufficient specimen for DNA testing. All 16 had detectable HBV DNA, 4 with viral load >2x104IU/ml. Sequencing found: 12 genotype (gt) A1 with 99.9% genetic identity between 1 IgM anti-HBc-positive and 1 anti-HBc-negative; 2 gtD1; and 2 with insufficient specimen. No statistically significant associations between risk factors and HBV infection were identified. Conclusions Integrated HIV surveillance identified likely recent adult HBV transmission, current HBV infection among females of reproductive age, moderate HBV infection prevalence (all gtA1 and D1), no HCV infections and low HIV frequency among Guyana military personnel. Integrated HIV surveillance helped characterize HBV and HCV epidemiology, including probable recent transmission, prompting targeted responses to control ongoing HBV transmission and examination of hepatitis B vaccine policies.
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Affiliation(s)
- Siobhan M. O’Connor
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
| | - Tonya Mixson-Hayden
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Lilia Ganova-Raeva
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Djeneba Audrey Djibo
- Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America
| | - Matthew Brown
- Division of Global HIV and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Guo-Liang Xia
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Saleem Kamili
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Marni Jacobs
- Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America
| | - Maxia Dong
- Division of Global HIV and Tuberculosis, United States Centers for Disease Control and Prevention, CDC Guyana, Georgetown, Guyana
| | - Anne G. Thomas
- Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America
| | - Marc Bulterys
- Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America
| | - Braden Hale
- Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America
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da Silva CM, de Peder LD, Guelere AM, Horvath JD, Silva ES, Teixeira JJV, Bertolini DA. Seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected patients in an HBV endemic area in Brazil. PLoS One 2018; 13:e0203272. [PMID: 30192795 PMCID: PMC6128547 DOI: 10.1371/journal.pone.0203272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 08/17/2018] [Indexed: 01/03/2023] Open
Abstract
Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) are a common cause of complications in liver disease and immunological impairment among human immunodeficiency virus (HIV)-infected patients. The aim of this study was to assess the seroprevalence of HBV and HCV and their correlation with CD4+ T-cells among HIV-infected patients in an HBV endemic area. Methods A cross-sectional observational and retrospective study was carried out in a reference center in Southern Brazil between January 2005 and December 2016. Socio-demographic data were collected by using a structured questionnaire. Serological tests and analysis of CD4+ T-cell count levels were performed using standard procedures. Results The seroprevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.10%, 3.10%, and 0.16%, respectively. At baseline, anti-hepatitis B surface and anti-hepatitis B core antigens were detected in 46.27% and 16.74% of HIV-monoinfected patients and in 31.25% and 21.86% of the HIV-HCV coinfected patients, respectively. The median CD4+ T-cell count at baseline in the HIV-monoinfected group was higher than that in the HIV-coinfected groups, but without statistical significance. The median CD4+ T-cell count and the CD4/CD8 ratio were significantly higher in HIV-HBV and HIV-HCV groups after 24 months of combination antiretroviral therapy (cART) compared to the pre-cART values. When comparing patients with HIV-HBV and HIV-HCV on cART, CD4+ T-cell recovery was more rapid for HIV-HBV patients. Conclusion Although the analyzed region was endemic for HBV, the prevalence of HIV-HBV and HIV-HCV coinfection was lower than the rate found in the general population of Brazil. HBV and HCV had no significant impact on CD4+ T-cell counts among HIV-infected patients at baseline.
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Affiliation(s)
| | - Leyde Daiane de Peder
- Post-graduate Program in Bioscience and Physiopathology, Maringá State University, Maringá, Paraná, Brazil
| | | | | | | | | | - Dennis Armando Bertolini
- Department of Clinical Analysis and Biomedicine, Maringá State University, Maringá, Paraná, Brazil
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Aurpibul L, Kariminia A, Vibol U, Fong MS, Le ON, Hansudewechakul R, Bunupuradah T, Kurniati N, Chokephaibulkit K, Kumarasamy N, Wati DK, Yusoff NKN, Razali KAM, Nallusamy RA, Sohn AH, Lumbiganon P. Seroprevalence of Hepatitis B Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy in the TREAT Asia Pediatric HIV Observational Database. Pediatr Infect Dis J 2018; 37:788-793. [PMID: 29846357 PMCID: PMC6097529 DOI: 10.1097/inf.0000000000001901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation, which can progress to liver fibrosis/cirrhosis and hepatocellular carcinoma. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database. METHODS A multisite cross-sectional study was conducted in HIV-infected patients currently <25 years old receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), or HBV surface antibody (anti-HBs) or HBV core antibody (anti-HBc) tested during 2012-2013. HBV coinfection was defined as having either a positive HBsAg test or being anti-HBc positive and anti-HBs negative, reflective of past HBV infection. HBV seroprotection was defined as having a positive anti-HBs test. RESULTS A total of 3380 patients from 6 countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia and India) were included. The current median (interquartile range) age was 11.2 (7.8-15.1) years. Of the 2755 patients (81.5%) with HBsAg testing, 130 (4.7%) were positive. Of 1558 (46%) with anti-HBc testing, 77 (4.9%) were positive. Thirteen of 1037 patients with all 3 tests were anti-HBc positive and HBsAg and anti-HBs negative. One child was positive for anti-HBc and negative for anti-HBs but did not have HBsAg tested. The prevalence of HBV coinfection was 144/2759 (5.2%) (95% confidence interval: 4.4-6.1). Of 1093 patients (32%) with anti-HBs testing, 257 (23.5%; confidence interval: 21.0-26.0) had positive tests representing HBV seroprotection. CONCLUSIONS The estimated prevalence of HBV coinfection in this cohort of Asian HIV-infected children and adolescents on ART was 5.2%. The majority of children and adolescents tested in this cohort (76.5%) did not have protective HBV antibody. The finding supports HBV screening of HIV-infected children and adolescents to guide revaccination, the use of ART with anti-HBV activity and future monitoring.
