High incidence of lamivudine-resistance-associated vaccine-escape HBV mutants among HIV-coinfected patients on prolonged antiretroviral therapy

Worldwide, frequent emergence of lamivudine (3TC)-resistant HBV mutants has been reported in HIV-HBV-coinfected patients during long-term antiretroviral therapy (ART) that contains 3TC as the sole anti-HBV drug. Three major patterns of mutations in HBV polymerase gene, namely single (rtM204V), doubl...

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Bibliographic Details
Published in:Antiviral therapy 2015-01, Vol.20 (5), p.545-554
Main Authors: Pal, Ananya, Sarkar, Neelakshi, Saha, Debraj, Guha, Subhashish K, Saha, Bibhuti, Chakrabarti, Sekhar, Chakravarty, Runu
Format: Article
Language:English
Subjects:
Anti-HIV Agents - therapeutic use
CD4 Lymphocyte Count
Coinfection
Cross-Sectional Studies
DNA, Viral - blood
Drug Resistance, Viral - genetics
Hepatitis B e Antigens - blood
Hepatitis B virus
Hepatitis B virus - drug effects
Hepatitis B virus - genetics
Hepatitis B, Chronic - drug therapy
Hepatitis B, Chronic - virology
HIV Infections - drug therapy
HIV Infections - virology
HIV-1 - drug effects
HIV-1 - genetics
Humans
India
Lamivudine - therapeutic use
Lentivirus
Liver Cirrhosis - virology
Retroviridae
Reverse Transcriptase Inhibitors - therapeutic use
Viral Load - genetics
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Summary:Worldwide, frequent emergence of lamivudine (3TC)-resistant HBV mutants has been reported in HIV-HBV-coinfected patients during long-term antiretroviral therapy (ART) that contains 3TC as the sole anti-HBV drug. Three major patterns of mutations in HBV polymerase gene, namely single (rtM204V), double (rtL180M+rtM204V) and triple (rtV173L+rtL180M+rtM204V) mutations, are associated with 3TC-resistance; additionally, the triple mutation has vaccine-escape potential due to a corresponding change in overlapping surface gene. Data from India, a major reservoir for HIV and HBV infection, is lacking. Here we investigated the effect of long-term 3TC treatment on virological response for HBV and characterized the 3TC-resistant HBV mutations in a cohort of HIV-HBV-coinfected patients from eastern India. A cross-sectional study was performed in HIV-infected patients (n=563) receiving 3TC-containing ART for ≥6 months from the major ART centre of eastern India during 2011-2012. The hepatitis B surface antigen-positive HIV-infected patients (n=62) were categorized into four groups with comparable sample size according to the 3TC exposure for ≥6-
ISSN:1359-6535
2040-2058
DOI:10.3851/IMP2942