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Moreira RC, Veras MADSM, Amianti C, McCartney DJ, Silva VCM, Lemos MF, Compri AP, de Oliveira EL, Bassichetto KC, Leal AF, Knauth DR, Magno L, Dourado I, Galan L, Fonseca PAM, de Queiroz RSB, da Silva RJC, Araujo S, Miyachi ME, Soares CDS, Ahagon LMK, Mayaud P, Sperandei S, Motta-Castro ARC. Hepatitis A, B and C prevalence among transgender women and travestis in five Brazilian capitals between 2019-2021. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27Suppl 1:e240005.supl.1. [PMID: 39166577 PMCID: PMC11338541 DOI: 10.1590/1980-549720240005.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE To estimate the prevalence and factors associated with hepatitis A, B, and C in transgender women and travestis's networks, in 5 regions of Brazil. METHODS This cross-sectional study includedtransgender women and travestis in five Brazilian capitals (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo), between December/2019 and July/2021. All samples were subjected to detection of serological markers of hepatitis virus A (HAV), B (HBV), and C (HCV) infections through rapid tests and chemiluminescent microparticle immunoassays. Positive samples in the screening tests were submitted to detect HBV DNA and HCV-RNA by real-time PCR and genotyped by Sanger sequencing. RESULTS Analysis of 1,317 samples showed network prevalence rates of 69.1%, 25.1%, and 1.5% for HAV, HBV, and HCV exposure, respectively. A high susceptibility rate to HBV infection (35.7%) and low prevalence of vaccine response markers (40%) were also observed. Age greater than 26 years, self-declared black/brown skin color, having only primary education, history of incarceration, and use of a condom in the last sexual intercourse with a casual partner were associated with total anti-HAV. Exposure to HBV was associated with age greater than 26 years, self-declared black/brown, history of being a sex worker, and incarceration. Age > 37 years, history of sexual abuse, and frequent alcohol consumption were associated with hepatitis C infection. CONCLUSION The highest prevalence of HAV in this population was found in the North and Northeast regions, and the prevalence found was higher than that in the general population, suggesting greater vulnerability. The prevalence of HCV infection in our study was similar to that observed in the general population.
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Affiliation(s)
- Regina Célia Moreira
- Instituto Adolfo Lutz, Virology Center, Viral Hepatitis Laboratory –São Paulo (SP), Brazil
| | - Maria Amélia de Sousa Mascena Veras
- Núcleo de Pesquisa e Direitos Humanos em Saúde da População LGBT+ – São Paulo (SP), Brazil
- Santa Casa de São Paulo, School of Medical Sciences – São Paulo (SP), Brazil
| | - Carolina Amianti
- Universidade Federal de Mato Grosso do Sul – Campo Grande (MS), Brazil
| | - Daniel Jason McCartney
- London School of Hygiene & Tropical Medicine, Faculty of Infectious & Tropical Diseases, Department of Clinical Research – London, United Kingdom
| | | | | | - Adriana Parise Compri
- Instituto Adolfo Lutz, Virology Center, Viral Hepatitis Laboratory –São Paulo (SP), Brazil
| | | | - Katia Cristina Bassichetto
- Núcleo de Pesquisa e Direitos Humanos em Saúde da População LGBT+ – São Paulo (SP), Brazil
- Santa Casa de São Paulo, School of Medical Sciences – São Paulo (SP), Brazil
| | | | | | - Laio Magno
- Universidade do Estado da Bahia, Department of Life Sciences – Salvador (BA), Brazil
- Universidade Federal da Bahia, Institute of Public Health – Salvador (BA), Brazil
| | - Inês Dourado
- Universidade Federal da Bahia, Institute of Public Health – Salvador (BA), Brazil
| | - Lenice Galan
- Núcleo de Pesquisa e Direitos Humanos em Saúde da População LGBT+ – São Paulo (SP), Brazil
| | | | | | | | - Sandra Araujo
- Laboratory of the STD/AIDS Reference and Training Center – São Paulo (SP), Brazil
| | - Marcia Eiko Miyachi
- Laboratory of the STD/AIDS Reference and Training Center – São Paulo (SP), Brazil
| | | | | | - Philippe Mayaud
- London School of Hygiene & Tropical Medicine, Faculty of Infectious & Tropical Diseases, Department of Clinical Research – London, United Kingdom
| | - Sandro Sperandei
- Estern Sydney University, Translation Health Research Institute – Penrityh, Australia
| | - Ana Rita Coimbra Motta-Castro
- Universidade Federal de Mato Grosso do Sul – Campo Grande (MS), Brazil
- Fundação Oswaldo Cruz – Campo Grande (MS), Brazil
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2
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Castro e Silva ED, Roca TP, Passos-Silva AM, Borzacov LMP, Silva Oliveira AAD, Queiroz JADS, Salcedo JMV, Vieira D. Clinical profile and parameters of patients monoinfected with HBV and infected with HDV in Western Amazon. Heliyon 2024; 10:e31065. [PMID: 38803893 PMCID: PMC11128886 DOI: 10.1016/j.heliyon.2024.e31065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Background Hepatitis Delta represents a greater risk in the progression of advanced liver disease and HCC compared with HBV. The exact mechanism that determines the spontaneous clearance of delta virus or its progression to cirrhosis remains unknown. Therefore, this study aimed to analyze the clinical profile of HBV and HBV/HDV individuals in the Western Amazon. Methods The study was carried out at the Specialized Outpatient Clinic for Viral Hepatitis belonging to the Centro de Pesquisa em Medicina Tropical de Rondônia/CEPEM. 100 individuals were included, stratified into two groups: 50 with hepatitis B virus and 50 with hepatitis Delta virus. Results The overall mean age was 48 years. For the HBV and HDV groups, 66 % (33/50) and 54 % (27/50) were men and 56 % (28/50) and 58 % (29/50) were on antiviral treatment, respectively. Patients with detectable HDV-RNA demonstrated high levels of ALT and AST compared to individuals with undetectable HDV-RNA. Comparative analysis between HBV carriers and infected with HDV shows significant differences in terms of age, HBV-DNA levels, albumin, hepatomegaly and splenomegaly. Conclusion Several markers were important for differentiating HBV and HDV infections. HDV-RNA detectable showed significant changes in biomarkers compared to undetectable patients, suggesting a possible worse prognostic effect in this group.