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Affiliation(s)
- Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Ung Vibol
- University of Health Sciences and National Pediatric Hospital, Phnom Penh, Cambodia
| | | | - Oanh Ngoc Le
- Worldwide Orphans Foundation, Ho Chi Minh City, Vietnam
| | | | | | - Nia Kurniati
- Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | | | | | | | - Annette H Sohn
- TREAT Asia/amfAR – The Foundation for AIDS Research, Bangkok, Thailand
| | - Pagakrong Lumbiganon
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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N'Guessan KF, Boyce C, Kwara A, Archampong TNA, Lartey M, Sagoe KW, Kenu E, Obo-Akwa A, Blackard JT. Human pegivirus (HPgV) infection in Ghanaians co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Virus Genes 2018; 54:361-367. [PMID: 29551002 PMCID: PMC5953819 DOI: 10.1007/s11262-018-1555-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/14/2018] [Indexed: 12/28/2022]
Abstract
Human pegivirus (HPgV) is a positive single-stranded RNA virus in the Flaviviridae family. Phylogenetic analysis reveals the presence of multiple HPgV genotypes with distinct geographic locations. HPgV is of interest because of its potential beneficial impact on HIV disease progression. Despite this, the effects of HPgV in the context of other viral infections, such as hepatitis B virus (HBV), are poorly understood, and data from resource-limited settings are scarce. Therefore, we conducted a cross-sectional analysis of HPgV in HIV/HBV co-infected patients in Ghana. Sera from 100 HIV/HBV co-infected individuals were evaluated for HPgV RNA, and the genotype determined by sequencing the 5' untranslated region. HPgV RNA was detected in 27 samples (27%). Of these, 26 were genotyped successfully with 23 belonging to HPgV genotype 1 and 3 belonging to HPgV genotype 2. The presence of HPgV RNA had no statistically significant impact on CD4 cell count or HBV DNA titers in the HIV/HBV co-infected patients. However, there was a trend towards decreased HBV DNA levels in HPgV RNA-positive patients with CD4 cell count < 200 (p = 0.0626). HPgV co-infection is common in Ghana. The effect of HPgV on HIV or HBV disease among HIV/HBV co-infected patients was minimal. However, decreased HBV DNA levels in HPgV RNA-positive patients with low CD4 cell counts highlight the need for prospective studies of HPgV in HIV and hepatitis co-infected patients, especially in those with advanced HIV disease, to study further the effects of HPgV on liver disease.
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Affiliation(s)
- Kombo F N'Guessan
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ceejay Boyce
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Awewura Kwara
- College of Medicine and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Timothy N A Archampong
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
- Korle-Bu Teaching Hospital, Accra, Ghana
| | - Margaret Lartey
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
- Korle-Bu Teaching Hospital, Accra, Ghana
| | - Kwamena W Sagoe
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ernest Kenu
- Korle-Bu Teaching Hospital, Accra, Ghana
- School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Adjoa Obo-Akwa
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Jason T Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Choi YM, Lee SY, Kim BJ. Naturally occurring hepatitis B virus reverse transcriptase mutations related to potential antiviral drug resistance and liver disease progression. World J Gastroenterol 2018; 24:1708-1724. [PMID: 29713126 PMCID: PMC5922991 DOI: 10.3748/wjg.v24.i16.1708] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 02/06/2023] Open
Abstract
The annual number of deaths caused by hepatitis B virus (HBV)-related disease, including cirrhosis and hepatocellular carcinoma (HCC), is estimated as 887000. The reported prevalence of HBV reverse transcriptase (RT) mutation prior to treatment is varied and the impact of preexisting mutations on the treatment of naïve patients remains controversial, and primarily depends on geographic factors, HBV genotypes, HBeAg serostatus, HBV viral loads, disease progression, intergenotypic recombination and co-infection with HIV. Different sensitivity of detection methodology used could also affect their prevalence results. Several genotype-dependent HBV RT positions that can affect the emergence of drug resistance have also been reported. Eight mutations in RT (rtL80I, rtD134N, rtN139K/T/H, rtY141F, rtM204I/V, rtF221Y, rtI224V, and rtM309K) are significantly associated with HCC progression. HBeAg-negative status, low viral load, and genotype C infection are significantly related to a higher frequency and prevalence of preexisting RT mutations. Preexisting mutations are most frequently found in the A-B interdomain of RT which overlaps with the HBsAg "a" determinant region, mutations of which can lead to simultaneous viral immune escape. In conclusion, the presence of baseline RT mutations can affect drug treatment outcomes and disease progression in HBV-infected populations via modulation of viral fitness and host-immune responses.
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Affiliation(s)
- Yu-Min Choi
- Department of Microbiology and Immunology, Biomedical Sciences, Liver Research Institute and Cancer Research Institute, Seoul National University, College of Medicine, Seoul 110799, South Korea
| | - So-Young Lee
- Department of Microbiology and Immunology, Biomedical Sciences, Liver Research Institute and Cancer Research Institute, Seoul National University, College of Medicine, Seoul 110799, South Korea
| | - Bum-Joon Kim
- Department of Microbiology and Immunology, Biomedical Sciences, Liver Research Institute and Cancer Research Institute, Seoul National University, College of Medicine, Seoul 110799, South Korea
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Mendy M, Lawlor RT, van Kappel AL, Riegman PHJ, Betsou F, Cohen OD, Henderson MK. Biospecimens and Biobanking in Global Health. Clin Lab Med 2018; 38:183-207. [PMID: 29412882 PMCID: PMC11232505 DOI: 10.1016/j.cll.2017.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biobanks provide a critical infrastructure to support research in human health. Biospecimens and their accompanying data are increasingly needed to support biomedical research and clinical care. The original text was initially published in the Handbook for Cancer Research in Africa. The value of this publication is great as it underlines the importance of biobanks in Africa as a key resource to increase quality scientific research and participate in global health research. Therefore, a revision to extend these principles to other low resource contexts, to include updated material and references and add the topic of biobank sustainability were relevant.
