Salpini Romina, Fokam Joseph, Ceccarelli Laura, Santoro Maria-Mercedes, Nanfack Aubin, Sosso Samuel Martin, Kowo Mathurin, Cento Valeria, Torimiro Judith, Sarmati Loredana, Andreoni Massimo, Colizzi Vittorio, Perno Carlo Federico, Njoya Oudou
Department of Experimental Medicine and Surgery University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy.
Curr HIV Res. 2016;14(2):165-71. doi: 10.2174/1570162x13666150930114742.
To investigate the prevalence and genotypic profile of overt and occult hepatitis-B infection (OBI) among HIV-infected individuals in Cameroon.
212 HIV-infected Cameroonians, aged 37.6 [IQR: 32.6-46.6] followed-up at the University Health Centre in Yaoundé, were tested for HBsAg, anti-HBs, anti-HBc IgG/IgM, HBV-DNA and anti-HCV IgG. HBV positive cases were tested for Hepatitis Delta virus (HDV) using anti-HDV IgG and HDV-RNA. Liver function was assessed by alanine and aspartate aminotransaminases. OBI was defined as negative-HBsAg and detectable HBV-DNA. In occult or overt HBVinfected participants, HBV reverse transcriptase (RT)/surface (S) sequences were analyzed for drug resistance, immuneescape mutants, and phylogeny.
Overall, 78.3% (166/212) participants had past/ongoing HBV-exposure, with 39.1% (83/212) carrying "HBcAbpositive alone". Prevalence of overt HBV (positive-HBsAg) was 11.8% (25/212), prevalence of HBV and HDV was respectively 6.9% (12/175) and 12% (3/25). Phylogeny of HBV-RT/S revealed the co-circulation of genotypes A and E. All HBV-coinfected participants harbored HBV strains with at least one immune-escape mutation. Of note, one HBV variant carried the vaccine-escape mutation G145R that hinders HBsAg neutralization by antibodies. For the first time, a novel 9 aa-deletion (s115-s123), located in the HBsAg "a" determinant, was found concomitantly with OBI. A stop codon in the S region (associated with increased risk of hepatocellular carcinoma) was found in six cases.
High prevalence of overt/occult HBV-infection and circulating atypical strains highlight the importance of HBV-surveillance among HIV-infected Cameroonians and strategies to detect OBI in highly endemic countries.
调查喀麦隆艾滋病毒感染者中显性和隐匿性乙型肝炎感染（OBI）的患病率及基因型特征。
对在雅温得大学健康中心接受随访的212名喀麦隆艾滋病毒感染者（年龄37.6岁[四分位间距：32.6 - 46.6岁]）进行乙肝表面抗原（HBsAg）、乙肝表面抗体（抗-HBs）、乙肝核心抗体IgG/IgM、乙肝病毒脱氧核糖核酸（HBV-DNA）及丙肝病毒抗体IgG检测。对HBV阳性病例采用抗丁型肝炎病毒IgG和丁型肝炎病毒核糖核酸（HDV-RNA）检测丁型肝炎病毒（HDV）。通过丙氨酸转氨酶和天冬氨酸转氨酶评估肝功能。OBI定义为HBsAg阴性且HBV-DNA可检测到。对隐匿或显性HBV感染参与者的HBV逆转录酶（RT）/表面（S）序列进行耐药性、免疫逃逸突变体及系统发育分析。
总体而言，78.3%（166/212）的参与者有既往/正在进行的HBV暴露，其中39.1%（83/212）为“仅HBcAb阳性”。显性HBV（HBsAg阳性）的患病率为11.8%（25/212），HBV和HDV的患病率分别为6.9%（12/175）和12%（3/25）。HBV-RT/S的系统发育分析显示A和E基因型共同流行。所有HBV合并感染参与者携带的HBV毒株至少有一个免疫逃逸突变。值得注意的是，一种HBV变异株携带疫苗逃逸突变G145R，可阻碍抗体对HBsAg的中和作用。首次发现一个位于HBsAg“a”决定簇的9个氨基酸缺失（s115 - s123）与OBI同时存在。在6例病例中发现S区域有一个终止密码子（与肝细胞癌风险增加相关）。
显性/隐匿性HBV感染的高患病率及循环中的非典型毒株凸显了喀麦隆艾滋病毒感染者中HBV监测以及在高流行国家检测OBI策略的重要性。