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Affiliation(s)
- Eugênia de Castro e Silva
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Programa de Pós-Graduação Em Medicina Tropical, Instituto Oswaldo Cruz/IOC, FIOCRUZ, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
- Departamento de Medicina, Universidade Federal de Rondônia – UNIR, Porto Velho, RO, Brazil
- Centro de Pesquisa Em Medicina Tropical – CEPEM, Porto Velho, RO, Brazil
| | - Tárcio Peixoto Roca
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Programa de Pós-Graduação Em Medicina Tropical, Instituto Oswaldo Cruz/IOC, FIOCRUZ, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz/IOC, FIOCRUZ, RJ, Brazil
| | - Ana Maísa Passos-Silva
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
- Programa de Pós-Graduação Em Biologia Experimental, Universidade Federal de Rondônia e Fundação Oswaldo Cruz Rondônia – UNIR/FIOCRUZ-RO, Porto Velho, RO, Brazil
| | | | - Adrhyan Araújo da Silva Oliveira
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
| | - Jackson Alves da Silva Queiroz
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
- Programa de Pós-Graduação Em Biologia Experimental, Universidade Federal de Rondônia e Fundação Oswaldo Cruz Rondônia – UNIR/FIOCRUZ-RO, Porto Velho, RO, Brazil
| | - Juan Miguel Villalobos Salcedo
- Departamento de Medicina, Universidade Federal de Rondônia – UNIR, Porto Velho, RO, Brazil
- Centro de Pesquisa Em Medicina Tropical – CEPEM, Porto Velho, RO, Brazil
| | - Deusilene Vieira
- Laboratório de Virologia Molecular, Fundação Oswaldo Cruz Rondônia - FIOCRUZ/RO, Porto Velho, RO, Brazil
- Instituto Nacional de Ciência e Tecnologia de Epidemiologia da Amazônia Ocidental – INCT-EpiAmO, Porto Velho, RO, Brazil
- Programa de Pós-Graduação Em Biologia Experimental, Universidade Federal de Rondônia e Fundação Oswaldo Cruz Rondônia – UNIR/FIOCRUZ-RO, Porto Velho, RO, Brazil
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Pearlman B. Hepatitis Delta Infection: A Clinical Review. Semin Liver Dis 2023; 43:293-304. [PMID: 37473778 PMCID: PMC10620035 DOI: 10.1055/a-2133-8614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
First discovered over 40 years ago, the hepatitis delta virus (HDV) is a unique RNA virus, requiring hepatitis B virus (HBV) antigens for its assembly, replication, and transmission. HBV and HDV can be acquired at the same time (coinfection) or HDV infection can occur in persons with chronic HBV (superinfection). Screening guidelines for HDV are inconsistent. While some guidelines recommend universal screening for all people with HBV, others recommend risk-based screening. Estimates of the global HDV prevalence range from 4.5 to 14.6% among persons with HBV; thus, there may be up to 72 million individuals with HDV worldwide. HDV is the most severe form of viral hepatitis. Compared to HBV monoinfection, HDV coinfection increases the risk of cirrhosis, hepatocellular carcinoma, hepatic decompensation, mortality, and necessity for liver transplant. Despite the severity of HDV, there are few treatment options. Pegylated interferon (off-label use) has long been the only available treatment, although bulevirtide is conditionally approved in some European countries. There are many potential treatments in development, but as yet, there are few effective and safe therapies for HDV infection. In conclusion, given the severity of HDV disease and the paucity of treatments, there is a great unmet need for HDV therapies.
