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Drug-resistant and immune-escape hepatitis B virus mutants, occult hepatitis B infection and coinfections in public hospital patients from Argentina

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Abstract

Argentina exhibits low serological prevalence for Hepatitis B virus (HBV); however, occult hepatitis B infection (OBI) has been reported in blood donors, Amerindians and individuals coinfected with hepatitis C virus (HCV), and/or human immunodeficiency virus (HIV). The aim of this study was to analyze the genetic diversity of HBV and to evaluate serological marker associations and coinfections with HCV and HIV in patients attending and treated in a public hospital in the province of Buenos Aires, Argentina. A total of 189 HBV reactive samples (HBsAg and/or anti-HBc) were analyzed for HBV DNA characterization. All reactive samples were tested for anti-HCV and HIV-antigen/antibody using CMIA assays. Thirty-six samples exhibited detectable HBV DNA, 7 of which were OBI. HBV sequences were classified as subgenotypes A1, A2, B2, D3, F1b, F3 and F4. Mutations related to the ability to escape the host’s immune response, resistance to antiviral therapy and progression to disease were found in patients, partly due to the variable sensitivity of HBsAg, the reverse transcriptase, the basal core promoter and the preCore. HCV and HIV prevalence was 10% and most of the genotypes found in the sequences were genotype 1 and B/F recombinant subtype, respectively. Of the total samples analyzed, 7 exhibited coinfections. This study shows the frequency of OBI, subgenotype distribution, HBV mutations and coinfections, which may have important clinical implications in public hospital patients. Planned prevention, detection and treatment adherence are needed to reduce transmission and morbidity in vulnerable populations.

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Acknowledgements

We would like to thank all the staff at the Virology Laboratory of Hospital Interzonal General de Agudos "Dr. Pedro Fiorito”, as well as Lucas Zapata for his collaboration and participation in this study.

Funding

This work was supported by Agencia Nacional de Promoción Científica y Tecnológica, grant number PICT 2016–0698.

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Authors and Affiliations

  1. Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) - Universidad de Buenos Aires (UBA), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), Paraguay 2155 P11 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina

    Cecilia María Delfino, Silvia Sánchez Puch & Verónica Lidia Mathet

  2. Laboratorio de Virología, Hospital Interzonal General de Agudos “Dr. Pedro Fiorito”, Avellaneda, Buenos Aires, Argentina

    Marianela Giorgio, Gabriela García & Estela Outon

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  1. Cecilia María Delfino
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  2. Marianela Giorgio
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  3. Gabriela García
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  4. Silvia Sánchez Puch
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  6. Verónica Lidia Mathet
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Correspondence to Cecilia María Delfino.

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This study was reviewed by the Bioethics Committee of “Fundación Huésped” and conducted in compliance with all federal regulations governing the protection of human subjects.

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Delfino, C.M., Giorgio, M., García, G. et al. Drug-resistant and immune-escape hepatitis B virus mutants, occult hepatitis B infection and coinfections in public hospital patients from Argentina. Virus Genes 57, 327–337 (2021). https://doi.org/10.1007/s11262-021-01850-z

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