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Iannetta M, Crea AMA, Di Lorenzo A, Campogiani L, Teti E, Malagnino V, Compagno M, Coppola L, Piermatteo L, Palmieri G, Cimino C, Salpini R, Zingaropoli MA, Ciardi MR, Mastroianni CM, Parisi SG, Svicher V, Andreoni M, Sarmati L. Hepatitis B-related hepatic flare during immune reconstitution syndrome after antiretroviral treatment initiation in an HBV surface antigen-positive patient with HIV: viroimmunological and histological characterization. Open Forum Infect Dis 2022; 9:ofac451. [PMID: 36092833 PMCID: PMC9454030 DOI: 10.1093/ofid/ofac451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022] Open
Abstract
HIV and hepatitis B virus (HBV) coinfection is relatively common. Initiation of antiretroviral therapy (ART) in people with HIV (PWH) causes a progressive restoration of cell-mediated immune functions. In the presence of overt or occult coinfections, immune restoration might lead to immune reconstitution inflammatory syndrome (IRIS). Here, we describe the clinical, immunological, virological, and histological characterization of a case of HBV-related IRIS hepatitis in a PWH after ART initiation. A liver biopsy was performed during HBV-related IRIS hepatic flare, and liver samples were analyzed through immunohistochemistry and molecular techniques, with the assessment of intrahepatic HBV-DNA, covalently closed circular DNA, and HBV pregenomic RNA through a droplet digital polymerase chain reaction system. Immune activation and senescence were also longitudinally assessed. In this clinical case, the hepatic flare occurred 6 weeks after ART initiation with a therapeutic regimen including tenofovir alafenamide (TAF) and emtricitabine (FTC). The episode was self-limiting, characterized by hyperactivation of peripheral blood CD4+ and CD8+ T-lymphocytes, and resolved without ART discontinuation, leading to the achievement of HBsAg seroconversion (HBsAg-/HBsAb+) and HBV-DNA plasma undetectability. Notably, hyperactivation of the immune system plays a pivotal role in promoting the control of HBV replication, thus triggering the achievement of HBsAg seroconversion during treatment with TAF/FTC.
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Affiliation(s)
- M Iannetta
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - A M A Crea
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - A Di Lorenzo
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Campogiani
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - E Teti
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - V Malagnino
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - M Compagno
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Coppola
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Piermatteo
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
| | - G Palmieri
- Department of Biomedicine and Prevention, Tor Vergata University , Rome , Italy
| | - C Cimino
- Department of Biomedicine and Prevention, Tor Vergata University , Rome , Italy
| | - R Salpini
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
| | - M A Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - M R Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - S G Parisi
- Department of Molecular Medicine, University of Padova , Padua , Italy
| | - V Svicher
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
- Department of Biology, Tor Vergata University , Rome , Italy
| | - M Andreoni
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Sarmati
- Department of System Medicine, Tor Vergata University , Rome , Italy
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Wandera BO, Onyango DM, Musyoki SK. Hepatitis B virus genetic multiplicity and the associated HBV lamivudine resistance mutations in HBV/HIV co-infection in Western Kenya: A review article. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 98:105197. [PMID: 34954390 DOI: 10.1016/j.meegid.2021.105197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infections are common as the two viruses use same routes of transmission. Studies show that HIV infection modifies the natural course of chronic HBV infection, leading to more severe and progressive liver disease, and a higher incidence of cirrhosis, liver cancer and mortality. Therefore, determining HBV status and genotypes among HIV co-infected patients would improve their therapeutic management. OBJECTIVE This article reviewed the HBV genetic multiplicity and the associated HBV Lamivudine resistance mutations in HBV/HIV co-infection in western Kenya. METHODS Comprehensive literature searches and analysis were performed in peer-reviewed journals in the National council for biotechnology information (NCBI), PubMed, and Web of science using key words of HIV, Hepatitis B genotypes, HBV/HIV co-infection and Lamivudine resistance. RESULTS HBV genotype A is predominant. D and E are also present in Kenya and neighboring countries in the region. HBV polymerase rtV173L, rtL180M, and rtM204V major substitutional mutations were identified. Currently, TDF + 3TC + DTG are recommended for treatment of HBV/HIV co-infection. CONCLUSION Evidence shows that HBV/HIV co-infection places a heavy burden to the society. Along with ART regimen, HBV genotype is a major factor determining the course of disease and treatment outcome. Treating HIV in HBV/HIV co-infection with antiretroviral agents may result in a very high prevalence of HBV 3TC-resistance mutations. Therefore, improved screening for HBV and extended follow-up of HBV/HIV co-infected individuals is needed to better understand the impact of different ART regimens on clinical outcomes.
