Hepatitis B virus compartmentalization in the cerebrospinal fluid of HIV-infected patients

Area of Science:

• Neurovirology
• Viral Hepatitis
• Infectious Diseases

Background:

• Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infection is common in adolescents.
• Neurological complications frequently occur in individuals with HIV.
• The presence and significance of HBV in the central nervous system (CNS) in co-infected individuals remain unclear.

Purpose of the Study:

• To detect hepatitis B virus (HBV) DNA in the cerebrospinal fluid (CSF) of adolescents co-infected with HIV and HBV presenting with neurological disease.
• To investigate the compartmentalization of HBV within the CNS.
• To explore the relationship between HBV DNA in CSF and blood-brain barrier integrity.

Main Methods:

• Detection of HBV DNA in plasma and CSF samples from 26 co-infected adolescents with neurological disease.
• Assessment of blood-brain barrier integrity.
• Analysis of HBV resistance mutation profiles in CSF and plasma to evaluate compartmentalized evolution.

Main Results:

• HBV DNA was detected in the CSF of a significant proportion of co-infected adolescents with neurological disease.
• More than 50% of subjects with detectable plasma HBV DNA also had detectable CSF HBV DNA.
• CSF HBV DNA was observed even in individuals with intact blood-brain barrier, and distinct resistance mutation profiles indicated compartmentalized HBV evolution in a subgroup.

Conclusions:

• HBV can be present in the CSF of co-infected adolescents with neurological disease, even with preserved blood-brain barrier integrity.
• Evidence suggests compartmentalized evolution of HBV within the CNS.
• Further research is needed to elucidate the clinical implications of CSF HBV and its role in HIV-associated neurological disorders.