Hepatitis B precore/core promoter mutations in isolates from HBV-monoinfected and HBV–HIV coinfected patients: A 3-yr prospective study☆

Abstract 

Background

The course of chronic HBV infection is modified by HIV-coexistence.

Objective

To analyze the role of HBV genomic heterogeneity in basal core promoter (BCP) and precore (Pc) genomic regions.

Study design

In a 3-yr prospective study, 39 HBV infected patients (20 monoinfected and 19 HIV-coinfected) were included. Eighty-two HBV isolates were studied at quasispecies level in the BCP/Pc genomic region. Clinical records obtained include data on lamivudine therapy and resistance mutations, HBV and HIV-viral load.

Results

HBV isolates were predominantly ascribed to genotype (Gt) A2 among HBV-monoinfected and HIV-coinfected patients. BCP mutations in isolates from monoinfected patients were significantly more frequent than in those from coinfected ones, irrespective of the HBe expression pattern (p<0.0001).

Regardless of the HIV-coexistence, the Pc mutation at G1896A only barely appeared among clone-derived sequences of GtF1 isolates, mainly from HBe(−) HBV-monoinfected patients.

Conclusions

HBV isolates characterized from HIV-coinfected patients seem to be more prone to exhibit a wild type genomic pattern at BCP regulatory region with respect to those from HBV-monoinfected ones. Besides, mutations at Pc region might be genotype-dependent in their frequency but not on HIV co-presence related.

Keywords: Hepatitis B virus, Precore/core mutant, HIV, Coinfection