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Affiliation(s)
- Bernard Onyango Wandera
- School of Biological and Physical Sciences, Maseno University, P.O. Box Private Bag, Maseno, Kisumu, Kenya.
| | - David Miruka Onyango
- School of Biological and Physical Sciences, Maseno University, P.O. Box Private Bag, Maseno, Kisumu, Kenya
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Wan Q, Anugwom C, Desalegn H, Debes JD. Hepatocellular carcinoma in Hepatitis B and Human Immunodeficiency Virus coinfection in Africa: a focus on surveillance. HEPATOMA RESEARCH 2022; 8:39. [PMID: 36277115 PMCID: PMC9583937 DOI: 10.20517/2394-5079.2022.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Human immunodeficiency virus (HIV) and hepatitis-B virus (HBV) infections are weighty public health challenges, especially in the African continent. The direct carcinogenic effect of HBV means that it remains a potent cause of early-onset hepatocellular carcinoma (HCC) in Sub-Saharan Africa (SSA), where it causes significant morbidity and mortality. The presence of HIV infection in HBV-infected patients poses a complicating factor, as coinfection has been shown to hasten the progression of liver disease to cirrhosis and HCC, and often resulting in early-age hepatocarcinogenesis with consequent late diagnosis and lower survival. In this review, we discuss this unique conundrum, the epidemiology of HIV-HBV coinfection in SSA, its effect on liver disease and development of HCC, as well as practices and barriers to HCC surveillance in this distinct population. We propose a way forward to curb this considerable health burden focusing on reduction of disease stigma, the need for easy-to-measure biomarkers, and implementation of large prospective studies in this population.
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Affiliation(s)
- Qian Wan
- Department of Medicine, Division of Infectious Disease and International Medicine & Division of Gastroenterology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Chimaobi Anugwom
- Department of Medicine, Division of Infectious Disease and International Medicine & Division of Gastroenterology, University of Minnesota, Minneapolis, MN 55455, USA.,Health Partners Digestive Care, Minneapolis, MN 55455, USA
| | | | - Jose D. Debes
- Department of Medicine, Division of Infectious Disease and International Medicine & Division of Gastroenterology, University of Minnesota, Minneapolis, MN 55455, USA.,Arusha Lutheran Medical Centre, Arusha, Tanzania
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Moutchia J, Njouom R, Rumpler E, Besombes C, Texier G, Tejiokem M, Crépey P, Fontanet A, Shimakawa Y. Maternal age at first childbirth and geographical variation in HBV prevalence in Cameroon: Important role of mother-to-child transmission. Clin Infect Dis 2021; 74:836-845. [PMID: 34125878 DOI: 10.1093/cid/ciab548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The prevalence of hepatitis B virus (HBV) infection varies geographically around the world. However, the underlying reasons for this variation are unknown. Using a nationally representative population-based sample from all 58 administrative divisions in Cameroon, we examined the association between median maternal age at first childbirth in a preceding generation, a proxy for the frequency of mother-to-child transmission (MTCT) of HBV in a region, and the risk of chronic HBV infection, defined as positive surface antigen (HBsAg), in the index generation. METHODS We estimated a division-specific median maternal age at first childbirth using historical data from Demographic Health Surveys (DHS) in 1991/1998/2004/2011. We tested HBsAg in 2011 DHS participants. We used maps to display spatial variation and spatial models for the analysis. RESULTS In 14,150 participants (median 27 years old, 51% females), the overall weighted prevalence of HBsAg was 11.9% (95%CI: 11.0-12.8), with a wide geographical variation across the divisions (range: 6.3-23.7%). After adjusting for confounding factors and spatial dependency, lower maternal age at first childbirth was significantly associated with positive HBsAg at the division level (β: 1.89 [95%CI: 1.26-2.52], p<0.001), and at the individual level (OR: 1.20 [95%CI: 1.04-1.39], p=0.016). A similar ecological correlation was observed across other African countries. CONCLUSIONS The significant association between the maternal age at first childbirth and HBsAg-positivity suggests a crucial role of MTCT in maintaining high HBV endemicity in some areas in Cameroon. This underlines an urgent need to effectively prevent MTCT in order to achieve WHO's global hepatitis elimination goals.