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Affiliation(s)
- Brian Pearlman
- Department of Internal Medicine, Wellstar Atlanta Medical Center, Medical College of Georgia, Emory School of Medicine, Atlanta, Georgia
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4
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Souza Campos M, Villalobos-Salcedo JM, Vieira Dallacqua DS, Lopes Borges Andrade C, Meyer Nascimento RJ, Menezes Freire S, Paraná R, Schinoni MI. Systemic Inflammatory Molecules Are Associated with Advanced Fibrosis in Patients from Brazil Infected with Hepatitis Delta Virus Genotype 3 (HDV-3). Microorganisms 2023; 11:1270. [PMID: 37317244 DOI: 10.3390/microorganisms11051270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND AND AIMS Hepatitis Delta virus (HDV) genotype 3 is responsible for outbreaks of fulminant hepatitis in Northeastern South America. This study investigates if systemic inflammatory molecules are differentially expressed in patients with advanced fibrosis chronically infected with Hepatitis Delta virusgenotype 3(HDV-3). METHODS Sixty-one patients from the north of Brazil coinfected with hepatitis B virus (HBV)/HDV-3 were analyzed. HDV quantification and genotyping were performed by semi-nested real-time polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) methodologies. Ninety-two systemic inflammatory molecules (SIMs) were measured by Proximity Extension Assay (PEA) technology. The Shapiro-Wilk, Student's t-test, Mann-Whitney tests, and logistic regression analysis were used when appropriate. RESULTS The median age was 41 years, and all patients were HBeAg negative. Advanced fibrosis or cirrhosis was diagnosed by histological staging in 17 patients, while 44 presented with minimal or no fibrosis. Advanced necroinflammatory activity correlated positively with serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Established non-invasive fibrosis scores (APRI, FIB-4, and AST/ALT ratio) revealed low sensitivities and positive predictive values (PPVs) with an AUROC maximum of 0.586. Among the 92 SIMs analyzed, MCP.4, CCL19, EN.RAGE, SCF, and IL18 showed a positive correlation with fibrosis stage. A combined score including CCL19 and MCP.4 revealed a sensitivity of 81% and an odds ratio of 2.202 for advanced fibrosis. CONCLUSIONS Standard non-invasive fibrosis scores showed poor performance in HDV-3 infection. We here suggest that the determination of CCL19 and MCP.4 may be used to identify patients with advanced fibrosis. Moreover, this study gives novel insights into the immunopathogenesis of HDV-3 infection.
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Affiliation(s)
- Mauricio Souza Campos
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Programa de Pós-Graduação em Processos Interativos de Órgãos e Sistemas, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
| | | | | | - Caio Lopes Borges Andrade
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Programa de Pós-Graduação em Imunologia, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Laboratório de Imunologia e Biologia Molecular, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300,Brazil
| | - Roberto José Meyer Nascimento
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Programa de Pós-Graduação em Imunologia, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Laboratório de Imunologia e Biologia Molecular, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300,Brazil
| | - Songeli Menezes Freire
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Programa de Pós-Graduação em Imunologia, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Laboratório de Imunologia e Biologia Molecular, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300,Brazil
| | - Raymundo Paraná
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Hospital Universitario Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Maria Isabel Schinoni
- Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Programa de Pós-Graduação em Processos Interativos de Órgãos e Sistemas, Instituto Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
- Hospital Universitario Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40110-060, Brazil
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Chida T, Ishida Y, Morioka S, Sugahara G, Han C, Lam B, Yamasaki C, Sugahara R, Li M, Tanaka Y, Liang TJ, Tateno C, Saito T. Persistent hepatic IFN system activation in HBV-HDV infection determines viral replication dynamics and therapeutic response. JCI Insight 2023; 8:162404. [PMID: 37154158 DOI: 10.1172/jci.insight.162404] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/22/2023] [Indexed: 05/10/2023] Open
Abstract
Hepatitis delta virus (HDV), a satellite virus of HBV, is regarded as the most severe type of hepatitis virus because of the substantial morbidity and mortality. The IFN system is the first line of defense against viral infections and an essential element of antiviral immunity; however, the role of the hepatic IFN system in controlling HBV-HDV infection remains poorly understood. Herein, we showed that HDV infection of human hepatocytes induced a potent and persistent activation of the IFN system whereas HBV was inert in triggering hepatic antiviral response. Moreover, we demonstrated that HDV-induced constitutive activation of the hepatic IFN system resulted in a potent suppression of HBV while modestly inhibiting HDV. Thus, these pathogens are equipped with distinctive immunogenicity and varying sensitivity to the antiviral effectors of IFN, leading to the establishment of a paradoxical mode of viral interference wherein HDV, the superinfectant, outcompetes HBV, the primary pathogen. Furthermore, our study revealed that HDV-induced constitutive IFN system activation led to a state of IFN refractoriness, rendering therapeutic IFNs ineffective. The present study provides potentially novel insights into the role of the hepatic IFN system in regulating HBV-HDV infection dynamics and its therapeutic implications through elucidating the molecular basis underlying the inefficacy of IFN-based antiviral strategies against HBV-HDV infection.
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Affiliation(s)
- Takeshi Chida
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Yuji Ishida
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
- PhoenixBio, Co., Ltd., Higashi-Hiroshima, Hiroshima, Japan
| | - Sho Morioka
- PhoenixBio, Co., Ltd., Higashi-Hiroshima, Hiroshima, Japan
| | - Go Sugahara
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
- PhoenixBio, Co., Ltd., Higashi-Hiroshima, Hiroshima, Japan
| | - Christine Han
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Bill Lam
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | | | - Remi Sugahara
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Meng Li
- Bioinformatics Service, Norris Medical Library, USC, Los Angeles, California, USA
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - T Jake Liang
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA
| | - Chise Tateno
- PhoenixBio, Co., Ltd., Higashi-Hiroshima, Hiroshima, Japan
| | - Takeshi Saito
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
- Department of Molecular Microbiology & Immunology
- Department of Pathology, and
- USC Research Center for Liver Diseases, Keck School of Medicine, USC, Los Angeles, California, USA
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Blaney H, Khalid M, Heller T, Koh C. Epidemiology, presentation, and therapeutic approaches for hepatitis D infections. Expert Rev Anti Infect Ther 2023; 21:127-142. [PMID: 36519386 PMCID: PMC9905306 DOI: 10.1080/14787210.2023.2159379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Chronic Hepatitis D virus (HDV) infection remains an important global public health problem, with a changing epidemiological landscape over the past decade along with widespread implementation of hepatitis B vaccination and human migration. The landscape of HDV treatments has been changing, with therapies that have been under development for the last decade now in late stage clinical trials. The anticipated availability of these new therapies will hopefully replace the current therapies which are minimally effective. AREAS COVERED This narrative review discusses the clinical course, screening and diagnosis, transmission risk factors, epidemiology, current and investigational therapies, and liver transplantation in HDV. Literature review was performed using PubMed and ClinicalTrials.gov and includes relevant articles from 1977 to 2022. EXPERT OPINION HDV infection is an important global public health issue with a true prevalence that is still unknown. The distribution of HDV infection has changed globally with the availability of HBV vaccination and patterns of human migration. As HDV infection is associated with accelerated disease courses and poor outcomes, the global community needs to agree upon a uniform HDV screening strategy to understand the truth of global prevalence such that new therapies can target appropriate individuals as they become available in the future.