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Affiliation(s)
- Maimuna Mendy
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - Rita T Lawlor
- ARC-Net Applied Research on Cancer Centre, University of Verona, Piazzale LA Scuro 10, Verona 37134, Italy
| | | | - Peter H J Riegman
- Department of Pathology, Tissue Bank, Erasmus MC, Dr Molewaterplein 40, Rotterdam 3015, The Netherlands
| | - Fay Betsou
- Integrated BioBank of Luxembourg, 6 rue Nicolas Ernest Barble, Luxembourg L-1210, Luxembourg
| | - Oliver D Cohen
- AGEIS EA 7407 Laboratory, Medical School of Grenoble, Joseph Fourier University, Domaine de la Merci, La Tronche 38700, France
| | - Marianne K Henderson
- Center for Global Health, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Room 3W534, Bethesda, MD 20892, USA.
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Comparison of Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Participants Enrolled in a Multinational Clinical Trial: HPTN 052. J Acquir Immune Defic Syndr 2018; 76:388-393. [PMID: 28749822 DOI: 10.1097/qai.0000000000001511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Data comparing hepatitis B virus (HBV) infection in HIV-infected [HIV(+)], and HIV-uninfected [HIV(-)] individuals recruited into the same study are limited. HBV infection status and chronic hepatitis B (cHB) were characterized in a multinational clinical trial: HIV Prevention Trials Network (HPTN 052). METHOD HBV infection status at enrollment was compared between HIV(+) (N = 1241) and HIV(-) (N = 1232) from 7 HBV-endemic countries. Hepatitis B e antigen and plasma HBV DNA were determined in cHB. Median CD4, median plasma HIV RNA, and prevalence of transaminase elevation were compared in HIV(+) with and without cHB. Significance was assessed with χ, Fisher exact, and median tests. RESULTS Among all participants, 33.6% had HBV exposure without cHB (8.9% isolated HBV core antibody, "HBcAb"; 24.7% HBcAb and anti-HB surface antibody positive, "recovered"), 4.3% had cHB, 8.9% were vaccinated, and 53.5% were uninfected. Data were similar among HIV(+) and HIV(-) except for isolated HBcAb, which was more prevalent in HIV(+) than HIV(-) [10.1% vs. 7.7%, P = 0.046]. Median HBV DNA trended higher in HIV(+) than in HIV(-). In HIV(+) with cHB versus those without cHB, transaminase elevations were more prevalent (alanine aminotransferase ≤ grade 2, 12% vs. 5.2%, P = 0.037; aspartate aminotransferase ≤ grade 2, 26% vs. 6.0%, P < 0.001), CD4 trended lower, and HIV RNA was similar. CONCLUSIONS HBV infection status did not differ by HIV infection status. HIV co-infection was associated with isolated HBcAb and a trend of increased HBV DNA. In HIV, cHB was associated with mild transaminase elevations and a trend toward lower CD4.
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Singh KP, Crane M, Audsley J, Avihingsanon A, Sasadeusz J, Lewin SR. HIV-hepatitis B virus coinfection: epidemiology, pathogenesis, and treatment. AIDS 2017; 31:2035-2052. [PMID: 28692539 PMCID: PMC5661989 DOI: 10.1097/qad.0000000000001574] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
: HIV infection has a significant impact on the natural history of chronic hepatitis B virus (HBV) infection, with increased levels of HBV DNA, accelerated progression of liver disease and increased liver-associated mortality compared with HBV monoinfection. Widespread uptake and early initiation of HBV-active antiretroviral therapy has substantially improved the natural history of HIV-HBV coinfection but the prevalence of liver disease remains elevated in this population. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease and seroconversion in HIV-HBV coinfection in the era of HBV-active antiretroviral therapy and the effects of HIV directly on liver disease. We also review novel therapeutics for the management of HBV with a particular emphasis on clinical strategies being developed for an HBV cure and an HIV cure and their impact on HIV-HBV coinfected individuals.
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Affiliation(s)
- Kasha P Singh
- aThe Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital bVictorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity cDepartment of Infectious Diseases, Alfred Hospital and Monash University, Melbourne Australia dThai Red Cross AIDS Research Center and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Sun T, Liu L, Wu A, Zhang Y, Jia X, Yin L, Lu H, Zhang L. iTRAQ based investigation of plasma proteins in HIV infected and HIV/HBV coinfected patients - C9 and KLK are related to HIV/HBV coinfection. Int J Infect Dis 2017; 63:64-71. [PMID: 28823846 DOI: 10.1016/j.ijid.2017.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/07/2017] [Accepted: 08/09/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) share similar routes of transmission, and rapid progression of hepatic and immunodeficiency diseases has been observed in coinfected individuals. Our main objective was to investigate the molecular mechanism of HIV/HBV coinfections. METHODS We selected HIV infected and HIV/HBV coinfected patients with and without Highly Active Antiretroviral Therapy (HAART). Low abundance proteins enriched using a multiple affinity removal system (MARS) were labeled with isobaric tags for relative and absolute quantitation (iTRAQ) kits and analyzed using liquid chromatography-mass spectrometry (LC-MS). The differential proteins were analyzed by Gene Ontology (GO) database. RESULTS A total of 41 differential proteins were found in HIV/HBV coinfected patients as compared to HIV mono-infected patients with or without HAART treatment, including 7 common HBV-regulated proteins. The proteins involved in complement and coagulation pathways were significantly enriched, including plasma kallikrein (KLK) and complement component C9 (C9). C9 and KLK were verified to be down-regulated in HIV/HBV coinfected patients through ELISA analysis. CONCLUSION The present iTRAQ based proteomic analyses identified 7 proteins that are related to HIV/HBV coinfection. HBV might influence hepatic and immune functions by deregulating complement and coagulation pathways. C9 and KLK could potentially be used as targets for the treatment of HIV/HBV coinfections.