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Affiliation(s)
- Jude Moutchia
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.,REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Université Rennes, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Eva Rumpler
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Camille Besombes
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Gaëtan Texier
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaoundé, Cameroon.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, Marseille, France
| | - Mathurin Tejiokem
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Pascal Crépey
- REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Université Rennes, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Arnaud Fontanet
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.,PACRI unit, Conservatoire National des Arts et Métiers, Paris, France
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
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Kasera GO, Nyamache AK, Onyango OK, Maingi JM. Hepatitis B virus genetic heterogeneity and drug resistance among jaundiced patients at Coast General Teaching and Referral Hospital, Mombasa County, Kenya. Int J Health Sci (Qassim) 2021; 15:20-25. [PMID: 34234632 PMCID: PMC8220643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES Hepatitis B virus (HBV) infection and emergence of drug resistance have remained one of the major public health puzzles. This study determined circulating HBV genotypes and nucleoside analog resistance to provide information in choosing the best therapy. METHODS A cross-sectional study was conducted among jaundiced patients visiting Coast General Teaching and Referral Hospital during the period between February and August 2018. A total of 222 patients were recruited and screened for HBsAg following the ethical procedure. Viral DNA was extracted from positive samples, partial HBV-pol gene amplified, and directly sequenced and analyzed using web-based software prediction to genotypic resistance mutations. RESULTS Forty-seven (21.2%) of the 222 patients tested positive for HBV. Of the 45 samples successfully sequenced, 12 (26.4%) had drug resistance. Six patients (13.3%) had rtV173L, rtL180M, and rtM204V mutations; five subjects (11.1%) with rtL180M and rtM204V while 1 patient (2.2%) had rtM204V mutations. Therefore, all patients had cross-resistance to lamivudine and entecavir. Phylogenetic analysis revealed that HBV genotype A1 35 (74.5%) was predominant. HBV genotypes A3, B, and C2 each occurred once (0.02%). In addition, existence of new HBV genotypes A3, B, and C2 1 (0.02%) in the country was also detected. CONCLUSION Findings suggest that HBV-infected patients should not be put on lamivudine monotherapy. These patients should be on a combination therapy; tenofovir plus lamivudine or emtricitabine to prevent emergence of drug resistance variants. In addition, HBV genotype A1 remains the most predominant genotype in this region. The detected new genotypes variants indicate a possible existence of 0.02% circulation within the population.
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Affiliation(s)
- Gordon Ochieng' Kasera
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya
| | - Anthony Kebira Nyamache
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya
| | - Omondi Kevin Onyango
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya
| | - John M Maingi
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya
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Mokaya J, McNaughton AL, Hadley MJ, Beloukas A, Geretti AM, Goedhals D, Matthews PC. A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. PLoS Negl Trop Dis 2018; 12:e0006629. [PMID: 30080852 PMCID: PMC6095632 DOI: 10.1371/journal.pntd.0006629] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/16/2018] [Accepted: 06/22/2018] [Indexed: 12/14/2022] Open
Abstract
International sustainable development goals for the elimination of viral hepatitis as a public health problem by 2030 highlight the pressing need to optimize strategies for prevention, diagnosis and treatment. Selected or transmitted resistance associated mutations (RAMs) and vaccine escape mutations (VEMs) in hepatitis B virus (HBV) may reduce the success of existing treatment and prevention strategies. These issues are particularly pertinent for many settings in Africa where there is high HBV prevalence and co-endemic HIV infection, but lack of robust epidemiological data and limited education, diagnostics and clinical care. The prevalence, distribution and impact of RAMs and VEMs in these populations are neglected in the current literature. We therefore set out to assimilate data for sub-Saharan Africa through a systematic literature review and analysis of published sequence data, and present these in an on-line database (https://livedataoxford.shinyapps.io/1510659619-3Xkoe2NKkKJ7Drg/). The majority of the data were from HIV/HBV coinfected cohorts. The commonest RAM was rtM204I/V, either alone or in combination with associated mutations, and identified in both reportedly treatment-naïve and treatment-experienced adults. We also identified the suite of mutations rtM204V/I + rtL180M + rtV173L, that has been associated with vaccine escape, in over 1/3 of cohorts. Although tenofovir has a high genetic barrier to resistance, it is of concern that emerging data suggest polymorphisms that may be associated with resistance, although the precise clinical impact of these is unknown. Overall, there is an urgent need for improved diagnostic screening, enhanced laboratory assessment of HBV before and during therapy, and sustained roll out of tenofovir in preference to lamivudine alone. Further data are needed in order to inform population and individual approaches to HBV diagnosis, monitoring and therapy in these highly vulnerable settings.
