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Angounda BM, Ngouloubi GH, Dzia AB, Boumba LMA, Baha W, Moukassa D, Ahombo G, Ennaji MM, Ibara JR. Molecular characterization of hepatitis B virus among chronic hepatitis B patients from Pointe Noire, Republic of Congo. Infect Agent Cancer 2016; 11:51. [PMID: 27651827 PMCID: PMC5025608 DOI: 10.1186/s13027-016-0088-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 06/24/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic Hepatitis B infection is a major health problem in Republic of Congo therefore molecular analysis of HBV strains is important to detect the patients at high risk of disease progression. METHODS Serum samples were obtained from 111 chronic HBV patients in Pointe Noire. HBsAg, HBeAg and HBeAb were detected. A fragment of the preS1 region of HBV was amplified and sequenced to determine genotypes, subgenotypes and to identify mutations. RESULTS Of the 111 samples analyzed, 35 patients were asymptomatic carriers (ASC), 24 with a chronic active hepatitis (CAH), 33 with liver cirrhosis (LC) and 19 have a hepatocellular carcinoma (HCC). The mean age were 45 ± 13 year, 88 (79.3 %) were male and 23 (20.7 %) female. The prevalence of HBeAg was 15.3 % and 73 % of subjects were anti-HBe positive. The mean serum level of alanine aminotransferase transaminase (ALT) and aspartate transaminase (AST) was 25.1 ± 9 IU/L and 28.6 ± 10 IU/L respectively. Eighty two samples out of 111 (73.9 %) were genotyped by the analyzing of the S region of HBV, 58 (70.7 %) cases belonged to HBV genotype E and 24 (29.3 %) were genotype A with three subgenotypes; A3 (66.7 %), A4 (20.8 %) and A6 (12.5 %). Prevalence of genotype A was relatively high in CAH (33.3 %) and HCC (31.6 %) patients in comparison with other groups. The most prevalent amino acids substitutions were R38K found in 14 (17.1 %) sequences, following by H44L in 11 (13.4 %), K13E in 8 (9.8 %), N29K in 8 (9.8 %), A35E in 8 (9.8 %), V80I in 7 (8.5 %) and in 6 (7.3 %) sequences for S90T. Different substitutions located in the hepatocyte binding site were higher among patients with LC and HCC (p < 0.05). CONCLUSIONS This study have shown that HBV genotype E and A were the most frequent strains circulating in Republic of Congo patients. HBV pres1 substitutions found in this study were associated with severe clinical forms of liver diseases. This data have shown the importance of implementing an effective program to fight HBV infection.
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Affiliation(s)
- Brunel Monic Angounda
- Laboratory of screening of the transmitted infectious diseases, National Blood Transfusion Centre, Brazzaville, Republic of Congo
- Cellular and Molecular Biology Laboratory, Faculty of Science and Technology, University Marien NGOUABI, Brazzaville, Congo
- Laboratory of Virology, Microbiology, Quality and Biotechnologies/Eco-toxicology and biodiversity, Virology Team, Cancerology, Quality and Medical Biotechnology, Faculty of Science and Techniques Mohammedia University Hassan II of Casablanca, BP: 146, Mohammedia, 20650 Morocco
| | | | - Amélia Bokilo Dzia
- Laboratory of screening of the transmitted infectious diseases, National Blood Transfusion Centre, Brazzaville, Republic of Congo
- Faculty of Health Sciences, University Marien NGOUABI, Brazzaville, Congo
| | - Luc Magloire Anicet Boumba
- Laboratory of Virology, Microbiology, Quality and Biotechnologies/Eco-toxicology and biodiversity, Virology Team, Cancerology, Quality and Medical Biotechnology, Faculty of Science and Techniques Mohammedia University Hassan II of Casablanca, BP: 146, Mohammedia, 20650 Morocco
- Faculty of Health Sciences, University Marien NGOUABI, Brazzaville, Congo
- General Laondjili Hospital, Pointe-Noire, Congo
| | - Warda Baha
- Laboratory of Virology, Microbiology, Quality and Biotechnologies/Eco-toxicology and biodiversity, Virology Team, Cancerology, Quality and Medical Biotechnology, Faculty of Science and Techniques Mohammedia University Hassan II of Casablanca, BP: 146, Mohammedia, 20650 Morocco
| | - Donatien Moukassa
- Faculty of Health Sciences, University Marien NGOUABI, Brazzaville, Congo
- General Laondjili Hospital, Pointe-Noire, Congo
| | - Gabriel Ahombo
- Cellular and Molecular Biology Laboratory, Faculty of Science and Technology, University Marien NGOUABI, Brazzaville, Congo
| | - Moulay Mustapha Ennaji