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Affiliation(s)
- Tao Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Li Liu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Ao Wu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Yujiao Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiaofang Jia
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Lin Yin
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
| | - Lijun Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
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Liver Fibrosis and Hepatitis B Coinfection among ART Naïve HIV-Infected Patients at a Tertiary Level Hospital in Northwestern Tanzania: A Cross-Sectional Study. J Trop Med 2017; 2017:5629130. [PMID: 28828009 PMCID: PMC5554579 DOI: 10.1155/2017/5629130] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/11/2017] [Accepted: 06/22/2017] [Indexed: 12/16/2022] Open
Abstract
Background Liver fibrosis which is a common complication of chronic hepatitis B infection is rarely diagnosed in low-resource countries due to limited capacity to perform biopsy studies. Data on the utilization of noninvasive techniques which are feasible for diagnosis of liver fibrosis in these settings among HIV-infected patients is scarce. The objective of this study was to establish the magnitude of liver fibrosis by using both aspartate-aminotransferase-to-platelets ratio and fibrosis-4 scores with associated hepatitis B coinfection among antiretroviral therapy naïve HIV-infected patients. Methods We reviewed data of 743 adult patients attending HIV clinic with available hepatitis B surface antigen test results. Baseline clinical information was recorded and aspartate-aminotransferase-to-platelet ratio and fibrosis-4 scores were calculated. The cut-off values of 1.5 and 3.25 were used for diagnosis of significant fibrosis by aspartate-aminotransferase-to-platelets ratio and fibrosis-4 scores, respectively. Results The prevalence of liver fibrosis was 3.5% when aspartate-aminotransferase-to-platelet score was used and 4.6% with fibrosis-4 score and they were both significantly higher among patients with hepatitis B coinfection. Younger patients with HIV advanced disease and elevated liver transaminases had increased risk of having hepatitis B coinfection. Conclusion A remarkable number of HIV-infected patients present with liver fibrosis, predominantly those with hepatitis B infection.
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Grant J, Agbaji O, Kramvis A, Yousif M, Auwal M, Penugonda S, Ugoagwu P, Murphy R, Hawkins C. Hepatitis B virus sequencing and liver fibrosis evaluation in HIV/HBV co-infected Nigerians. Trop Med Int Health 2017; 22:744-754. [PMID: 28376292 DOI: 10.1111/tmi.12873] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Molecular characteristics of hepatitis B virus (HBV), such as genotype and genomic mutations, may contribute to liver-related morbidity and mortality. The association of these characteristics with liver fibrosis severity in sub-Saharan Africa is uncertain. We aimed to characterise molecular HBV features in human immunodeficiency virus (HIV)/HBV co-infected Nigerians and evaluate associations between these characteristics and liver fibrosis severity before and after antiretroviral therapy (ART) initiation. METHODS HIV/HBV co-infected Nigerians underwent liver fibrosis estimation by transient elastography (TE) prior to and 36 months after ART initiation. Basal core promoter/precore (BCP/PC) and preS1/preS2/S regions of HBV were sequenced from baseline plasma samples. We evaluated associations between HBV mutations and liver fibrosis severity by univariate and multivariable regression. RESULTS At baseline, 94 patients underwent TE with median liver stiffness of 6.4 (IQR 4.7-8.7) kPa. Patients were predominantly infected with HBV genotype E (45/46) and HBe-antigen negative (75/94, 79.8%). We identified BCP A1762T/G1764A in 15/35 (43%), PC G1896A in 20/35 (57%), 'a' determinant mutations in 12/45 (26.7%) and preS2 deletions in 6/16 (37.5%). PreS2 mutations were associated with advanced fibrosis in multivariable analysis. At follow-up, median liver stiffness was 5.2 (IQR 4.1-6.6) kPa. No HBV molecular characteristics were associated with lack of fibrosis regression, although HIV virologic control, body mass index (BMI) and baseline CD4+ T-cell count were associated with a decline in fibrosis stage. CONCLUSION Frequent BCP/PC and preS1/preS2/S mutations were found in ART-naïve HIV/HBV co-infected Nigerians. Median liver stiffness declined after initiation of ART, regardless of pre-ART HBV mutational pattern or virologic characteristics.
