Hepatitis B virus drug resistance mutations in HIV/HBV co-infected children in Windhoek, Namibia
Date
2020-09-11
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
ENGLISH ABSTRACT: In patients who are HIV infected, hepatitis B virus (HBV) infection is an important co-morbidity. However, antiretroviral options for HIV/HBV co-infected children are limited and, at the time of this study, only included lamivudine. These children may remain on this regimen for many years until late adolescence. They are at high risk of developing HBV drug resistance and uncontrolled HBV disease. The aim of this study was to characterize HBV infection in HIV/HBV co-infected children. Known HIV-infected/HBsAg-positive children, previously exposed to lamivudine monotherapy against HBV, and their mothers were recruited at the Katutura Hospital paediatric HIV clinic in Windhoek, Namibia. Dried blood spot and serum samples were collected for HBV characterization and serological testing, respectively. Fifteen children and six mothers participated in the study. Eight of the 15 children (53.3%) tested HBV DNA positive; all eight children were on lamivudine-based ART. Lamivudine-associated resistance variants, together with immune escape mutants in the surface gene, were identified in all eight children. Resistance mutations included rtL80I, rtV173L, rtL180M, rtM204I/V and the overlapping sE164D, sW182*, sI195M and sW196LS variants. HBV strains belonged to genotypes E (6/8, 75%) and D3 (2/8, 25%). Further analysis of the HBV core promoter region revealed mutations associated with reduced expression of HBeAg protein and hepatocarcinogenesis. All six mothers, on HBV-active ART containing tenofovir and lamivudine, tested HBV DNA negative. This study confirms the importance of screening HIV-infected children for HBV and ensuring equity of drug access to effective HBV treatment if co-infected.
Description
CITATION: Tchuem, C. R. T., et al. 2020. Hepatitis B virus drug resistance mutations in HIV/HBV co-infected children in Windhoek, Namibia. PLoS ONE, 15(9):e0238839, doi:10.1371/journal.pone.0238839.
The original publication is available at https://journals.plos.org/plosone/
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://journals.plos.org/plosone/
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Hepatitis B virus, Drug resistance, HIV-positive persons, HIV infections -- Children -- Complications, Windhoek, Namibia
Citation
Tchuem, C. R. T., et al. 2020. Hepatitis B virus drug resistance mutations in HIV/HBV co-infected children in Windhoek, Namibia. PLoS ONE, 15(9):e0238839, doi:10.1371/journal.pone.0238839