Prevalence and characteristics of Hepatitis B and C in HIV infected - - PowerPoint PPT Presentation

Prevalence and characteristics of Hepatitis B and C in HIV‐infected patients from the RESINA cohort

• RESINA‐Study: treatment naive patients from 35 HIV‐centers in NRW

before starting the first ART

• Characterization of coinfection with HBV

and HCV, analysis of risk factors

• HBsAg, anti‐HBc, anti‐HBs (HBeAg, anti‐HBe) of 918 patients

HBV‐DNA in randomly selected 554 patients

• HCV‐Ab determined in 917 patients, HCV RNA in a subgroup of Ab‐positive

patients

• Epidemiological paramters:

age, gender, mode of transmission, ethnicity clinical parameters: CDC stage laboratory values: HIV viral load, CD4, AST, ALT, GGT

HBV‐Screening

AREVIR‐meeting Bonn 2010

Düsseldorf and Cologne

n=517 and n=401

Analysis of HBV‐DNA

n=554

HBV-DNA pos HBV-DNA neg Total HBsAg pos 3,2 % (18) 1,1 % (6) 4,3 % (24) HBsAg neg 2,9 % (16)

• Total

6,1 % (34)

• 7,2 % (40)

Anti-HBc + Anti-HBs + Anti-HBc + Anti-HBs - Anti-HBc - Anti-HBs + Anti-HBc - Anti-HBs - Total Anti-HBc + Total Anti-HBc - OHBV 7 3 2 4 10 6 % 4,3 (7 / 164) 6,4 (3 / 47) 3,8 (2/ 52) 1,9 (4 / 213) 4,6 (10 / 217) 1,9 (6 / 313)

Occult HBV infection (OHBV): HBsAg negative and HBV-DNA positive

HBV‐ und HCV coinfections: risk factors and observations

• HBV‐DNA:

significant: higher ALT and AST trend: more MSM, caucasian and CDC‐C

• OHBV:

no parameter showed significant correlation

HBV‐ und HCV coinfections: risk factors and observations

Isolated antiHBc

HBV resistance analysis

• 30 / 34 samples sequenced (genotypes):

18 x A 7 x D 3 x G 1 x C 1 x Es

• Sequences differing from wild‐type in 19 / 30
• 5 patients with mutations conferring to drug resistance

I169T, L180M, V191IV, M204V

4 / 13 in patients with OHBV, 1 / 17 in HBsAg positive patients

German HBV‐incidence (RKI) NRW HBV‐prevalence (RESINA)

HCV‐Screening

HBV‐ und HCV coinfections: risk factors and observations

Positive HCV serostatus

HIV primary drug resistance (PDR)

• 8,3% (76 / 912)

46% NRTI (35), 47% NNRTI (36), 18% PI (14)

• HIV‐PDR was significantly correlated with

any parameter of active HBV infection (HBV‐DNA, HBsAg, OHBV) anti‐HCV

• patients with HIV‐PDR were significantly
• lder

more MSM more IVDU caucasian origin showed higher ALT and GGT

CONCLUSIONS

• HBV and HCV are frequent co‐infections in

treatment‐naive HIV patients

• HCV co‐infection influences HIV replication
• OHBV constitutes a major proportion of all

chronic HBV infections

• HIV‐PDR associated with active HBV infection

THANK YOU !!!

• Frank Clemens Wilhelm
• Mark Oette
• Rolf Kaiser
• Bastian Beggel
• Melanie Balduin
• Finja Schweitzer
• Jens Verheyen
• Ortwin Adams
• Dieter Häussinger

HBV resistance analysis

No. Genotype HBV-polymerase mutations HBsAg mutations 1 A N131DN, I187L, V191IV, L217R, L229M Q101H, K122KR, A159V, S167L, V168AV, W182*W, P217LP, F220L 2 D S119PST, F122L, Q130P, L132M, I169T, M171V, A211G L109LQ, T125M, F161L, P203A 3 E V191IV S167LS, W182*W, L226*L 4 G V142T, L180M, M204V, L229F M133I, Y134H, I195M, C221F 5 D H126R, Y135H, V173L, L180M, M204V, Q215S L97P, T118A, G130E, E164G, I195M, S204N, S207R 6 A L140I N131K 7 A R138K, S219A G130N, S210R 8 A R138KR, S219A G130DGNS, S210R 9 C R153QR, S223A, I224V G145GR, S210N

HBV‐Screening and HCV seroprevalence