Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

High Prevalence of Hepatitis B Virus Drug Resistance Mutations to Lamivudine Among People with HIV/HBV Coinfection in Rural and Peri-Urban Communities in Botswana

Bonolo B. Phinius
,
Motswedi Anderson
,
Irene Gobe
,
Margaret Mokomane
,
Wonderful T. Choga
ORCID logo ,
Margaret Mokomane
,
Wonderful T. Choga
,
Gorata Mpebe
,
Joseph Makhema
,
Roger Shapiro
,
Shahin Lockman
,
Rosemary Musonda
,
Sikhulile Moyo
,
Simani Gaseitsiwe
*
Version 1 : Received: 12 March 2024 / Approved: 13 March 2024 / Online: 13 March 2024 (11:38:15 CET)

A peer-reviewed article of this Preprint also exists.

Phinius, B.B.; Anderson, M.; Gobe, I.; Mokomane, M.; Choga, W.T.; Phakedi, B.; Ratsoma, T.; Mpebe, G.; Makhema, J.; Shapiro, R.; Lockman, S.; Musonda, R.; Moyo, S.; Gaseitsiwe, S. High Prevalence of Hepatitis B Virus Drug Resistance Mutations to Lamivudine among People with HIV/HBV Coinfection in Rural and Peri-Urban Communities in Botswana. Viruses 2024, 16, 592. Phinius, B.B.; Anderson, M.; Gobe, I.; Mokomane, M.; Choga, W.T.; Phakedi, B.; Ratsoma, T.; Mpebe, G.; Makhema, J.; Shapiro, R.; Lockman, S.; Musonda, R.; Moyo, S.; Gaseitsiwe, S. High Prevalence of Hepatitis B Virus Drug Resistance Mutations to Lamivudine among People with HIV/HBV Coinfection in Rural and Peri-Urban Communities in Botswana. Viruses 2024, 16, 592.

Abstract

(1) Background: We aimed to determine the prevalence of hepatitis B virus (HBV) resistance-associated mutations (RAMs) in people with HBV and human immunodeficiency virus (HBV/HIV) in Botswana. (2) Methods: We sequenced HBV from participants with HBV/HIV from the Botswana Combination Prevention Project study (2013-2018) using the Oxford Nanopore GridION platform. Consensus sequences were analyzed for genotypic and mutational profiles. (3) Results: Overall, 98 HBV sequences had evaluable reverse transcriptase region coverage. The median participant age was 43 years (IQR: 37, 49) and 66/98 (67.4%) were female. Most participants, 85/97 (87.6%) had suppressed HIV viral load (VL). HBV RAMs were identified in 61/98 (62.2%) participants. Most RAMs were in positions 204 (60.3%), 180 (50.5%) and 173 (33.3%), mostly associated with lamivudine resistance. The triple mutations, rtM204V/L180M/V173L and was the most predominant (17/61 [27.9%]). Most participants (96.7%) with RAMs were on antiretroviral therapy for a median duration of 7.5 years (IQR: 4.8, 10.5). Approximately 27.9% (17/61) of participants with RAMs had undetectable HBV VL, 50.8% (31/61) had VL <2000IU/mL and 13/61 (21.3%) had VL ≥2000 IU/mL. (4) Conclusions: The high prevalence of lamivudine RAMs discourages the use of ART regimens with 3TC as the only HBV-active drug in people with HIV/HBV.

Keywords

Hepatitis B virus; drug resistance; people living with HIV; Botswana; Africa

Subject

Biology and Life Sciences, Virology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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