Hepatitis B genotype G and high frequency of lamivudine-resistance mutations among human immunodeficiencyvirus/hepatitis B virus co-infected patients in Brazil|
da Silva, Adriana Cristina; Spina, Ângela Maria Miranda; Lemos, Marcílio Figueiredo; Oba, Isabel Takano; de Fátima Guastini, Cristina; Gomes-Gouvêa, Michele Soares; Pinho, João Renato Rebello & Mendes-Correa, Maria Cássia Jacintho
In this study, we evaluated the hepatitis B virus (HBV) genotype distribution and HBV genomic mutations among a
group of human immunodeficiency virus-HBV co-infected patients from an AIDS outpatient clinic in São Paulo. HBV
serological markers were detected by commercially available enzyme immunoassay kits. HBV DNA was detected us-
ing in-house nested polymerase chain reaction and quantified by Cobas Amplicor. HBV genotypes and mutations in
the basal core promoter (BCP)/pre-core/core regions and surface/polymerase genes were determined by sequencing.
Among the 59 patients included in this study, 55 reported prior use of lamivudine (LAM) or tenofovir. HBV DNA was
detected in 16/22 patients, with a genotype distribution of A (n = 12,75%), G (n = 2,13%), D (n = 1,6%) and F (n = 1,6%).
The sequence data of the two patients infected with genotype G strongly suggested co-infection with genotype A. In 10
patients with viremia, LAM-resistance mutations in the polymerase gene (rtL180M + rtM204V and rtV173L + rtL180M
+ rtM204V) were found, accompanied by changes in the envelope gene (sI195M, sW196L and sI195M/sE164D). Muta-
tions in the BCP and pre-core regions were identified in four patients. In conclusion, genotype G, which is rarely seen
in Brazil, was observed in the group of patients included in our study. A high prevalence of mutations associated with
LAM-resistance and mutations associated with anti-HBs resistance were also found among these patients.
hepatitis B - HIV - genotypes - genotype G - mutation - lamivudine