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,
Basetsana Phakedi,
Tsholofelo Ratsoma,
Gorata Mpebe,
Joseph Makhema,
Roger Shapiro,
Shahin Lockman,
Rosemary Musonda,
Sikhulile Moyo,
Simani Gaseitsiwe
Affiliations
Bonolo B. Phinius
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Motswedi Anderson
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Irene Gobe
School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
Margaret Mokomane
School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
Wonderful T. Choga
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Basetsana Phakedi
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Tsholofelo Ratsoma
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Gorata Mpebe
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Joseph Makhema
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Roger Shapiro
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Shahin Lockman
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Rosemary Musonda
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Sikhulile Moyo
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
Simani Gaseitsiwe
Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana
(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 deoxyribonucleic acid (DNA) 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, i.e., 86/98 (87.8%) 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 were 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 < 2000 IU/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.