- Laboratory of Virology, Microbiology, Quality and Biotechnologies/Eco-toxicology and biodiversity, Virology Team, Cancerology, Quality and Medical Biotechnology, Faculty of Science and Techniques Mohammedia University Hassan II of Casablanca, BP: 146, Mohammedia, 20650 Morocco
| | - Jean-Rosaire Ibara
- Faculty of Health Sciences, University Marien NGOUABI, Brazzaville, Congo
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Kim J, Lee SH, Kim HS, Choi K, Jeong SW, Kim SG, Jang JY, Kim YS, Kim BS. Long-term outcomes and dynamics of mutants associated with lamivudine-adefovir rescue therapy in patients with lamivudine-resistant chronic hepatitis B. Gut Liver 2015; 9:103-8. [PMID: 25287170 PMCID: PMC4282849 DOI: 10.5009/gnl14018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background/Aims To investigate the association between the baseline profiles and dynamics of hepatitis B virus (HBV) DNA polymerase gene mutations and the long-term virological response of lamivudine (LAM)-adefovir (ADV) combination therapy in patients with LAM-resistant chronic hepatitis B. Methods Seventy-five patients who received LAM-ADV combination therapy for more than 12 months were analyzed. Restriction fragment mass polymorphism assays were used to detect and monitor the dynamics of LAM- and ADV-resistant mutations. Results The median duration of LAM-ADV combination therapy was 26 months (range, 12 to 58 months). The baseline mutation profiles, rtM204I (p=0.992), rtM204I/V (p=0.177), and rtL180M (p=0.051), were not correlated with the cumulative virological response, and the baseline HBV DNA level (p=0.032) was the only independent predictive factor for cumulative virological response. Tests for LAM- and ADV-resistant mutations were performed in 12 suboptimal responders in weeks 48 and 96. The population of rtM204 mutants persisted or increased in 8 of 12 patients, and rtA181T mutants newly emerged as a minor population in four patients until 96 weeks. Nevertheless, the viral loads progressively decreased during rescue therapy, and these dynamics did not correlate with virological response. Conclusions The baseline profile and dynamics of LAM-resistant mutations during LAM-ADV combination therapy are not associated with a virological response.
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Affiliation(s)
- Jihyun Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Sae Hwan Lee
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hong Soo Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Kanghyug Choi
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Soung Won Jeong
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jae Young Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Boo Sung Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
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Koumbi L. Current and future antiviral drug therapies of hepatitis B chronic infection. World J Hepatol 2015; 7:1030-1040. [PMID: 26052392 PMCID: PMC4450180 DOI: 10.4254/wjh.v7.i8.1030] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/12/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023] Open
Abstract
Despite significant improvement in the management of chronic hepatitis B virus (HBV) it remains a public health problem, affecting more than 350 million people worldwide. The natural course of the infection is dynamic and involves a complex interplay between the virus and the host’s immune system. Currently the approved therapeutic regimens include pegylated-interferon (IFN)-α and monotherapy with five nucleos(t)ide analogues (NAs). Both antiviral treatments are not capable to eliminate the virus and do not establish long-term control of infection after treatment withdrawal. IFN therapy is of finite duration and associates with low response rates, liver decompensating and numerous side effects. NAs are well-tolerated therapies but have a high risk of drug resistance development that limits their prolonged use. The imperative for the development of new approaches for the treatment of chronic HBV infection is a challenging issue that cannot be over-sided. Research efforts are focusing on the identification and evaluation of various viral replication inhibitors that target viral replication and a number of immunomodulators that aim to restore the HBV specific immune hyporesponsiveness without inducing liver damage. This review brings together our current knowledge on the available treatment and discusses potential therapeutic approaches in the battle against chronic HBV infection.
