Observational studyJournal of clinical virology : the official publication of the Pan American Society for Clinical Virology2020
Evidence of tenofovir resistance in chronic hepatitis B virus (HBV) infection: An observational case series of South African adults.
Observational study in Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- Evaluation of Hepatitis B core-related antigen (HBcrAg) as a biomarker in cohorts from the United Kingdom and South Africa.The Journal of infection · 2025Observational
- Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.JHEP reports : innovation in hepatology · 2025Article
- Hepatitis B virus (HBV) viremia despite tenofovir disoproxil fumarate-containing antiretroviral therapy in persons with HBV/HIV coinfection.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2024Article
- Multiple risk factors for persistent HBV viraemia in an adult receiving nucleos/tide analogue therapy.Sexually transmitted infections · 2024Article
- Hepatitis B Virus Prevalence and Mother-to-Child Transmission Risk in an HIV Early Intervention Cohort in KwaZulu-Natal, South Africa.Open forum infectious diseases · 2023Article
- Long-term follow-up of treatment-naïve HBeAg-negative patients with chronic hepatitis B.Irish journal of medical science · 2023Article
- Barriers that prevent adults living with HBV infection from participating in clinical research: experience from South Africa.Journal of virus eradication · 2023Article
- Health inequalities in the management of chronic hepatitis B virus infection in patients from sub-Saharan Africa in high-income countries.JHEP reports : innovation in hepatology · 2023Review
- High Prevalence of Hepatitis B Virus Infection Among People With HIV in Rural and Periurban Communities in Botswana.Open forum infectious diseases · 2023Article
- Hepatitis B Virus Research in South Africa.Viruses · 2022Review
- Whole genome analysis of hepatitis B virus before and during long-term therapy in chronic infected patients: Molecular characterization, impact on treatment and liver disease progression.Frontiers in microbiology · 2022Article
- Au@Zr-based metal-organic framework composite as an immunosensing platform for determination of hepatitis B virus surface antigen.Mikrochimica acta · 2021Article
- Endemic HBV among hospital in-patients in Bangladesh, including evidence of occult infection.The Journal of general virology · 2021Article
- Suboptimal Response to Tenofovir Alafenamide in Two Patients With HBeAg-Positive Hepatitis B: A Case Report.Frontiers in medicine · 2021Article
- A systematic review and meta-analysis of hepatitis B virus drug resistance and escape mutations in low- and middle-income countries.Therapeutic advances in infectious diseaseArticle
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
Abstract
introductionTenofovir disoproxil fumarate (TDF) is widely recommended for treatment of chronic hepatitis B virus (HBV) infection because it is safe, affordable and has a high genetic barrier to resistance. TDF resistance associated mutations (RAMs) have been reported, but data are limited, particularly for Africa. We set out to identify potential RAMs in individuals with detectable HBV viraemia on TDF treatment.
methodsWe recruited adults with chronic HBV infection from Cape Town, South Africa, identifying individuals with a TDF resistance phenotype, defined as persistent HBV vireamia despite >12 months of TDF treatment. We sequenced HBV DNA using MiSeq Illumina with whole genome target enrichment, and sought potential TDF RAMs, based on a pre-defined list of polymorphisms.
resultsAmong 66 individuals with chronic HBV (genotypes A and D), three met our clinical definition for TDF resistance, of whom two were coinfected with HIV. In one participant, the consensus HBV sequence contained nine polymorphisms that have been described in association with TDF resistance. Significant treatment non-adherence in this individual was unlikely, as HIV RNA was suppressed. TDF RAMs were also present in HBV sequences from the other two participants, but other factors including treatment non-adherence may also have had a role in failure of HBV DNA suppression in these cases. DISCUSSION: Our findings add to the evidence that RAMs in HBV reverse transcriptase may underpin a TDF resistant phenotype. This is the first time these RAMs have been reported from Africa in association with clinical evidence of TDF resistance.
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