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Affiliation(s)
- Hanna Blaney
- Digestive Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Mian Khalid
- Digestive Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Theo Heller
- Liver Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher Koh
- Liver Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Santos Alves FAGD, Nogueira Lima FDS, Ribeiro JR, Roca TP, Santos ADOD, Botelho Souza LF, Villalobos-Salcedo JM, Vieira DS. Genetic diversity of HBV in indigenous populations on the border between Brazil and Bolivia. Braz J Infect Dis 2022; 26:102700. [PMID: 36088957 PMCID: PMC9513627 DOI: 10.1016/j.bjid.2022.102700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 02/07/2023] Open
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Osiowy C, Swidinsky K, Haylock-Jacobs S, Sadler MD, Fung S, Wong D, Minuk GY, Doucette KE, Wong P, Tam E, Cooper C, Ramji A, Ma M, Nudo C, Tsoi K, Coffin CS. Molecular epidemiology and clinical characteristics of hepatitis D virus infection in Canada. JHEP Rep 2022; 4:100461. [PMID: 35360523 PMCID: PMC8961228 DOI: 10.1016/j.jhepr.2022.100461] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/26/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022] Open
Abstract
Background & Aims HDV affects 4.5-13% of chronic hepatitis B (CHB) patients globally, yet the prevalence of HDV infection in Canada is unknown. To investigate the prevalence, genotype, demographics, and clinical characteristics of HDV in Canada, we conducted a retrospective analysis of (1) HDV antibody and RNA positivity among referred specimens, and (2) a cross-sectional subset study of 135 HDV seropositive +/-RNA (HDV+) patients compared with 5,132 HBV mono-infected patients in the Canadian HBV Network. Methods Anti-HDV IgG-positive specimens collected between 2012 and 2019 were RNA tested and the genotype determined. Patients enrolled in the Canadian HBV Network were >18 years of age and HBsAg-positive. Clinical data collected included risk factors, demographics, comorbidities, treatment, fibrosis assessment, and hepatic complications. Results Of the referred patients, 338/7,080 (4.8%, 95% CI 4.3-5.3) were HDV seropositive, with 219/338 RNA-positive (64.8%, 95% CI 59.6-69.7). The HDV+ cohort were more likely to be born in Canada, to be White or Black/African/Caribbean than Asian, and reporting high-risk behaviours, compared with HBV mono-infected patients. Cirrhosis, complications of end-stage liver disease, and liver transplantation were significantly more frequent in the HDV+ cohort. HDV viraemia was significantly associated with elevated liver transaminases and cirrhosis. Five HDV genotypes were observed among referred patients but no association between genotype and clinical outcome was detected within the HDV+ cohort. Conclusions Nearly 5% of the Canadian HBV referral population is HDV seropositive. HDV infection is highly associated with risk behaviours and both domestic and foreign-born patients with CHB. HDV was significantly associated with progressive liver disease highlighting the need for increased screening and surveillance of HDV in Canada. Lay summary Evidence of HDV infection was observed in approximately 5% of Canadians who were infected with HBV referred to medical specialists. HDV-positive patients were more likely to be male, born in Canada, or White or Black/African/Caribbean compared to Asian, and to have reported high-risk activities such as injection or intranasal drug use or high-risk sexual contact compared with patients infected with only HBV. Patients infected with HDV were also more likely to suffer severe liver disease, including liver cancer, compared with HBV mono-infected patients.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- CHB, chronic HBV infection
- CanHepB Network, Canadian HBV network
- Cirrhosis
- Epidemiology
- Genotype
- HCC, hepatocellular carcinoma
- Hepatitis B virus
- Hepatitis D virus
- IFNα, pegylated interferon-alpha
- INR, international normalised ratio (prothrombin time of blood clotting)
- NAs, nucleos(t)ide analogue inhibitors
- NML, National Microbiology Laboratory
- TE, transient elastography
- bp, base pairs
- gt, genotype
- n, count
- qHBsAg, quantitative HBsAg
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Affiliation(s)
- Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- University of Manitoba, Winnipeg, MB, Canada
| | - Ken Swidinsky
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | | | | | - Scott Fung
- University of Toronto, Toronto, ON, Canada
| | - David Wong
- University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | - Alnoor Ramji
- University of British Columbia, Vancouver, BC, Canada
| | - Mang Ma
- University of Alberta, Edmonton, AB, Canada
| | - Carmine Nudo
- Hôpital de la Cité-de-la-Santé, Laval, QC, Canada
| | - Keith Tsoi
- McMaster University, Hamilton, ON, Canada
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9
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Araújo SDR, Malheiros AP, Sarmento VP, Nunes HM, Freitas PEB. Molecular investigation of occult hepatitis B virus infection in a reference center in Northern Brazil. Braz J Infect Dis 2022; 26:102367. [PMID: 35598631 PMCID: PMC9387453 DOI: 10.1016/j.bjid.2022.102367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/30/2022] [Indexed: 11/18/2022] Open
Abstract
The goal of this study was to investigate the prevalence of occult HBV infection in a reference center for the Northern Brazil from 2005 to 2015 and to identify mutations associated with occult hepatitis B. Molecular analysis was performed on 110 serum samples in which anti-HBc was the only positive serological marker. Regions of the HBV genome were amplified by polymerase chain reaction to detect HBV DNA. A prevalence of 4.1% (793/18,889) for anti-HBc alone was identified. Molecular analysis revealed a prevalence of occult HBV infection of 0.04%. HBV DNA detected were identified in individuals who underwent hemodialysis, infected with the hepatitis C virus and from area of high endemicity for HBV. Direct DNA nucleotide sequencing and phylogenetic analysis identified that genotypes A and D and mutations E164D, I195M, P217L and P120S were associated with occult HBV infection in the S gene. This study contributed with epidemiological and molecular information on Northern Brazil samples with a suggestive profile of occult HBV infection in addition to reinforcing the importance of molecular diagnosis in this type of infection.