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Affiliation(s)
- Jennifer Grant
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Oche Agbaji
- Department of Medicine, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Anna Kramvis
- School of Clinical Medicine, Faculty of Health Sciences, Hepatitis Virus Diversity Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Mukhlid Yousif
- School of Clinical Medicine, Faculty of Health Sciences, Hepatitis Virus Diversity Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Mu'azu Auwal
- HIV Care and Treatment Center, Jos University Teaching Hospital, Jos, Nigeria
| | - Sudhir Penugonda
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Placid Ugoagwu
- HIV Care and Treatment Center, Jos University Teaching Hospital, Jos, Nigeria
| | - Robert Murphy
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Claudia Hawkins
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Baudi I, Iijima S, Chin'ombe N, Mtapuri-Zinyowera S, Murakami S, Isogawa M, Hachiya A, Iwatani Y, Tanaka Y. Molecular epidemiology of co-infection with hepatitis B virus and human immunodeficiency virus (HIV) among adult patients in Harare, Zimbabwe. J Med Virol 2017; 89:257-266. [PMID: 27458715 DOI: 10.1002/jmv.24641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 12/20/2022]
Abstract
The objective of this study was to determine the prevalence of co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) and the genetic characteristics of both viruses among pre-HIV-treatment patients in Harare, Zimbabwe. This cross-sectional survey involved 176 remnant plasma samples collected from consenting HIV patients (median age 35 [18-74]) between June and September 2014. HBV seromarkers were determined by high-sensitivity chemiluminescence assays. Molecular evolutionary analyses were conducted on the basal core promoter/precore (BCP/PC) and S regions of HBV, as well as part of the HIV pol region. Of the 176 participants (65.7% female), 19 (10.8%) were positive for HBsAg (median 0.033 IU/ml (IQR 0.01-415). The HBsAg incidence was higher in men than women (P = 0.009). HBsAg-positive subjects had lower median CD4 counts (P = 0.016). HBV DNA was detectable in 12 HBsAg-positive samples (median 3.36 log cp/ml (2.86-4.51), seven being amplified and sequenced. All isolates were subgenotype A1 without HBV drug resistance mutations but each had at least one BCP/PC mutation. PreS deletion mutants and small S antigen variants M133I/T and D144G were identified. Of the 164 HIV isolates successfully genotyped, 163 (99.4%) were HIV-1 subtype C and only one was HIV-1 subtype F1. Sixteen (9.8%) had at least one drug resistance mutation, predominantly non-nucleoside reverse transcriptase inhibitor-related mutations, observed mostly among female participants. This study shows that co-infection with HBV is present among HIV patients enrolling into HIV care in Zimbabwe, suggesting that HBV screening and monitoring programmes be strengthened in this context. J. Med. Virol. 89:257-266, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ian Baudi
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sayuki Iijima
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Nyasha Chin'ombe
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Shuko Murakami
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masanori Isogawa
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsuko Hachiya
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yasumasa Iwatani
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yasuhito Tanaka
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Anderson M, Gaseitsiwe S, Moyo S, Thami KP, Mohammed T, Setlhare D, Sebunya TK, Powell EA, Makhema J, Blackard JT, Marlink R, Essex M, Musonda RM. Slow CD4 + T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana. Open Forum Infect Dis 2016; 3:ofw140. [PMID: 27800524 PMCID: PMC5084712 DOI: 10.1093/ofid/ofw140] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 06/21/2016] [Indexed: 12/21/2022] Open
Abstract
Background. Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection has emerged as an important cause of morbidity and mortality. We determined the response to Truvada-based first-line combination antiretroviral therapy (cART) in HIV/HBV-coinfected verus HIV-monoinfected patients in Botswana. Methods. Hepatitis B virus surface antigen (HBsAg), HBV e antigen (HBeAg), and HBV deoxyribonucleic acid (DNA) load were determined from baseline and follow-up visits in a longitudinal cART cohort of Truvada-based regimen. We assessed predictors of HBV serostatus and viral suppression (undetectable HBV DNA) using logistic regression techniques. Results. Of 300 participants, 28 were HBsAg positive, giving an HIV/HBV prevalence of 9.3% (95% confidence interval [CI], 6.3-13.2), and 5 of these, 17.9% (95% CI, 6.1-36.9), were HBeAg positive. There was a reduced CD4+ T-cell gain in HIV/HBV-coinfected compared with HIV-monoinfected patients. Hepatitis B virus surface antigen and HBeAg loss was 38% and 60%, respectively, at 24 months post-cART initiation. The HBV DNA suppression rates increased with time on cART from 54% to 75% in 6 and 24 months, respectively. Conclusions. Human immunodeficiency virus/HBV coinfection negatively affected immunologic recovery compared with HIV-1C monoinfection. Hepatitis B virus screening before cART initiation could help improve HBV/HIV treatment outcomes and help determine treatment options when there is a need to switch regimens.
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Affiliation(s)
- Motswedi Anderson
- Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership; Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | | | - Terence Mohammed
- Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone
| | | | - Theresa K Sebunya
- Department of Biological Sciences , University of Botswana , Gaborone
| | | | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Richard Marlink
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Max Essex
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Rosemary M Musonda
- Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Shiferaw MB, Tulu KT, Zegeye AM, Wubante AA. Liver Enzymes Abnormalities among Highly Active Antiretroviral Therapy Experienced and HAART Naïve HIV-1 Infected Patients at Debre Tabor Hospital, North West Ethiopia: A Comparative Cross-Sectional Study. AIDS Res Treat 2016; 2016:1985452. [PMID: 27493798 PMCID: PMC4963552 DOI: 10.1155/2016/1985452] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/26/2016] [Accepted: 06/16/2016] [Indexed: 01/26/2023] Open
Abstract
Liver disease has emerged as the most common non-AIDS-related cause of death in HIV patients. However, there is limited data regarding this condition including our setting in Ethiopia. Hence, liver enzyme abnormalities among highly active antiretroviral therapy (HAART) experienced and HAART naïve patients were assessed in this study. A total of 164 HAART experienced and 164 HAART naïve patients were studied. Blood specimen was collected to determine alanine aminotransferase (ALT) and aspartate aminotransferase (AST), CD4 count, and viral hepatitis. The prevalence of liver enzyme abnormality was 20.1% and 22.0% among HAART experienced and HAART naïve patients, respectively. The HAART experienced patients had higher mean ALT than HAART naïve patients (P = 0.002). Viral hepatitis (AOR = 6.02; 95% CI = 1.87-19.39), opportunistic infections (AOR = 2.91; 95% CI = 1.04-8.19), current CD4 count <200 cells/mm(3) (AOR = 2.16; 95% CI = 1.06-4.39), and male sex (AOR = 1.83; 95% CI = 1.001-3.33) were associated with elevated ALT and/or AST. In conclusion, liver enzyme abnormalities were high in both HAART experienced and HAART naïve HIV-1 infected patients. Hence, monitoring and management of liver enzyme abnormalities in HIV-1 infected patients are important in our setting.
