TY - JOUR
T1 - Effect of HIV co-infection on mutation patterns of HBV in patients with lamivudine-resistant chronic hepatitis B
AU - Iacomi, Fabio
AU - Vincenti, Donatella
AU - Vairo, Francesco
AU - Solmone, Mariacarmela
AU - Mariano, Andrea
AU - Piselli, Pierluca
AU - Puro, Vincenzo
AU - Capobianchi, Maria Rosaria
AU - Antonucci, Giorgio
PY - 2009/7
Y1 - 2009/7
N2 - A retrospective review was performed comparing lamivudine-resistance mutation patterns between patients infected with hepatitis B virus (HBV) with or without human immunodefi-ciency virus (HIV) co-infection. Medical records that included a genotypic test of patients infected with HBV and treated with lamivudine as the only anti-HBV drug were reviewed. Pol gene mutations were assessed by direct sequencing of the reverse transcriptase fragment 125-213 aa. Eighty-nine patients infected with HBV (29 coinfected with HIV) with rtM204V or rtM204I mutations were included. Multiple mutations associated with the YMDD motif were observed in 33 (55%) of 60 patients infected with HBV only and in 28 (96.6%) of patients co-infected with HIV/HBV. In this latter group, the prevalence of the rtV173L + rtL 180M + rtM204V triple mutation was 31% versus a prevalence of 3.4% observedamong patients infected withHBV only. All patients with the triple mutational pattern showed sE164D + sI195M changes in the envelope gene. Multivariate analysis demonstrated that HIV co-infection (adjusted OR 11.2, 95% CI 2.0-61.0) and HBV genotype A (adjusted OR 7.2, 95% CI 1.5-34.8) were the only independent variables associated with the chance of harboring rtM204V. Patients with HBV genotype A or HIV co-infection were more likely to harbor the rtM204V mutation. Patients coinfected with HIV showed multiple mutations more frequently, including the triple mutation that may elicit a vaccine escape phenotype. Among patients co-infected with HIV/HBV, strict HBV DNA monitoring is essential to detect treatment failure and adapt therapy to avoid limitations of future therapeutic options or the emergence of a public health threat.
AB - A retrospective review was performed comparing lamivudine-resistance mutation patterns between patients infected with hepatitis B virus (HBV) with or without human immunodefi-ciency virus (HIV) co-infection. Medical records that included a genotypic test of patients infected with HBV and treated with lamivudine as the only anti-HBV drug were reviewed. Pol gene mutations were assessed by direct sequencing of the reverse transcriptase fragment 125-213 aa. Eighty-nine patients infected with HBV (29 coinfected with HIV) with rtM204V or rtM204I mutations were included. Multiple mutations associated with the YMDD motif were observed in 33 (55%) of 60 patients infected with HBV only and in 28 (96.6%) of patients co-infected with HIV/HBV. In this latter group, the prevalence of the rtV173L + rtL 180M + rtM204V triple mutation was 31% versus a prevalence of 3.4% observedamong patients infected withHBV only. All patients with the triple mutational pattern showed sE164D + sI195M changes in the envelope gene. Multivariate analysis demonstrated that HIV co-infection (adjusted OR 11.2, 95% CI 2.0-61.0) and HBV genotype A (adjusted OR 7.2, 95% CI 1.5-34.8) were the only independent variables associated with the chance of harboring rtM204V. Patients with HBV genotype A or HIV co-infection were more likely to harbor the rtM204V mutation. Patients coinfected with HIV showed multiple mutations more frequently, including the triple mutation that may elicit a vaccine escape phenotype. Among patients co-infected with HIV/HBV, strict HBV DNA monitoring is essential to detect treatment failure and adapt therapy to avoid limitations of future therapeutic options or the emergence of a public health threat.
KW - HBV genotype
KW - HBV resistance
KW - HIV/HBV Co-infection
KW - Lamivudine
KW - Vaccine escape mutants
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U2 - 10.1002/jmv.21505
DO - 10.1002/jmv.21505
M3 - Article
C2 - 19475624
AN - SCOPUS:67650001532
VL - 81
SP - 1151
EP - 1156
JO - Journal of Medical Virology
JF - Journal of Medical Virology
SN - 0146-6615
IS - 7
ER -