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).
WHO. Hepatitis B fact sheet. 2016. http://www.who.int/mediacentre/factsheets/fs204/en/. Accessed 20 Sept 2016.
Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;385(9963):117–171. doi: 10.1016/S0140-6736(14)61682-2.
Sagnelli C, Macera M, Pisaturo M, Zampino R, Coppola M, Sagnelli E. Occult HBV infection in the oncohematological setting. Infection. 2016. doi: 10.1007/s15010-016-0891-1.
Marrone A, Zampino R, Karayannis P, Cirillo G, Cesaro G, Guerrera B, et al. Clinical reactivation during lamivudine treatment correlates with mutations in the precore/core promoter and polymerase regions of hepatitis B virus in patients with anti-hepatitis B e-positive chronic hepatitis. Aliment Pharmacol Ther. 2005;22(8):707–14. doi: 10.1111/j.1365-2036.2005.02653.x. CrossRefPubMed
Marite B, Montalvo MC, Rodriguez Lde L, Sariego S, Verdasquera D, Vincent M, et al. Occult hepatitis B in Cuban HIV patients. MEDICC Rev. 2011;13(2):32–7. PubMed
Firnhaber C, Chen CY, Evans D, Maskew M, Schulz D, Reyneke A, et al. Prevalence of hepatitis B virus (HBV) co-infection in HBV serologically-negative South African HIV patients and retrospective evaluation of the clinical course of mono- and co-infection. Int J Infect Dis. 2012;16(4):e268–72. doi: 10.1016/j.ijid.2011.12.007. CrossRefPubMed
Soriano V, Puoti M, Bonacini M, Brook G, Cargnel A, Rockstroh J, et al. Care of patients with chronic hepatitis B and HIV co-infection: recommendations from an HIV-HBV International Panel. AIDS. 2005;19(3):221–40. PubMed
- Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon
Helen K. Kimbi
Roland N. Ndip
Pascal O. Bessong
- BioMed Central
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