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Lee AJ, Lee CH, Jeon CH. Analysis of reverse transcriptase gene mutations in the hepatitis B virus at a university hospital in Korea. Ann Lab Med 2014; 34:230-4. [PMID: 24790911 PMCID: PMC3999322 DOI: 10.3343/alm.2014.34.3.230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 10/07/2013] [Accepted: 02/13/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Most mutations in the reverse transcriptase (RT) gene of the hepatitis B virus (HBV) are related to resistance to antiviral agents. Cross-sectional studies on the mutations of this gene are rare. Thus, we analyzed the mutation patterns of RT genes and their biochemical parameters. METHODS From 2009 to 2012, 301 blood specimens from patients with chronic hepatitis B at Daegu Catholic University Medical Center were retrospectively analyzed for the RT gene sequence of HBV, ALT, hepatitis B e antigen (HBeAg), and HBV DNA. The mutation patterns of the RT gene were compared with the biochemical parameters. RESULTS Of the 301 patients, 100 (33.2%) had no RT gene mutations. The remaining showed the following mutation patterns: rtM204I/V (50.2%), rtL180M (39.2%), and rtA181T/V (19.6%). Combined mutations were found in 146 cases (48.5%). Of these, the combination of amino acid changes at rt180+rt204 (49.3%) was most frequently detected, followed by rt181+rt236 (11.0%) and rt173+rt180+rt204 (9.6%). In the mutated group, HBV DNA and HBeAg positive rates were significantly higher (P<0.05 for both). Phenotypic analysis showed that lamivudine resistance was most frequently detected (34.6%), followed by adefovir resistance (15.6%). Multidrug resistance was detected in 48 cases (15.9%). The adefovir-resistant group had a higher proportion of cases with HBV loads greater than 2,000 IU/mL. CONCLUSIONS We found correlations between the mutation status of the RT domain and biochemical parameters such as HBV DNA and HBeAg positive rate. The presence of RT gene mutations could therefore be utilized to predict clinical status.
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Affiliation(s)
- A-Jin Lee
- Department of Laboratory Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Chang Hyeong Lee
- Department of Internal Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Chang-Ho Jeon
- Department of Laboratory Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea
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Yim HJ, Hwang SG. Options for the management of antiviral resistance during hepatitis B therapy: reflections on battles over a decade. Clin Mol Hepatol 2013; 19:195-209. [PMID: 24133659 PMCID: PMC3796671 DOI: 10.3350/cmh.2013.19.3.195] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/18/2013] [Indexed: 12/14/2022] Open
Abstract
Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance.
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Affiliation(s)
- Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Antiviral Resistance Study Group, Korea
| | - Seong Gyu Hwang
- Department of Internal Medicine, CHA University School of Medicine, Seongnam, Korea
- Antiviral Resistance Study Group, Korea
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Yim HJ, Seo YS, Yoon EL, Kim CW, Lee CD, Park SH, Lee MS, Park CK, Chae HB, Kim MY, Baik SK, Kim YS, Kim JH, Lee JI, Lee JW, Hong SP, Um SH. Adding adefovir vs. switching to entecavir for lamivudine-resistant chronic hepatitis B (ACE study): a 2-year follow-up randomized controlled trial. Liver Int 2013; 33:244-54. [PMID: 23295056 DOI: 10.1111/liv.12036] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 10/15/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Management of lamivudine-resistant chronic hepatitis B (CHB) remains challenging, as inappropriate choice of treatment may cause multidrug resistance. Until now, randomized trials directly comparing adding adefovir and switching to entecavir monotherapy have not been reported. AIMS This multicentre prospective randomized study was designed to compare the efficacy of these two strategies. METHODS Two hundred and nineteen lamivudine-resistant CHB patients were randomized to either adefovir-lamivudine combination group or entecavir monotherapy group (n = 110 vs. 109), and followed up for 24 months. RESULTS One hundred and eighty patients completed this study. At month 24, virological response rate [hepatitis B virus (HBV) DNA <60 IU/ml] was higher in the adefovir-lamivudine combination group compared with entecavir group (56.7% vs. 40%, P = 0.025), although biochemical and serological response rates were not significantly different. Genotypic resistance (9.2% vs. 24.6%, P = 0.005) and combined viral breakthrough (2.0% vs. 17.6%, P < 0.001) were more frequent in the entecavir group. However, by subgroup analysis, virological response rates were not significantly different between the two therapies in HBeAg-positive patients (44.9% vs. 35.7%, P = 0.268) or in patients with high baseline HBV DNA (≥7 log IU/ml) (40.7% vs. 31.3%, P = 0.320) at month 24. CONCLUSION This study showed that adefovir-lamivudine combination provides significantly higher antiviral efficacy and the lower resistance rate compared with the entecavir monotherapy in the management of lamivudine-resistant CHB. However, it had limited efficacy in HBeAg-positive patients or in patients with high baseline HBV DNA.
