A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action.
International sustainable development goals for the elimination of viral hepatitis as a public health problem by 2030 highlight the pressing need to optimize strategies for prevention, diagnosis and treatment. Selected or transmitted resistance associated mutations (RAMs) and vaccine escape mutation...
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ftdoajarticles:oai:doaj.org/article:68851f0d5bfa45019cea0655556819e5 2023-05-15T15:16:28+02:00 A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. Jolynne Mokaya Anna L McNaughton Martin J Hadley Apostolos Beloukas Anna-Maria Geretti Dominique Goedhals Philippa C Matthews 2018-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006629 https://doaj.org/article/68851f0d5bfa45019cea0655556819e5 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6095632?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006629 https://doaj.org/article/68851f0d5bfa45019cea0655556819e5 PLoS Neglected Tropical Diseases, Vol 12, Iss 8, p e0006629 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006629 2022-12-31T14:05:25Z International sustainable development goals for the elimination of viral hepatitis as a public health problem by 2030 highlight the pressing need to optimize strategies for prevention, diagnosis and treatment. Selected or transmitted resistance associated mutations (RAMs) and vaccine escape mutations (VEMs) in hepatitis B virus (HBV) may reduce the success of existing treatment and prevention strategies. These issues are particularly pertinent for many settings in Africa where there is high HBV prevalence and co-endemic HIV infection, but lack of robust epidemiological data and limited education, diagnostics and clinical care. The prevalence, distribution and impact of RAMs and VEMs in these populations are neglected in the current literature. We therefore set out to assimilate data for sub-Saharan Africa through a systematic literature review and analysis of published sequence data, and present these in an on-line database (https://livedataoxford.shinyapps.io/1510659619-3Xkoe2NKkKJ7Drg/). The majority of the data were from HIV/HBV coinfected cohorts. The commonest RAM was rtM204I/V, either alone or in combination with associated mutations, and identified in both reportedly treatment-naïve and treatment-experienced adults. We also identified the suite of mutations rtM204V/I + rtL180M + rtV173L, that has been associated with vaccine escape, in over 1/3 of cohorts. Although tenofovir has a high genetic barrier to resistance, it is of concern that emerging data suggest polymorphisms that may be associated with resistance, although the precise clinical impact of these is unknown. Overall, there is an urgent need for improved diagnostic screening, enhanced laboratory assessment of HBV before and during therapy, and sustained roll out of tenofovir in preference to lamivudine alone. Further data are needed in order to inform population and individual approaches to HBV diagnosis, monitoring and therapy in these highly vulnerable settings. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 8 e0006629 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Jolynne Mokaya Anna L McNaughton Martin J Hadley Apostolos Beloukas Anna-Maria Geretti Dominique Goedhals Philippa C Matthews A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
International sustainable development goals for the elimination of viral hepatitis as a public health problem by 2030 highlight the pressing need to optimize strategies for prevention, diagnosis and treatment. Selected or transmitted resistance associated mutations (RAMs) and vaccine escape mutations (VEMs) in hepatitis B virus (HBV) may reduce the success of existing treatment and prevention strategies. These issues are particularly pertinent for many settings in Africa where there is high HBV prevalence and co-endemic HIV infection, but lack of robust epidemiological data and limited education, diagnostics and clinical care. The prevalence, distribution and impact of RAMs and VEMs in these populations are neglected in the current literature. We therefore set out to assimilate data for sub-Saharan Africa through a systematic literature review and analysis of published sequence data, and present these in an on-line database (https://livedataoxford.shinyapps.io/1510659619-3Xkoe2NKkKJ7Drg/). The majority of the data were from HIV/HBV coinfected cohorts. The commonest RAM was rtM204I/V, either alone or in combination with associated mutations, and identified in both reportedly treatment-naïve and treatment-experienced adults. We also identified the suite of mutations rtM204V/I + rtL180M + rtV173L, that has been associated with vaccine escape, in over 1/3 of cohorts. Although tenofovir has a high genetic barrier to resistance, it is of concern that emerging data suggest polymorphisms that may be associated with resistance, although the precise clinical impact of these is unknown. Overall, there is an urgent need for improved diagnostic screening, enhanced laboratory assessment of HBV before and during therapy, and sustained roll out of tenofovir in preference to lamivudine alone. Further data are needed in order to inform population and individual approaches to HBV diagnosis, monitoring and therapy in these highly vulnerable settings. |
format |
Article in Journal/Newspaper |
author |
Jolynne Mokaya Anna L McNaughton Martin J Hadley Apostolos Beloukas Anna-Maria Geretti Dominique Goedhals Philippa C Matthews |
author_facet |
Jolynne Mokaya Anna L McNaughton Martin J Hadley Apostolos Beloukas Anna-Maria Geretti Dominique Goedhals Philippa C Matthews |
author_sort |
Jolynne Mokaya |
title |
A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
title_short |
A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
title_full |
A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
title_fullStr |
A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
title_full_unstemmed |
A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action. |
title_sort |
systematic review of hepatitis b virus (hbv) drug and vaccine escape mutations in africa: a call for urgent action. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006629 https://doaj.org/article/68851f0d5bfa45019cea0655556819e5 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 8, p e0006629 (2018) |
op_relation |
http://europepmc.org/articles/PMC6095632?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006629 https://doaj.org/article/68851f0d5bfa45019cea0655556819e5 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006629 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
12 |
container_issue |
8 |
container_start_page |
e0006629 |
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