Prevalence of HBV Lamivudine-resistance mutations in a cohort of Iranian HBV-infected patients with and without HIV co-infection
Abstract number: P1145
Aghasadeghi M.R., Farahani Far A., Bahramali G., Sadat S.M., Memarnejadian A., Siadat S.D., Mohraz M., Foroughi M., Javadi F., Roohvand F., Vahabpour R., Pouriayevali M.S.
Objectives: Individuals co-infected with human immunodeficiency virus 1 (HIV-1) and hepatitis B virus (HBV) often receive treatment with an antiretroviral regimen including lamivudine (LAM) that is a nucleoside analogue and inhibits HIV/HBV reverse transcriptase (RT). However, its efficacy is limited by the development of LAM-resistant strains within the YMDD motif of the HBV polymerase gene. Prevalence of mutations between HBV/HIV co-infected (HIVpos) and HBV mono-infected (HIVneg) individuals on LAM therapy have not been extensively documented in the Middle-East. The aim of this study was to determine the prevalence of HBV LAM-resistance mutations in Iranian HBV infected patients with and without HIV infection.
Methods: Fifty eight chronic hepatitis B patients including 30 HBV mono-infected and 28 HIV/HBV co-infected patients were studied, while receiving LAM as a part of antiretroviral therapy. The YMDD motif was PCR-amplified and directly sequenced in HBV isolations. HBeAg, HBV genotype and polymerase gene mutations were additionally assessed.
Results: The average LAM exposure was 24.35 ±21.91 and 25.3 ±13.94 months in HIVpos and HIVneg groups, respectively. All the patients were infected with HBV genotype-D and the study revealed a significant correlation between the HBV/HIV co-infection and both HBV subtypes of ayw3 and ayw4 (P < 0.001). Seventeen out of 28 HIVpos patients and 19 out of 30 HIVneg infected ones were shown to be HBeAg negative. No association was observed between the type of infection and HBeAg status (P > 0.05). M204V, M204I and L180M mutations were observed in 2 (6.66%), 7 (23.33%) and 5 (16.66%) HIVneg patients, respectively. The dual mutations (M204V/I+L180M) were detected in 5 (16.66%) HIVneg patients. Interestingly, LAM-resistance mutations were not detected in HBV/HIV co-infected individuals.
Conclusion: In accordance to previous studies in Iran, HBV-D was the only detected genotype in both HIVpos and HIVneg patients. This study suggested that individuals With HBV infection that carry ayw4 and ayw3 subtypes are more likely to be infected with HIV. Moreover, in contrast to several European investigations, reporting the LAM-resistance mutations in mono- and co-infections, our study for the first time in Iran indicated these mutations just in HBV mono-infected patients. However, further studies to clarify the role of HIV in HBV LAM-resistance mutations are needed.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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