High Burden of Occult Hepatitis B Infection in HIV-Infected Patients in Southern Vietnam: Insights from Serological and Molecular Analysis.

Authors

Huynh Hoang Khanh Thu, Yulia V Ostankova, Alexander N Shchemelev, Elena N Serikova, Vladimir S Davydenko, Nadezhda A Pechnikova, Tran Ton, Truong Thi Xuan Lien, Edward S Ramsay, Areg A Totolian

Published in

International journal of molecular sciences. Volume 27. Issue 15. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

Hepatitis B virus (HBV) infection remains a major concern among people living with HIV (PLWH), particularly in high-endemic settings such as Vietnam. The study evaluated the serological and molecular characteristics of HBV among PLWH receiving antiretroviral therapy (ART) in southern Vietnam. A cross-sectional study was conducted among 316 HIV-infected patients receiving ART. Serological markers (HBsAg, anti-HBs IgG, and anti-HBc IgG) and HBV DNA were assessed using highly sensitive assays, and the Pre-S1/Pre-S2/S regions were sequenced for genotype and mutation analysis. Associations were evaluated using appropriate statistical methods. HBV DNA was detected in 32.6% of the patients, whereas HBsAg was present in only 16.1%. The most common serological profile was susceptibility (36.4%), followed by occult HBV infection (OBI) (17.4%), including 6.6% with completely seronegative OBI, and chronic HBV (CHB) (15.8%). Males and older individuals showed a significantly higher risk of CHB (adjusted odds ratio [aOR] = 2.58 and aOR = 1.87, respectively). Genotype B predominated (78.4%) overall, but genotype C was significantly more frequent in OBI than in CHB patients (31.5% vs. 8.3%, p = 0.008). Moreover, the burden of surface S gene escape mutations was significantly higher in the OBI group (p = 0.023). The LASSO model showed a moderate discriminatory ability for predicting OBI status (Area Under the Receiver Operating Characteristic [ROC] Curve [AUC] = 0.76). Lamivudine-associated resistance (rtM204I/V) was the most common RT mutation detected in the overlapping RT/S region. HIV-infected individuals in southern Vietnam face a burden of both CHB and OBI, including a high proportion of seronegative OBI. The presence of seronegative OBI further supports the risk of underdiagnosis when relying only on standard serological markers, and reflects the need for integrated strategies combining highly sensitive serological assays with molecular diagnostics to improve HBV detection among high-risk populations.

PMID:
42589692
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.

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