Hepatitis B Virus (HBV) Variants in Untreated and Tenofovir Treated Chronic Hepatitis B (CHB) Patients during Pregnancy and Post-Partum Follow-Up

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dc.contributor.authorVirine, Boris
dc.contributor.authorOsiowy, Carla
dc.contributor.authorGao, Shan
dc.contributor.authorWang, Tong
dc.contributor.authorCastillo, Eliana
dc.contributor.authorMartin, Steven R.
dc.contributor.authorLee, Samuel S.
dc.contributor.authorSimmonds, Kimberley
dc.contributor.authorvan Marle, Guido
dc.contributor.authorCoffin, Carla
dc.date.accessioned2015-11-22T22:07:47Z
dc.date.available2015-11-22T22:07:47Z
dc.date.issued2015-10-16
dc.description.abstractBACKGROUND: Chronic hepatitis B (CHB) is a dynamic disease that may be affected by immune changes in pregnancy. Guidelines suggest consideration of nucleos/tide analogs (NA), i.e., tenofovir, (TDF) in highly viremic mothers to reduce vertical transmission risk. HBV variability affects CHB outcome, but little is known about HBV genetic changes in pregnancy due to immune or NA selection. OBJECTIVES: To evaluate HBV diversity in NA treated or untreated pregnant vs. post-partum CHB carriers. STUDY DESIGN: In plasma collected from 21 mothers (7 matching pre/post-partum), HBV serological tests, genotype and viral load were assayed. The HBV pre-surface (S) /S overlapping polymerase (P) (N = 20), pre-core (C) /C (N = 11) and/or full genome PCR amplicons (N = 3) underwent clonal sequence analysis. RESULTS: The median age was 31 y, 71% Asian, 68% genotype B or C, 33% HBV eAg+, 5 received TDF (median HBV DNA 8.5 log IU/ml). In untreated mothers, median antepartum vs. post-partum ALT was 21 vs. 24 U/L and HBV DNA was 2.7 vs. 2.4 log(10) IU/ml. ALT and/or HBV DNA flares occurred during pregnant and/or post-partum period in 47% (10/21). Clonal sequencing antepartum showed the presence of minor "a determinant" and/or vaccine escape mutants (VEM) but drug resistant variants were infrequent. Analysis of pregnant vs. post-partum samples showed different HBV variants and viral diversity. CONCLUSIONS: Differences in immune and/or by NA selective pressures during pregnancy may affect HBV evolution during pregnancy. The presence of minor VEM warrant infant follow-up.en_US
dc.description.refereedYesen_US
dc.identifier.citationVirine B, Osiowy C, Gao S, Wang T, Castillo E, Martin SR, Lee SS, Simmonds K, van Marle G, Coffin CS. Hepatitis B Virus (HBV) Variants in Untreated and Tenofovir Treated Chronic Hepatitis B (CHB) Patients during Pregnancy and Post-Partum Follow-Up. PLoS One. 2015 Oct 16;10(10):e0140070.en_US
dc.identifier.doi10.1371/journal.pone.0140070.
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/33834
dc.identifier.urihttp://hdl.handle.net/1880/51019
dc.language.isoen_USen_US
dc.publisherPLoS Oneen_US
dc.publisher.departmentLiver Unit, Division of Gastroenterology and Hepatologyen_US
dc.publisher.facultyMedicineen_US
dc.publisher.institutionUniversity of Calgaryen_US
dc.subjectPregnancyen_US
dc.subjectLiver disease and pregnancyen_US
dc.subjectHepatitis B Virusen_US
dc.subjectSequence analysisen_US
dc.subjectInfantsen_US
dc.subjectViral evolutionen_US
dc.subjectDNA sequene analysisen_US
dc.subjectVaccinesen_US
dc.titleHepatitis B Virus (HBV) Variants in Untreated and Tenofovir Treated Chronic Hepatitis B (CHB) Patients during Pregnancy and Post-Partum Follow-Upen_US
dc.typejournal article
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