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10
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Kumar R. Review on hepatitis B virus precore/core promoter mutations and their correlation with genotypes and liver disease severity. World J Hepatol 2022; 14:708-718. [PMID: 35646275 PMCID: PMC9099108 DOI: 10.4254/wjh.v14.i4.708] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/04/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Of 350 million people worldwide are chronically infected with hepatitis B virus (HBV) and are at risk of developing cirrhosis and hepatocellular carcinoma (HCC) later in life. HBV is the most diverse DNA virus, and its genome is composed of four open reading frames: Presurface antigen/surface antigen gene (preS/S), precore/core gene (preC/C), polymerase gene (P), and the X gene (X). HBV produces quasispecies naturally or in response to antiviral agents because of the absence of proofreading activity amid reverse transcription and a high replication rate. The virus has 10 genotypes (A to J) with different geographical distributions. There are various HBV mutations in the HBV genome, including preC/C mutations, preS/S mutations, P gene mutations, and X gene mutations. The core promoter region plays a vital part in the replication, morphogenesis and pathogenesis of the virus. The precore region also plays a crucial role in viral replication. Both core promoter and precore mutations rescue the virus from host immune surveillance and result in the formation of mutated strains that may have altered pathogenicity. preC/C mutations are associated with liver disease progression. Precore mutations stop hepatitis B e antigen (HBeAg) production and basal core promoter mutations downregulate HBeAg production. Mutations in the basal core promoter are also associated with increased HBV replication and an increased incidence of advanced liver diseases such as cirrhosis and HCC. The emergence of antiviral-resistant mutations is the main reason for treatment failure. This review focuses mainly on preC/C promoter mutations and their correlation with genotypes and liver disease severity. Thorough perception and knowledge of HBV genetic variety and mutants could be vital to discover techniques for the prognosis and control of HBV infection.
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Affiliation(s)
- Rajesh Kumar
- Department of School Education, Haryana Government, Panchkula 134109, Haryana, India
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11
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Sagnelli C, Pisaturo M, Curatolo C, Codella AV, Coppola N, Sagnelli E. Hepatitis B virus/hepatitis D virus epidemiology: Changes over time and possible future influence of the SARS-CoV-2 pandemic. World J Gastroenterol 2021; 27:7271-7284. [PMID: 34876788 PMCID: PMC8611207 DOI: 10.3748/wjg.v27.i42.7271] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis D virus (HDV) is a defective liver-tropic virus that needs the helper function of hepatitis B virus (HBV) to infect humans and replicate. HDV is transmitted sexually or by a parenteral route, in co-infection with HBV or by super-infection in HBV chronic carriers. HDV infection causes acute hepatitis that may progress to a fulminant form (7%-14% by super-infection and 2%-3% by HBV/HDV co-infection) or to chronic hepatitis (90% by HDV super-infection and 2%-5% by HBV/HDV co-infection), frequently and rapidly progressing to cirrhosis or hepatocellular carcinoma (HCC). Peg-interferon alfa the only recommended therapy, clears HDV in only 10%-20% of cases and, consequently, new treatment strategies are being explored. HDV endemicity progressively decreased over the 50 years from the identification of the virus, due to improved population lifestyles and economic levels, to the use of HBV nuclei(t)side analogues to suppress HBV replication and to the application of universal HBV vaccination programs. Further changes are expected during the severe acute respiratory syndrome coronavirus-2 pandemic, unfortunately towards increased endemicity due to the focus of healthcare towards coronavirus disease 2019 and the consequently lower possibility of screening and access to treatments, lower care for patients with severe liver diseases and a reduced impulse to the HBV vaccination policy.
