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01.12.2017 | Research | Ausgabe 1/2017 Open Access

AIDS Research and Therapy 1/2017

Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon

AIDS Research and Therapy > Ausgabe 1/2017
George Gachara, Tshifhiwa Magoro, Lufuno Mavhandu, Emmaculate Lum, Helen K. Kimbi, Roland N. Ndip, Pascal O. Bessong
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12981-017-0136-0) contains supplementary material, which is available to authorized users.



Occult hepatitis B infection (OBI) among HIV positive patients varies widely in different geographic regions. We undertook a study to determine the prevalence of occult hepatitis B infection among HIV infected individuals visiting a health facility in South West Cameroon and characterized occult HBV strains based on sequence analyses.


Plasma samples (n = 337), which previously tested negative for hepatitis B surface antigen (HBsAg), were screened for antibodies against hepatitis B core (anti-HBc) and surface (anti-HBs) antigens followed by DNA extraction. A 366 bp region covering the overlapping surface/polymerase gene of HBV was then amplified in a nested PCR and the amplicons sequenced using Sanger sequencing. The resulting sequences were then analyzed for genotypes and for escape and drug resistance mutations.


Twenty samples were HBV DNA positive and were classified as OBI giving a prevalence of 5.9%. Out of these, 9 (45%) were anti-HBs positive, while 10 (52.6%) were anti-HBc positive. Additionally, 2 had dual anti-HBs and anti-HBc reactivity, while 6 had no detectable HBV antibodies. Out of the ten samples that were successfully sequenced, nine were classified as genotype E and one as genotype A. Three sequences possessed mutations associated with lamivudine resistance. We detected a number of mutations within the major hydrophilic region of the surface gene where most immune escape mutations occur.


Findings from this study show the presence of hepatitis B in patients without any of the HBV serological markers. Further prospective studies are required to determine the risk factors and markers of OBI.
Additional file 1: Figure S1. A representation gel showing amplified HBV DNA from HBsAg negative plasma. Lane L is a 100 bp molecular weight marker. Expected DNA band sizes of 366 bp were readily detected for samples on lanes 2, 5, 7, 8, 10–14. Lane P is a positive control obtained from the PCR optimization process and confirmed by sequencing. Lane N is a negative control (sterilized distilled water used as template).
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