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Affiliation(s)
| | - Ketema Tafess Tulu
- Department of Biomedical Science, School of Health and Hospital, Adama Science and Technology University, Asella, Ethiopia
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Cornelissen M, Zorgdrager F, Bruisten SM, Bakker M, Berkhout B, van der Kuyl AC. Widespread hepatitis B virus genotype G (HBV-G) infection during the early years of the HIV epidemic in the Netherlands among men who have sex with men. BMC Infect Dis 2016; 16:268. [PMID: 27286832 PMCID: PMC4901482 DOI: 10.1186/s12879-016-1599-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/27/2016] [Indexed: 01/05/2023] Open
Abstract
Background Hepatitis B virus (HBV) variants belong to different genotypes, A-J, whose worldwide distribution is linked with geography, probably because viral spread was associated with ancient human migrations. HBV genotype G (HBV-G) is an aberrant genotype with little sequence divergence, suggesting a recent origin. HBV-G is strongly associated with certain risk groups such as intravenous drug users (IDUs) and men who have sex with men (MSM), but hardly with geography. The origin and epidemiology of HBV-G remain unresolved, as is the disease association. Methods To estimate the prevalence and possible time of introduction of HBV-G into the MSM community in Amsterdam, the Netherlands, we have retrospectively analysed 226 blood serum samples from HBsAg positive MSM enrolled in the Amsterdam Cohort Studies (ACS) on HIV infection and AIDS dating from 1984 to 1999 using genotype-specific PCR assays. Results Of the 226 HBsAg-positive samples, 149 were HBV DNA positive. Of those, 104 were positive for HBV genotype A (HBV-A) and five for HBV-G, and 40 showed a dual infection with both HBV-A and HBV-G. Being HIV-infected was significantly associated with a reduced HBV DNA viral load in blood, but not with the prevalence of HBV-G. Early virus already contained stop codons in the precore region and a 36 bp insertion in the core gene which are the characteristics of HBV-G. Conclusions HBV-G was introduced before 1985 into the Amsterdam MSM community. Early isolates show very limited sequence variation, confirming a low evolutionary rate. HBV-G acquisition was independent of HIV infection, but being HIV-infected was significantly associated with a reduced HBV viral load in blood, indicating a beneficial effect of early HIV infection in controlling HBV replication. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1599-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Fokla Zorgdrager
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Sylvia M Bruisten
- Public Health Laboratory, GGD Amsterdam, Cluster Infectious Diseases, Nieuwe Achtergracht 100, Amsterdam, 1018 WT, The Netherlands
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Antoinette C van der Kuyl
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
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Prevalence of hepatitis B and C viruses in HIV-positive patients in China: a cross-sectional study. J Int AIDS Soc 2016; 19:20659. [PMID: 26979535 PMCID: PMC4793284 DOI: 10.7448/ias.19.1.20659] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/06/2016] [Accepted: 02/16/2016] [Indexed: 12/26/2022] Open
Abstract
Introduction Liver disease related to hepatitis B (HBV) and hepatitis C (HCV) may temper the success of antiretroviral therapy (ART) in China. Limited data exist on their prevalence in HIV-positive Chinese. A multi-centre, cross-sectional study was carried out to determine the prevalence and disease characteristics of HBV and HCV co-infection in HIV-positive patients across 12 provinces. Methods HIV-positive ART-naïve patients were recruited from two parent cohorts established during November 2008–January 2010 and August 2012–September 2014. Hepatitis B surface antigen (HBsAg), hepatitis B e antigen and HCV antibody (anti-HCV) status were retrieved from parent databases at the visit prior to ART initiation. HBV DNA was then determined in HBsAg+ patients. HCV RNA was quantified in anti-HCV+ patients. Aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 (FIB4) were calculated. Chi-square test, Kruskal–Wallis test and logistic regression were used for statistical analysis, as appropriate. Results Of 1944 HIV-positive patients, 186 (9.5%) were HIV–HBV co-infected and 161 (8.3%) were HIV–HCV co-infected. The highest HIV–HBV prevalence (14.5%) was in Eastern China while the highest HIV–HCV prevalence was in the Central region (28.2%). HIV–HBV patients had lower median CD4 + T cell count (205 cells/μL) than either HIV monoinfected (242 cells/μL, P=0.01) or HIV–HCV patients (274 cells/μL, P=0.001). Moderate-to-significant liver disease was present in >65% of the HIV–HCV, ~35% of the HIV–HBV and ~20% of the HIV monoinfected patients. Independent associations with moderate-to-significant liver disease based on APRI included HBV (Odds ratio, OR 2.37, P < 0.001), HCV (OR 9.64, P<0.001), CD4 count≤200 cells/μL (OR 2.55, P<0.001) and age ≥30 years (OR 1.80, P=0.001). Conclusions HBV and HCV prevalence is high in HIV-positive Chinese and differs by geographic region. HBV and HCV co-infection and HIV monoinfection are risks for moderate-to-significant liver disease. Only HIV–HBV is associated with greater HIV-related immunosuppression. Incorporating screening and management of hepatitis virus infections into Chinese HIV programmes is needed.