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Affiliation(s)
- Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples 80131, Italy
| | - Mariantonietta Pisaturo
- Department of Mental Health and Public Medicine, University of Campania, Naples 80135, Italy
| | - Caterina Curatolo
- Department of Mental Health and Public Medicine, University of Campania, Naples 80135, Italy
| | - Alessio Vinicio Codella
- Department of Mental Health and Public Medicine, University of Campania, Naples 80135, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples 80135, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples 80131, Italy
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12
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Meneghello BHDS, Soares MMCN, Silva VCM, Lemos MF, Cervato MC, Caetano Filho J, Sitnik R, Estécio TCH, Compri AP, Pinho JRR, Moreira RC. Hepatitis B in the Northwestern region of Sao Paulo State: genotypes and resistance mutations. Rev Inst Med Trop Sao Paulo 2021; 63:e78. [PMID: 34755817 PMCID: PMC8580483 DOI: 10.1590/s1678-9946202163078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/15/2021] [Indexed: 11/22/2022] Open
Abstract
In Brazil, few studies on the molecular aspects of hepatitis B virus (HBV)
infection have been conducted in the interior regions of Sao Paulo State. This
study aimed to identify HBV genotypes and evaluate strains with resistance
mutations for nucleoside analogues in the Administrative Region (AR) of the
municipality of Sao Jose do Rio Preto. We performed nested PCRs of 127 samples
from the Health Care Services of the AR to amplify, sequence and analyze
fragments of the HBV DNA, in order to identify genotypes and resistance
mutations. The HBV S/Pol regions of 126 samples were successfully amplified and
sequenced. Five different genotypes were found, and the main ones were A, D and
F; a greater number of samples contained the subgenotypes A1 (n = 51; 40.5%), D3
(n = 36; 28.6%), A2 (n = 14; 11.1%) and F2a (n = 9; 7.1%). Resistance mutations
(rtM204V/I/S) associated or not with compensatory mutations (rtL180M, rtV173L)
were identified in 13.9% (5/36) of patients undergoing viral treatment and 1.1%
(1/90) of naïve patients. The diversity of genotypes/subgenotypes found is
probably due to the intense migration occurring in the region. These data can
complement epidemiological and clinical surveillance, and can be used for a more
effective management of chronic HBV patients.
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Affiliation(s)
| | | | | | | | | | - João Caetano Filho
- Instituto Adolfo Lutz, Centro de Laboratório Regional, São José do Rio Preto, São Paulo, Brazil
| | - Roberta Sitnik
- Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | | | | | - João Renato Rebello Pinho
- Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Hospital das Clínicas, LIM-03, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Gastroenterologia e Hepatologia Tropical "João de Queiroz e Castorina Bettencourt Alves", LIM-07, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo, São Paulo, Brazil
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13
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Asif B, Koh C. Hepatitis D virus (HDV): investigational therapeutic agents in clinical trials. Expert Opin Investig Drugs 2021; 31:905-920. [PMID: 34482769 DOI: 10.1080/13543784.2021.1977795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Chronic Hepatitis D virus (HDV) infection is a global disease leading to rapidly progressive liver disease with increased liver-related mortality and hepatocellular carcinoma. Therapies are minimally effective; however, an increased understanding of the HDV lifecycle has provided new potential drug targets. Thus, there is a growing number of investigational therapeutics under exploration for HDV with the potential for successful viral eradication. AREAS COVERED This review discusses the clinical impact of HDV infection and offers an in-depth look at the HDV life cycle. The authors examine current and new drug targets and the investigational therapies in clinical trials. The search strategy was based on PubMed database and clinicaltrials.gov which highlight the most up-to-date aspects of investigational therapies for chronic HDV infection.
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Affiliation(s)
- Bilal Asif
- Digestive Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, USA
| | - Christopher Koh
- Liver Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, USA
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14
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Zakh R, Churkin A, Totzeck F, Parr M, Tuller T, Etzion O, Dahari H, Roggendorf M, Frishman D, Barash D. A Mathematical Analysis of HDV Genotypes: From Molecules to Cells. MATHEMATICS (BASEL, SWITZERLAND) 2021; 9:2063. [PMID: 34540628 PMCID: PMC8445514 DOI: 10.3390/math9172063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hepatitis D virus (HDV) is classified according to eight genotypes. The various genotypes are included in the HDVdb database, where each HDV sequence is specified by its genotype. In this contribution, a mathematical analysis is performed on RNA sequences in HDVdb. The RNA folding predicted structures of the Genbank HDV genome sequences in HDVdb are classified according to their coarse-grain tree-graph representation. The analysis allows discarding in a simple and efficient way the vast majority of the sequences that exhibit a rod-like structure, which is important for the virus replication, to attempt to discover other biological functions by structure consideration. After the filtering, there remain only a small number of sequences that can be checked for their additional stem-loops besides the main one that is known to be responsible for virus replication. It is found that a few sequences contain an additional stem-loop that is responsible for RNA editing or other possible functions. These few sequences are grouped into two main classes, one that is well-known experimentally belonging to genotype 3 for patients from South America associated with RNA editing, and the other that is not known at present belonging to genotype 7 for patients from Cameroon. The possibility that another function besides virus replication reminiscent of the editing mechanism in HDV genotype 3 exists in HDV genotype 7 has not been explored before and is predicted by eigenvalue analysis. Finally, when comparing native and shuffled sequences, it is shown that HDV sequences belonging to all genotypes are accentuated in their mutational robustness and thermodynamic stability as compared to other viruses that were subjected to such an analysis.
