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Farooqui N, Mir F, Siddiqui D, Hotwani A, Nathwani AA, Mahmood SF, Sadiq K, Kayani HA, Sheikh SA, Shah SA, Ferrand RA, Abidi SH. Phylogenetic and drug- and vaccine-resistance profiles of Hepatitis B Virus among children with HIV co-infection in Pakistan. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 105:105371. [PMID: 36179949 PMCID: PMC9614405 DOI: 10.1016/j.meegid.2022.105371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION HIV-1 and hepatitis B virus (HBV) share common routes of transmission and therefore co-infection is common. In 2019, an HIV-1 outbreak that resulted in >1000 children being infected, predominantly through nosocomial transmission, occurred in Sindh, Pakistan. We conducted a phylogenetic and drug resistance analysis of the HBV Reverse Transcriptase (RT) gene in children with HIV-1 and HBV co-infection. METHODOLOGY Blood samples were collected from 321 children with HIV who were recruited as part of a study to investigate the HIV-1 outbreak. All samples were tested for HBV surface antigen (HBsAg) using an ELISA assay, and positive samples were used to amplify and sequence the HBV RT gene. The phylogenetic relationship between sequences was analyzed, and drug- and vaccine- resistance mutations in the RT gene were explored. RESULTS Of 321 samples, 23% (n = 75) were positive for HBsAg on ELISA. Phylogenetic analysis of the sequences revealed that 63.5% of HBV sequences were sub-genotype D1, while the rest were sub-genotype D2. Cluster analysis revealed grouping of sub-genotype D1 sequences exclusively with Pakistani sequences, while clustering of sub-genotypes D2 predominantly with global sequences. The 236Y mutation associated with resistance to tenofovir was observed in 2.8% of HBV sequences. Additionally, seven vaccine escape mutations were observed, the most common being 128 V. CONCLUSION Our study suggests ongoing transmission of HBV D1 and D2 sub-genotypes in the HIV-1 co-infected population, likely nosocomially, given common routes of HVB and HIV-1 transmission. The prevalence of major HBV drug- and vaccine-resistant mutations remains low. Surveillance for further transmissions and the possible emergence of major drug- or vaccine-resistant variants is required.
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Affiliation(s)
- Nida Farooqui
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan; Department of Biosciences, The Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Fatima Mir
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Dilsha Siddiqui
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Apsara Ali Nathwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Kamran Sadiq
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Hammad Afzal Kayani
- Department of Biosciences, The Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | | | | | - Rashida Abbas Ferrand
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Syed Hani Abidi
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan; Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan.
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Erdinc FS, Dokuzoguz B, Unal S, Komur S, Inkaya AC, Inan D, Karaoglan I, Deveci A, Celen MK, Kose S, Erben N, Senturk GC, Heper Y, Kutlu SS, Hatipoglu CA, Sumer S, Kandemir B, Sirmatel F, Bayindir Y, Yilmaz E, Ersoy Y, Kazak E, Yildirmak MT, Kayaaslan B, Ozden K, Sener A, Kara A, Gunal O, Birengel S, Akbulut A, Yetkin F, Cuvalci NO, Sargin F, Pullukcu H, Gokengin D, Multicentric Hiv Study Group. Temporal Trends in the Epidemiology of HIV in Turkey. Curr HIV Res 2021; 18:258-266. [PMID: 32342820 DOI: 10.2174/1570162x18666200427223823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016. METHODS Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes. RESULTS A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy. CONCLUSION The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.
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Affiliation(s)
- F S Erdinc
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - B Dokuzoguz
- Ankara Numune Training and Researh Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Unal
- Hacettepe Universitesi Hastaneleri, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Komur
- Cukurova University, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey
| | - A C Inkaya
- Ankara Numune Training and Researh Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - D Inan
- Akdeniz University, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - I Karaoglan
- Gaziantep University, Department of Infectious Diseases and Clinical Microbiology, Gaziantep, Turkey
| | - A Deveci
- Ondokuz Mayis University, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - M K Celen
- Dicle University, Department of Infectious Diseases and Clinical Microbiology, Diyarbakır, Turkey
| | - S Kose
- Izmir Tepecik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
| | - N Erben
- Eskisehir Osmangazi University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
| | - G C Senturk
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Y Heper
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - S S Kutlu
- Pamukkale University, Department of Infectious Diseases and Clinical Microbiology, Denizli, Turkey
| | - C A Hatipoglu
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Sumer
- Selcuk University, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
| | - B Kandemir
- Necmettin Erbakan University, Meram Medical Faculty Hospital, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
| | - F Sirmatel
- Abant Izzet Baysal University, Department of Infectious Diseases and Clinical Microbiology, Bolu, Turkey
| | - Y Bayindir
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - E Yilmaz
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - Y Ersoy
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - E Kazak
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - M T Yildirmak
- Okmeydani Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - B Kayaaslan
- Yildirim Beyazit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - K Ozden
- Ataturk University, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
| | - A Sener
- Canakkale Onsekiz Mart University, Department of Infectious Diseases and Clinical Microbiology, Canakkale, Turkey
| | - A Kara
- Hacettepe University Ihsan Dogramaci Children's Hospital, Department of Infectious Diseases, Ankara, Turkey
| | - O Gunal
- Samsun Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - S Birengel
- Ankara University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - A Akbulut
- Firat University, Department of Infectious Diseases and Clinical Microbiology, Elazig, Turkey
| | - F Yetkin
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - N O Cuvalci
- Antalya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - F Sargin
- Medeniyet University Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Pullukcu
- Ege University, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - D Gokengin
- Ege University, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
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