Comparison of HBV viral load levels between HBeAg status.

<p>Comparison of HBV viral load levels between HBeAg status.</p

Analysis of HBV basal core promoter/precore gene variability in patients with HBV drug resistance and HIV co-infection in Northwest Ethiopia

<div><p>Background</p><p>We recently reported complex hepatitis B virus (HBV) drug resistant and concomitant vaccine escape hepatitis B surface antigen (HBsAg) variants during human immunodeficiency virus (HIV) co-infection and antiretroviral therapy (ART) exposure in Ethiopia. As a continuation of this report using the HBV positive sera from the same study participants, the current study further analyzed the HBV basal core promoter (BCP)/precore (PC) genes variability in patients with HBV drug resistance (at tyrosine-methionine-aspartate-aspartate (YMDD) reverse transcriptase (RT) motifs) and HIV co-infection in comparison with HBV mono-infected counterparts with no HBV drug resistant gene variants.</p><p>Materials and methods</p><p>A total of 143 participants of HBV-HIV co-infected (n = 48), HBV mono-infected blood donors (n = 43) and chronic liver disease (CLD) patients (n = 52) were included in the study. The BCP/PC genome regions responsible for HBeAg expression from the EcoRI site (nucleotides 1653–1959) were sequenced and analyzed for the BCP/PC mutant variants.</p><p>Results</p><p>Among the major mutant variants detected, double BCP mutations (A1762T/G1764A) (25.9%), Kozak sequences mutations (nt1809-1812) (51.7%) and the classical PC mutations such as A1814C/C1816T (15.4%), G1896A (25.2%) and G1862T (44.8%) were predominant mutant variants. The prevalence of the double BCP mutations was significantly lower in HIV co-infected patients (8.3%) compared with HBV mono-infected blood donors (32.6%) and CLD patients (36.5%). However, the Kozak sequences BCP mutations and the majority of PC mutations showed no significant differences among the study groups. Moreover, except for the overall BCP/PC mutant variants, co-prevalence rates of each major BCP/PC mutations and YMDDRT motif associated lamivudine (3TC)/entecavir (ETV) resistance mutations showed no significant differences when compared with the rates of BCP/PC mutations without YMDD RT motif drug resistance gene mutations. Unlike HIV co-infected group, no similar comparison made among HBV mono-infected blood donors and CLD patients since none of them developed the YMDD RT motif associated 3TC/ETV resistance mutations. However, HBV mono-infected blood donors and CLD patients who had no any drug resistance gene variants developed comparable G1862T (60.6% vs. 65.1%) and G1896A (24.2% vs. 11.6%) PC gene mutations.</p><p>Conclusion</p><p>No correlation observed between the BCP/PC genome variability and the YMDD RT motif associated HBV drug resistance gene variants during HIV co-infection. Nevertheless, irrespective of HIV co-infection status, the higher records of the BCP/PC gene variability in this study setting indicate a high risk of potential HBeAg negative chronic HBV infection in Northwest Ethiopia.</p></div

Frequency distribution of BCP and PC mutations among study groups, HBeAg status and HBV genotypes.

<p>Frequency distribution of BCP and PC mutations among study groups, HBeAg status and HBV genotypes.</p

Comparison of HBV BCP/ PC nucleotide sequence changes with respect to HBV drug resistance associated polymerase gene mutations from HIV co-infected patients (n = 28), liver disease patients (n = 9) and blood donors (n = 10).

<p>Comparison of HBV BCP/ PC nucleotide sequence changes with respect to HBV drug resistance associated polymerase gene mutations from HIV co-infected patients (n = 28), liver disease patients (n = 9) and blood donors (n = 10).</p

Demographic, virological and clinical characteristics of study subjects.

<p>Demographic, virological and clinical characteristics of study subjects.</p

Additional file 3: of Hepatitis viruses in Ethiopia: a systematic review and meta-analysis

Results of meta-regression analysis of HBV and HCV prevalence. (DOCX 27 kb

Additional file 2: of Hepatitis viruses in Ethiopia: a systematic review and meta-analysis

The major characteristics of studies which reported HCV seroprevalence in Ethiopia. Description of data: Abbreviations; CE-Central Ethiopia, NE-North Ethiopia,NW- Northwest Ethiopia, SE-South Ethiopia, SW-Southwest Ethiopia. CS-Cross sectional, RS-Retrospective study, PC-Prospective Cross sectional, PL-Prospective longitudinal study. EIA: Enzyme immunoassay, ELISA: Enzyme linked immunoassay, RIA: Radioimmunoassay, CIA-Chromatographic immunoassay. ANC-antenatal care, MWHs/NMWHs-medical waste handlers / Non-medical waste handlers, CLD-Chronic liver disease. +DNA Hybridization. ** (A = 9–12), (B =5–8), (C = 1–4). ¥For the meta-analysis. Blank cells in the table indicated that the information was unavailable in the original articles. Different quality scores might be observed in a single study which reported both HBV and HCV simultaneously. (DOCX 70 kb