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Affiliation(s)
- Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Molecular epidemiological study of hepatitis B virus in blood donors from five Chinese blood centers. Arch Virol 2012; 157:1699-707. [PMID: 22669316 PMCID: PMC3431469 DOI: 10.1007/s00705-012-1331-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 03/29/2012] [Indexed: 12/18/2022]
Abstract
Although the genetic variability of hepatitis B virus (HBV) in HBV-infected patients has been extensively studied, reports on genotypes, subtypes and mutations in the S region of HBV strains from Chinese blood donors are limited. In this study, 245 blood samples from HBsAg-positive blood donors were collected from five geographically diverse blood centers in China. The S region of HBV was amplified, and the HBV genotype and subtype were determined. The amino acid sequences of the S region were aligned, and mutations related to the failure of immunization and HBsAg detection were determined. Of the 245 samples, 228 (93 %) were genotyped successfully. We found that genotypes B, C, D and A accounted for 58.8 %, 21.9 %, 6.6 % and 3.95 % of the isolates, respectively. The distribution of HBV antigen subtypes was as follows: adw (67.6 %), adr (23.3 %) and ayw (8.7 %). Mutations were present in 39 (17.1 %) of 228 samples in the major hydrophilic region (MHR) of the S region. This study demonstrated that HBV genotype/subtype B/adw was the most frequent strain circulating in HBV-infected Chinese blood donors, followed by C/adr. The occurrence of MHR mutants in HBV-infected blood donors and the potential failure to detect some of them in collected units poses a threat to transfusion safety.
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Yang CH, Song BC, Cho M. A natural mutation of the hepatitis B virus X gene affects cell cycle progression and apoptosis in Huh7 cells. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s13765-012-2012-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Wu HY, Chang CI, Lin BW, Yu FL, Lin PY, Hsu JL, Yen CH, Liao MH, Shih WL. Suppression of hepatitis B virus x protein-mediated tumorigenic effects by ursolic Acid. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2011; 59:1713-22. [PMID: 21314126 DOI: 10.1021/jf1045624] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study investigated the potential effects of natural products ursolic acid (UA) and oleanolic acid (OA) against HBx-mediated tumorigenic activities in vitro and in vivo. HBx transactivated Sp-1 and Smad 3/4 in Huh7 and FL83B hepatocytes and induced cell migration of Huh7 and HepG2. HBx also induced MMP-3 secretion in Huh7 and acted against TGF-β-induced apoptosis in Hep3B. UA almost completely blocked the HBx-mediated effects, while OA had a partial inhibitive effect. Utilization of specific MAPK inhibitors and immunoblotting demonstrated that UA selectively activated MAPK signaling in certain tested cells. Preintraperitoneal injection of UA fully prevented the tumor growth of HBV-containing 2.2.15 cells, while OA-treated mice had smaller tumors than the control group. Our results suggested that UA possesses a hepatoprotective ability and illustrated the evident effects against HBx-mediated tumorigenic activities without toxicity in a mouse model.
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Affiliation(s)
- Hong-Yin Wu
- Graduate Institute of Biotechnology, National Pingtung University of Science and Technology, 1, Shuefu Rd., Neipu, Pingtung, 91201, Taiwan
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