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Affiliation(s)
- Rami Zakh
- Department of Computer Science, Ben-Gurion University, Beer-Sheva 8410501, Israel
| | - Alexander Churkin
- Department of Software Engineering, Sami Shamoon College of Engineering, Beer-Sheva 8410501, Israel
| | - Franziska Totzeck
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Maximus-von-Imhof-Forum 3, 85354 Freising, Germany
| | - Marina Parr
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Maximus-von-Imhof-Forum 3, 85354 Freising, Germany
| | - Tamir Tuller
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Ohad Etzion
- Soroka University Medical Center, Ben-Gurion University, Beer-Sheva 8410501, Israel
| | - Harel Dahari
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Michael Roggendorf
- Institute of Virology, Technische Universität München, 81675 Munich, Germany
| | - Dmitrij Frishman
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Maximus-von-Imhof-Forum 3, 85354 Freising, Germany
| | - Danny Barash
- Department of Computer Science, Ben-Gurion University, Beer-Sheva 8410501, Israel
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15
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Silva RJS, do Nascimento RS, Oliveira-Neto JAJ, Silva FQ, Piauiense JNF, Gomes CM, Pinheiro LML, Resque RL, Pinho JRR, Kupek E, Fischer B, Machado LFA, Martins LC, Lemos JAR, Oliveira-Filho AB. Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region. Viruses 2021; 13:v13071380. [PMID: 34372586 PMCID: PMC8310228 DOI: 10.3390/v13071380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.
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Affiliation(s)
- Ronylson José S. Silva
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Raquel Silva do Nascimento
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - José Augusto J. Oliveira-Neto
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Fabricio Quaresma Silva
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Juliana Nádia F. Piauiense
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
| | - Camila Moraes Gomes
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Luiz Marcelo L. Pinheiro
- Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, PA, Brazil;
| | - Rafael Lima Resque
- Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, AP, Brazil;
| | - João Renato R. Pinho
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil;
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil;
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada;
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, SP, Brazil
| | - Luiz Fernando A. Machado
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Luísa Caricio Martins
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, PA, Brazil
| | - José Alexandre R. Lemos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Aldemir B. Oliveira-Filho
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
- Correspondence: ; Tel.: +55-91-3425-1209
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16
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Ferrante ND, Lo Re V. Epidemiology, Natural History, and Treatment of Hepatitis Delta Virus Infection in HIV/Hepatitis B Virus Coinfection. Curr HIV/AIDS Rep 2020; 17:405-414. [PMID: 32607773 DOI: 10.1007/s11904-020-00508-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Limited data exist on the prevalence, determinants, and outcomes of hepatitis delta virus (HDV) infection among HIV/hepatitis B virus (HBV)-coinfected persons. This review provides current evidence on the epidemiology, natural history, and treatment of HDV infection in patients with HIV/HBV coinfection and highlights future research needs. RECENT FINDINGS Cross-sectional studies in Europe, Africa, South America, and Asia show that the prevalence of HDV among HIV/HBV-coinfected patients ranges from 1.2 to 25%. No studies have evaluated the prevalence of HDV infection among HIV/HBV-coinfected patients in the USA. HDV infection increases the risk of hepatic decompensation and hepatocellular carcinoma among HIV/HBV-coinfected patients. HDV treatment remains limited to pegylated interferon-alpha, which results in sustained virologic response in fewer than 25%. Data on the epidemiology, natural history, and treatment of HDV among HIV/HBV-coinfected persons remain limited. More research is needed to address these knowledge gaps in order to better manage HDV coinfection in HIV/HBV-coinfected patients.
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Affiliation(s)
- Nicole D Ferrante
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, 836 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA.
- Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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17
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Pujol F, Jaspe RC, Loureiro CL, Chemin I. Hepatitis B virus American genotypes: Pathogenic variants ? Clin Res Hepatol Gastroenterol 2020; 44:825-835. [PMID: 32553521 DOI: 10.1016/j.clinre.2020.04.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) chronic infection is responsible for almost 900.000 deaths each year, due to cirrhosis or hepatocellular carcinoma (HCC). Ten HBV genotypes have been described (A-J). HBV genotype F and H circulate in America. HBV genotypes have been further classified in subgenotypes. There is a strong correlation between the genetic admixture of the American continent and the frequency of genotypes F or H: a high frequency of these genotypes is found in countries with a population with a higher ratio of Amerindian to African genetic admixture. The frequency of occult HBV infection in Amerindian communities from Latin America seems to be higher than the one found in other HBV-infected groups, but its association with American genotypes is unknown. There is growing evidence that some genotypes might be associated with a faster evolution to HCC. In particular, HBV genotype F has been implicated in a frequent and rapid progression to HCC. However, HBV genotype H has been associated to a less severe progression of disease. This study reviews the diversity and frequency of autochthonous HBV variants in the Americas and evaluates their association to severe progression of disease. Although no significant differences were found in the methylation pattern between different genotypes and subgenotypes of the American types, basal core promoter mutations might be more frequent in some subgenotypes, such as F1b and F2, than in other American subgenotypes or genotype H. F1b and probably F2 may be associated with a severe presentation of liver disease as opposed to a more benign course for subgenotype F4 and genotype H. Thus, preliminary evidence suggests that not all of the American variants are associated with a rapid progression to HCC.
