Hepatitis B virus genotype G: Prevalence and impact in patients co-infected with human immunodeficiency virus

Authors

  • Doan Y. Dao,

    1. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • Jody Balko,

    1. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • Nahid Attar,

    1. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • Enayet Neak,

    1. Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • He-Jun Yuan,

    1. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • William M. Lee,

    1. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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  • Mamta K. Jain MD, MPH

    Corresponding author
    1. Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
    • UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9113.
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    • Assistant Professor.


  • Financial Disclosure: MKJ—Research Support Roche Pharmaceuticals, TaiMed Biologics, Gilead Sciences, Pfizer Inc., Boehringer Ingelheim, and Vertex Pharmaceuticals. Consulting: Merck Pharmaceuticals. Advisory Board: Vertex Pharmaceuticals, Boehringer Ingelheim. WML—Research Support Bristol Myers Squibb, Merck, Roche Pharmaceuticals, Schering Plough Research Institute, Vertex Pharmaceuticals. Consulting: FoldRx Pharma, Facet Biotech, GSK Pharmaceuticals, Gilead Sciences Inc., Merck, Lilly and Novartis.

Abstract

Relatively little is known about the role of hepatitis B virus (HBV) genotype G (HBV/G) in patients co-infected with human immunodeficiency virus (HIV) and HBV. This study examined the prevalence and association of HBV/G to liver fibrosis in co-infected patients. HBV genotypes were determined by direct sequencing of the HBV surface gene or Trugene® HBV 1.0 assay in 133 patients infected with HIV/HBV. Quantitative testing of HBV-DNA, HBeAg, and anti-HBe were performed using the Versant® HBV 3.0 (for DNA) and the ADVIA®Centaur assay. The non-invasive biomarkers Fib-4 and APRI were used to assess fibrosis stage. Genotype A was present in 103/133 (77%) of the cohort, genotype G in 18/133 (14%) with genotypes D in 8/133, (6%), F 2/133 (1.5%), and H 2/133 (1.5%). Genotype G was associated with hepatitis B e antigen-positivity and high HBV-DNA levels. Additionally, HBV/G (OR 8.25, 95% CI 2.3–29.6, P = 0.0012) was associated with advanced fibrosis score using Fib-4, whereas, being black was not (OR 0.19, 95% CI 0.05–0.07, P = 0.01). HBV/G in this population exhibited a different phenotype than expected for pure G genotypes raising the question of recombination or mixed infections. The frequent finding of HBV/G in co-infected patients and its association with more advanced fibrosis, suggests that this genotype leads to more rapid liver disease progression. Further studies are needed to understand why this genotype occurs more frequently and what impact it has on liver disease progression in patients with HBV/HIV. J. Med. Virol. 83:1551–1558, 2011. © 2011 Wiley-Liss, Inc.

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