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Affiliation(s)
- Jolynne Mokaya
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Anna L. McNaughton
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Martin J. Hadley
- Oxford University Academic IT Department, Oxford, United Kingdom
| | - Apostolos Beloukas
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Anna-Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Dominique Goedhals
- Division of Virology, University of the Free State/National Health Laboratory Service, Bloemfontein, Republic of South Africa
| | - Philippa C. Matthews
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Microbiology and Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headington, Oxford, United Kingdom
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Molu JP, Essome MCN, Monamele CG, Njouom R. Sero-prevalence of HBsAg in naive HIV-infected patients in a rural locality of Cameroon. BMC Res Notes 2018; 11:39. [PMID: 29338763 PMCID: PMC5771100 DOI: 10.1186/s13104-018-3159-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/11/2018] [Indexed: 02/07/2023] Open
Abstract
Objective This study was performed in order to fill the gap of knowledge regarding sero-epidemiology of hepatitis B virus (HBV) amongst Human Immunodeficiency virus (HIV)-infected patients and to assess the risk factors associated with HBV co-infection in a rural locality of Cameroon. A retrospective and cross-sectional study was carried out from January 2008 to April 2014 within the Mfou District Hospital. Naive HIV-infected patients were enrolled in the study and tested for hepatitis B surface antigen (HBsAg). Preliminary pre-therapeutic data essential for follow-up was collected from the participants. Results Overall, the sample size was constituted of 712 HIV-infected patients. The prevalence of HBsAg was 8.99%. A significant difference was observed in the proportion of HBsAg positive subjects with respect to the year of inclusion; higher proportions were observed between 2011 and 2014 (P-value = 0.007). Majority of HBV co-infected participants had severe immuno-suppression with CD4 counts lower than 100 cells/µL as compared to HIV mono-infected population but the difference was not statistically significant. Our results confirm the high prevalence for HBV infection among HIV-infected patients in the Mfou District Hospital. These findings will enable stake holders to be better armed in the elimination of viral hepatitis as a public health problem.
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Affiliation(s)
- Jean-Patrick Molu
- Laboratoire de Biologie Humaine, Centre de Recherches Médicales, Institut de Recherches Médicales et d'Etudes de Plantes Médicinales, PO Box 13033, Yaounde, Cameroon
| | | | - Chavely Gwladys Monamele
- Department of Microbiology and Parasitology, University of Buea, PO Box 63, Buea, Cameroon.,Centre Pasteur of Cameroun, PO Box 1274, Yaoundé, Cameroon
| | - Richard Njouom
- Centre Pasteur of Cameroun, PO Box 1274, Yaoundé, Cameroon.
