Romina Salpini, Joseph Fokam, Laura Ceccarelli, Maria-Mercedes Santoro, Aubin Nanfack, Samuel Martin Sosso, Mathurin Kowo, Valeria Cento, Judith Torimiro, Loredana Sarmati, Massimo Andreoni, Vittorio Colizzi, Carlo Federico Perno and Oudou Njoya Pages 165 - 171 ( 7 )
Aim: To investigate the prevalence and genotypic profile of overt and occult hepatitis-B infection (OBI) among HIV-infected individuals in Cameroon.
Methods: 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.
Results: 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.
Conclusion: 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.
Hepatitis B virus, occult Hepatitis B, drug resistance, genotyping, immune escape, HDV co-infection, HIV-infected Cameroonians.
Department of Experimental Medicine and Surgery University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy, Department of Experimental Medicine and Surgery University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy