Genomic variations of hepatitis B virus strains in patients chronically coinfected with hepatitis B and human immunodeficiency viruses.

Serum samples from 56 human immunodeficiency virus type 1 (HIV-1)-infected adult men were analysed for the presence of hepatitis B virus (HBV) serological markers. Two or more samples from each patient, collected over an interval of 1-6 years, were tested. The antibody against HBV core antigen (anti-HBc) prevalence was 79%. Three (5%) patients No. 5, 7, and 9 were chronic carriers of HBV surface antigen (HBsAg). HBV DNAs from serial samples of these three patients and from two HIV-seronegative control patients were characterised after amplification of different genome regions by polymerase chain reaction (PCR). Size and restriction analyses of the PCR products showed that samples from patients No. 7 (with chronic active hepatitis) and 9 (asymptomatic) contained heterogeneous HBV DNA populations. In patient No. 7, HBV DNA contained a precore gene stop codon mutation at nucleotide (nt) 1896. In addition, a deletion in the core gene was found in a sample collected two years after the onset of acquired immunodeficiency syndrome (AIDS). PCR products from serial samples of patient No. 9 indicated a mixture of HBV DNA molecules that were cloned. Sequencing of the pre-S region of the clones and phylogenetic analysis showed that patient No. 9 was superinfected with three HBV populations of distinct origin, all belonging to genotype A. HBV DNA of patient No. 5 (with AIDS) did not present any variability during a 6-year follow-up. Although two of three HIV/HBV coinfected patients harboured heterogeneous HBV DNA populations during the follow-up, no common event with respect to HBV DNA evolution was observed among the coinfected patients.