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Chen M, Wong WW, Law MG, Kiertiburanakul S, Yunihastuti E, Merati TP, Lim PL, Chaiwarith R, Phanuphak P, Lee MP, Kumarasamy N, Saphonn V, Ditangco R, Sim BLH, Nguyen KV, Pujari S, Kamarulzaman A, Zhang F, Pham TT, Choi JY, Oka S, Kantipong P, Mustafa M, Ratanasuwan W, Durier N, Chen YMA. Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival. PLoS One 2016; 11:e0150512. [PMID: 26933963 PMCID: PMC4774987 DOI: 10.1371/journal.pone.0150512] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/14/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region. METHODS Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test. RESULTS A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive. CONCLUSION In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.
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Affiliation(s)
- Marcelo Chen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Cosmetic Applications and Management, MacKay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan
| | - Wing-Wai Wong
- Department of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Sasisopin Kiertiburanakul
- Division of Infectious Diseases, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Evy Yunihastuti
- Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | | | | | | | - Man Po Lee
- Queen Elizabeth Hospital, Hong Kong, China
| | - Nagalingeswaran Kumarasamy
- Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India
| | - Vonthanak Saphonn
- National Center for HIV/AIDS, Dermatology & STDs, and University of Health Sciences, Phnom Penh, Cambodia
| | | | | | | | | | | | - Fujie Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | | | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Shinichi Oka
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Winai Ratanasuwan
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nicolas Durier
- TREAT Asia, amfAR—The Foundation for AIDS Research, Bangkok, Thailand
| | - Yi-Ming Arthur Chen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Noubiap JJN, Aka PV, Nanfack AJ, Agyingi LA, Ngai JN, Nyambi PN. Hepatitis B and C Co-Infections in Some HIV-Positive Populations in Cameroon, West Central Africa: Analysis of Samples Collected Over More Than a Decade. PLoS One 2015; 10:e0137375. [PMID: 26371878 PMCID: PMC4570762 DOI: 10.1371/journal.pone.0137375] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/14/2015] [Indexed: 01/15/2023] Open
Abstract
As people infected with the human immunodeficiency virus (HIV) in Sub-Saharan Africa live longer due to availability of antiretroviral treatment (ART), so is the rise of associated infections with their burdens on patients. But reliable data on the prevalence of co-infection with hepatitis B (HBV) or C (HCV) still remains sparse and many individuals with HIV do not know their co-infection status. This study attempted to estimate the seroprevalence and identify risk factors associated with hepatitis B and/or C co-infections in HIV-infected individuals from five Regions of Cameroon by screening 531 HIV infected subjects for the presence of HBV surface antigen (HBsAg) and antibodies to HCV (HCV-Ab). A Screening and a confirmatory Enzyme linked immunosorbent assay were used to detect presence of markers of infection. CD4 count levels were also examined. The results indicate that of the 531 participants, 68% were females and 32% males. Mean CD4 count was ~400 cells/μl. Seroprevalence rates for HBsAg and HCV-Ab were 23.7%, and 7.2%, respectively. Associations assessed using logistic regression revealed that HBsAg but not HCV-Ab positivity was linked to age, lower CD4 count and residing in an urban rather than in a rural setting. This high prevalence of co-infection with HBV raises the urgent need to systematically screen all newly diagnosed HIV cases for co-infection in Cameroon and other regions of sub-Saharan Africa where HIV accounts for the majority of the global infection, so as to improve management strategies for HBV infection and ART implementation.
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Affiliation(s)
| | - Peter V. Aka
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Aubin J. Nanfack
- Department of Pathology, New York University School of Medicine, New York, New York, United States of America
- Faculty of Medicine and Surgery, Department of Immunology and Applied Biotechnology, University of Rome Tor Vergatta, Rome, Italy
| | - Lucy A. Agyingi
- Serology Unit, Medical Diagnostic Center, Yaounde, Cameroon
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | | | - Phillipe N. Nyambi
- Department of Pathology, New York University School of Medicine, New York, New York, United States of America
- Veterans Affairs New York Harbor Healthcare Systems, New York, New York, United States of America
- * E-mail:
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Gu L, Han Y, Li Y, Zhu T, Song X, Huang Y, Yang F, Guan S, Xie J, Gohda J, Hosoya N, Kawana-Tachikawa A, Liu W, Gao GF, Iwamoto A, Li T, Ishida T. Emergence of Lamivudine-Resistant HBV during Antiretroviral Therapy Including Lamivudine for Patients Coinfected with HIV and HBV in China. PLoS One 2015; 10:e0134539. [PMID: 26288093 PMCID: PMC4543549 DOI: 10.1371/journal.pone.0134539] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 07/11/2015] [Indexed: 02/06/2023] Open
Abstract
In China, HIV-1-infected patients typically receive antiretroviral therapy (ART) that includes lamivudine (3TC) as a reverse-transcriptase inhibitor (RTI) (ART-3TC). Previous studies from certain developed countries have shown that, in ART-3TC, 3TC-resistant HBV progressively emerges at an annual rate of 15–20% in patients coinfected with HIV-1 and HBV. This scenario in China warrants investigation because >10% of all HIV-infected patients in China are HBV carriers. We measured the occurrence of 3TC-resistant HBV during ART-3TC for HIV-HBV coinfection and also tested the effect of tenofovir disoproxil fumarate (TDF) used as an additional RTI (ART-3TC/TDF) in a cohort study in China. We obtained 200 plasma samples collected from 50 Chinese patients coinfected with HIV-1 and HBV (positive for hepatitis B surface antigen) and examined them for the prevalence of 3TC-resistant HBV by directly sequencing PCR products that covered the HBV reverse-transcriptase gene. We divided the patients into ART-3TC and ART-3TC/TDF groups and compared the efficacy of treatment and incidence of drug-resistance mutation between the groups. HIV RNA and HBV DNA loads drastically decreased in both ART-3TC and ART-3TC/TDF groups. In the ART-3TC group, HBV breakthrough or insufficient suppression of HBV DNA loads was observed in 20% (10/50) of the patients after 96-week treatment, and 8 of these patients harbored 3TC-resistant mutants. By contrast, neither HBV breakthrough nor treatment failure was recorded in the ART-3TC/TDF group. All of the 3TC-resistant HBV mutants emerged from the cases in which HBV DNA loads were high at baseline. Our results clearly demonstrated that ART-3TC is associated with the emergence of 3TC-resistant HBV in patients coinfected with HIV-1 and HBV and that ART-3TC/TDF reduces HBV DNA loads to an undetectable level. These findings support the use of TDF-based treatment regimens for patients coinfected with HIV-1 and HBV.
