Evidence of HIV impact on HBV Genotypic Dominance in Coinfected Patients

MORETTI F, LAUFER N, CASSINO L, BOUZAS MB, FERNÁNDEZ S, PEREZ H, CAHN P, SALOMÓN H, QUARLERI J

Sydney, Australia

Conferencia; 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention; 2007

International AIDS Society

Evidence of HIV impact on HBV Genotypic Dominance in Coinfected Patients Moretti F1, Laufer N1, 3, Cassino L1, Bouzas MB2, Fernández S2, Perez H3, Cahn P3, Salomón H1 Quarleri J1 1Argentinean National Reference Center for AIDS, University of Buenos Aires; 2 F.J. Muñiz Hospital, Virology Unit, 3Fernández Hospital, Infectious Diseases Unit; Buenos Aires, Argentina. Objectives: Coinfection with hepatitis B virus (HBV) and HIV is one of the leading causes of morbidity and mortality. Different HBV genotypes have distinct geographical distribution associated with severity of liver disease. The present study aims to investigate the epidemiology of HBV genotypes among Argentinean patients coinfected with HIV-1.  In Argentina the HBV-F genotype is predominant among HIV-1 non-infected patients.Methods: A cross-sectional analysis examined HBV-related characteristics in a cohort of 246 HIV-1 patients who exhibited HBsAg and/or anti-HBc serological reactivity. HBV DNA detection and genotyping were carried out by PCR and by phylogenetic analyses of the surface (S) partial gene, respectively. Molecular cloning was performed in samples with unclear phylogenetic clustering. Recombinant analysis at the S gene was carried out by bootscanning. Results: HBV DNA was found in 24 out of 246 patients (9.8%); 4 of them with occult infection. The HBV genotype distribution was A: 83.3% (20/24); D: 8.3 % (2/24); F: 4.2% (1/24). One sample exhibited an heterogeneous viral population involving genotypes A and D and also 3 intergenotypic recombinants forms with different mosaic S-gene patterns at first; in a subsequent sample 18 months after, the HBV population was homogeneous and exclusively ascribed to genotype A. HBV occult infection was only related to genotype A. Genotype distribution was unrelated to a particular risk transmission group. Conclusions: We report data of HIV impact on HBV genotypic dominance in coinfected patients showing a switch toward a wide prevalence of HBV-A. Preliminary, this genotype appears to prevail against genotypes D and F when HIV is also present by unidentified reasons. Previously unknown HBV A-D intergenotypic recombinant strains with 3 different motifs were characterized by first time in South America. The modification of the HBV genotype pattern in HIV-coinfected patients may require new therapeutic strategies, and further survey studies.