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Oladeinde BH, Ekejindu IM, Omoregie R, Odia I, Aguh OD, Okwu UM. New strains of hepatitis B virus genotype E circulating in Nigeria. Int J Health Sci (Qassim) 2018; 12:25-29. [PMID: 30534040 PMCID: PMC6257873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Hepatitis B virus (HBV) is not uncommon among persons infected with human immunodeficiency virus (HIV). Severity of HBV infection and treatment outcome are associated with specific HBV genotypes. No study has reported the types of HBV genotypes circulating among HIV-infected subjects in Nigeria. This study was designed to determine the prevalence of HBV, as well as its genotypic distribution among HIV-infected subjects in Benin City, Nigeria. METHODS Whole blood was collected from a total of 564 HIV-infected and 250 apparently healthy HIV-negative subjects. Serodiagnosis of HBV infection was done using an immunochromatographic kit. Detection of HBV-DNA and sequencing of amplicons were done using standard molecular techniques. RESULTS HIV status was not significantly associated with HBV seroinfection (HIV vs. non-HIV: 4.6% vs. 4.0%; odds ratio = 1.168, 95% confidence interval = 0.550, 2.444, and P = 0.854). HIV-infected subjects were observed to have an insignificantly (P = 0.645) higher prevalence of true HBV infection than their non-HIV-infected counterparts (HIV positive vs. HIV negative: 23.1% vs. 10.0%). All patients with true HBV infection were found to harbor HBV genotype E, which did not cluster around other HBV genotype E. CONCLUSION This study reports novel strains of HBV genotype E circulating in Nigeria.
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Affiliation(s)
- Bankole H. Oladeinde
- Department of Medical Laboratory Science, Edo University, Iyamho, Edo State, Nigeria,Address for correspondence: Bankole H. Oladeinde, Department of Medical Laboratory Science, Edo University Iyamho, Edo State, Nigeria. Tel.: +2348053096120. E-mail:
| | - Ifeoma M. Ekejindu
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, College of Health Science, Nnamdi Azikiwe University, Awka, Nigeria
| | - Richard Omoregie
- School of Medical Laboratory Sciences, University of Benin Teaching Hospital, Benin City, Nigeria,Medical Microbiology Unit, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Ikpomwonosa Odia
- Institute of Lassa Fever Research and Control, Irrua Specialist Hospital, Irrua, Edo State, Nigeria
| | - Obiora D. Aguh
- Medical Microbiology Unit, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Uchechukwu M. Okwu
- Department of Biological Sciences (Microbiology), College of Natural and Applied Sciences, Igbinedion University, Okada, Edo State, Nigeria
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Ghoma Linguissi LS, Nkenfou CN. Epidemiology of viral hepatitis in the Republic of Congo: review. BMC Res Notes 2017; 10:665. [PMID: 29197421 PMCID: PMC5712139 DOI: 10.1186/s13104-017-2951-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023] Open
Abstract
Objective Considered an endemic zone, Republic of Congo has a high seroprevalence rate of hepatitis B and C virus. To know the extent of hepatitis infection as a public health problem, we reviewed published literature and other sources for reports of these viral infections in the country. Results High seroprevalence of HBV and HCV carriage in blood donors were observed in studies confirming Congo’s place in the hyperendemic area of HBV and HCV infection. These prevalence were compared by Chi square test. We compared the prevalence of three studies conducted in 1996, 2015 and 2016. The statistical results were very significant. HBV genotype E was most prevalent. Very few studies were done on pregnant women. Difficulties in the care and management of patients were also noted because of the high cost of often unavailable treatments. Difficulties arise, however, when an attempt was made to implement the National Hepatitis Control Program. Despite studies conducted on hepatitis prevalence, health interventions are still needed to care and manage these patients and the need to implement the national hepatitis control is more pressing in the Congo.
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Affiliation(s)
| | - Celine Nguefeu Nkenfou
- Chantal Biya International Reference Centre for Research on Prevention and Management on HIV and AIDS, Yaounde, Cameroon.,Higher Teachers Training College, University of Yaounde I, Yaounde, Cameroon
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10
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Gachara G, Magoro T, Mavhandu L, Lum E, Kimbi HK, Ndip RN, Bessong PO. Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon. AIDS Res Ther 2017; 14:11. [PMID: 28270215 PMCID: PMC5341455 DOI: 10.1186/s12981-017-0136-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/15/2017] [Indexed: 12/16/2022] Open
Abstract
Purpose 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. Methods 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. Results 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. Conclusions 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. 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.
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