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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-08-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC6095632?pdf=render |
| _version_ | 1831839055059353600 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-23T05:47:14Z |
| format | Article |
| id | doaj.art-68851f0d5bfa45019cea0655556819e5 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-23T05:47:14Z |
| publishDate | 2018-08-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-68851f0d5bfa45019cea0655556819e52022-12-21T17:58:04ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352018-08-01128e000662910.1371/journal.pntd.0006629A systematic review of hepatitis B virus (HBV) drug and vaccine escape mutations in Africa: A call for urgent action.Jolynne MokayaAnna L McNaughtonMartin J HadleyApostolos BeloukasAnna-Maria GerettiDominique GoedhalsPhilippa C MatthewsInternational 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.http://europepmc.org/articles/PMC6095632?pdf=render |
| spellingShingle | 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. PLoS Neglected Tropical Diseases |
| title | 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_short | 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 |
| url | http://europepmc.org/articles/PMC6095632?pdf=render |
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