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Affiliation(s)
- Lijun Gu
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Yang Han
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Yijia Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ting Zhu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Xiaojing Song
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ying Huang
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
| | - Feifei Yang
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
| | - Shuo Guan
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
| | - Jing Xie
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Jin Gohda
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Noriaki Hosoya
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Ai Kawana-Tachikawa
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Wenjun Liu
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
| | - George Fu Gao
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
| | - Aikichi Iwamoto
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China
- * E-mail: (TI); (TL)
| | - Takaomi Ishida
- China-Japan Joint Laboratory of Molecular Immunology & Molecular Microbiology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P.R. China
- Research Center for Asian Infectious Diseases, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- * E-mail: (TI); (TL)
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Chakravarty R, Pal A. Insights into human immunodeficiency virus-hepatitis B virus co-infection in India. World J Virol 2015; 4:255-264. [PMID: 26279986 PMCID: PMC4534816 DOI: 10.5501/wjv.v4.i3.255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 02/12/2015] [Accepted: 05/08/2015] [Indexed: 02/05/2023] Open
Abstract
Shared routes of transmission lead to frequent human immunodeficiency virus (HIV)-hepatitis B virus (HBV) co-infection in a host which results in about 10% of HIV positive individuals to have chronic hepatitis B infection worldwide. In post-antiretroviral therapy era, liver diseases have emerged as the leading cause of morbidity and mortality in HIV-infected individuals and HBV co-infection have become the major health issue among this population particularly from the regions with endemic HBV infection. In setting of HIV-HBV co-infection, HIV significantly impacts the natural history of HBV infection, its disease profile and the treatment outcome in negative manner. Moreover, the epidemiological pattern of HBV infection and the diversity in HBV genome (genotypic and phenotypic) are also varied in HIV co-infected subjects as compared to HBV mono-infected individuals. Several reports on the abovementioned issues are available from developed parts of the world as well as from sub-Saharan African countries. In contrast, most of these research areas remained unexplored in India despite having considerable burden of HIV and HBV infections. This review discusses present knowledge from the studies on HIV-HBV co-infection in India and relevant reports from different parts of the world. Issues needed for the future research relevant to HIV-HBV co-infection in India are also highlighted here, including a call for further investigations on this field of study.
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Hearn B, Chasan R, Bichoupan K, Suprun M, Bagiella E, Dieterich DT, Perumalswami P, Branch AD, Huprikar S. Low adherence of HIV providers to practice guidelines for hepatocellular carcinoma screening in HIV/hepatitis B coinfection. Clin Infect Dis 2015; 61:1742-8. [PMID: 26240206 DOI: 10.1093/cid/civ654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/27/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In the era of combination therapy for human immunodeficiency virus (HIV), liver disease, and hepatocellular carcinoma (HCC) are major causes of death for patients coinfected with HIV and hepatitis B virus (HBV). This study compared HIV provider and hepatologist awareness of and adherence to the American Association for the Study of Liver Diseases (AASLD) practice guidelines for chronic HBV management. The primary endpoint of HIV provider adherence to HCC screening recommendations was compared to that of hepatologists at a large metropolitan academic medical center. METHODS Medical record database searches by ICD-9 codes were used to identify HIV/HBV coinfected (n = 144) and HBV monoinfected (n = 225) patients who were seen at least twice over a 2-year period in outpatient clinics. Adherence to AASLD guidelines was assessed by chart review. Provider awareness was evaluated through a voluntary anonymous survey with knowledge-based questions. RESULTS Over a 2-year period, only 36.0% of HIV/HBV coinfected patients seen in HIV practices completed HCC screening compared to 81.8% of HBV monoinfected patients in hepatology practices (P < .00001). Similarly, HIV providers less frequently monitored HBV viral load (P < .0001), HBeAg/anti-HBe (P < .00001), HBsAg/anti-HBs (P < .00001) than hepatologists but screened more often for hepatitis A immunity (P = .028). Self-reported adherence and knowledge scores were similar among 19 HIV providers and 16 hepatologists. CONCLUSIONS HIV providers ordered significantly fewer HCC screening and HBV monitoring tests than hepatologists within a single academic medical center. In the setting of increased reliance on quality indicators for care, both patients and providers will benefit from greater adherence to established guidelines.
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Affiliation(s)
- Bevin Hearn
- Department of Medicine, Division of Infectious Diseases, Carolinas HealthCare System, Charlotte, North Carolina
| | - Rachel Chasan
- Department of Medicine, Division of Infectious Diseases
| | | | - Maria Suprun
- Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Emilia Bagiella
- Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
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