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Affiliation(s)
- Flor Pujol
- Laboratorio de Virología Molecular, CMBC, IVIC, Apdo 20632, Caracas 1020A, Venezuela.
| | - Rossana C Jaspe
- Laboratorio de Virología Molecular, CMBC, IVIC, Apdo 20632, Caracas 1020A, Venezuela
| | - Carmen L Loureiro
- Laboratorio de Virología Molecular, CMBC, IVIC, Apdo 20632, Caracas 1020A, Venezuela
| | - Isabelle Chemin
- INSERM U1052, CNRS 5286, Université de Lyon, Université Claude Bernard Lyon 1, centre Léon Bérard, centre de recherche en cancérologie de Lyon, 69000, Lyon, France
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18
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Leroux N, Nouhin J, Prak S, Roth B, Rouet F, Dussart P, Marx N. Prevalence and Phylogenetic Analysis of Hepatitis B in Captive and Wild-Living Pileated Gibbons (Hylobates pileatus) in Cambodia. INT J PRIMATOL 2020. [DOI: 10.1007/s10764-020-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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HDVdb: A Comprehensive Hepatitis D Virus Database. Viruses 2020; 12:v12050538. [PMID: 32422927 PMCID: PMC7290977 DOI: 10.3390/v12050538] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023] Open
Abstract
Hepatitis D virus (HDV) causes the most severe form of viral hepatitis, which may rapidly progress to liver cirrhosis and hepatocellular carcinoma (HCC). It has been estimated that 15-20 million people worldwide are suffering from the chronic HDV infection. Currently, no effective therapies are available to treat acute or chronic HDV infection. The remarkable sequence variability of the HDV genome, particularly within the hypervariable region has resulted in the provisional classification of eight major genotypes and various subtypes. We have developed a specialized database, HDVdb (http://hdvdb.bio.wzw.tum.de/), which contains a collection of partial and complete HDV genomic sequences obtained from the GenBank and from our own patient cohort. HDVdb enables the researchers to investigate the genetic variability of all available HDV sequences, correlation of genotypes to epidemiology and pathogenesis. Additionally, it will contribute in understanding the drug resistant mutations and develop effective vaccines against HDV infection. The database can be accessed through a web interface that allows for static and dynamic queries and offers integrated generic and specialized sequence analysis tools, such as annotation, genotyping, primer prediction, and phylogenetic analyses.
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20
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Nogueira-Lima FS, Botelho-Souza LF, Roca TP, Santos AOD, Oliveira SDC, Queiroz JADS, Santos-Alves FAGD, Salcedo JMV, Vieira DS. Phylodynamic and Phylogeographic Analysis of Hepatitis Delta Virus Genotype 3 Isolated in South America. Viruses 2019; 11:v11110995. [PMID: 31671829 PMCID: PMC6893442 DOI: 10.3390/v11110995] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/21/2019] [Indexed: 12/13/2022] Open
Abstract
The hepatitis delta virus (HDV) is a globally distributed agent, and its genetic variability allows for it to be organized into eight genotypes with different geographic distributions. In South America, genotype 3 (HDV-3) is frequently isolated and responsible for the most severe form of infection. The objective of this study was to evaluate the evolutionary and epidemiological dynamics of HDV-3 over the years and to describe its distribution throughout this continent in an evolutionary perspective. While using Bayesian analysis, with strains being deposited in the Nucleotide database, the most recent common ancestor was dated back to 1964 and phylogenetic analysis indicated that the dispersion may have started in Brazil, spreading to Venezuela and then to Colombia, respectively. Exponential growth in the effective number of infections was observed between the 1950s and 1970s, years after the first report of the presence of HDV on the continent, during the Labrea Black Fever outbreak, which showed that the virus continued to spread, increasing the number of cases decades after the first reports. Subsequently, the analysis showed a decrease in the epidemiological levels of HDV, which was probably due to the implantation of the vaccine against its helper virus, hepatitis B virus, and serological screening methods implemented in the blood banks.
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Affiliation(s)
- Felipe Souza Nogueira-Lima
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Luan Felipo Botelho-Souza
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Tárcio Peixoto Roca
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Alcione Oliveira Dos Santos
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Suyane da Costa Oliveira
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Jackson Alves da Silva Queiroz
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
| | - Fabianne Araújo Gomes Dos Santos-Alves
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Juan Miguel Villalobos Salcedo
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Deusilene Souza Vieira
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
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21
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Coppola N, Alessio L, Onorato L, Sagnelli C, Sagnelli E, Pisaturo M. HDV infection in immigrant populations. J Med Virol 2019; 91:2049-2058. [PMID: 31429940 DOI: 10.1002/jmv.25570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/10/2019] [Indexed: 12/16/2022]
Abstract
AIMS Little data have been published so far on the epidemiological aspects of hepatitis D virus (HDV) infection in immigrant populations and even poorer is the information on the virological, phylogenetic, and clinical aspects of this infection in these populations. This review article, aimed primarily at physicians caring for immigrants, summarizes the information available on HDV infection and analyzes data on this topic concerning the immigrant populations. METHODS AND RESULTS The prevalence of HDV infection in HBsAg-positive immigrants varies according to the country of origin. For example, in immigrants from sub-Saharan Africa, this prevalence is higher in those born in Equatorial Guinea (24.4%) than those from other African countries (10.3%). The epidemiological impact of HDV infection linked to migratory flows is a function of the different endemicity between countries of origin and countries in which a new existence has been established. This impact is high when immigrants from areas endemic to HDV infection (eg, Equatorial Guinea) settle in areas of low endemicity (eg, Germany or England, with a prevalence of around 4%), while the impact is lesser or nonexistent if the migratory flows are directed toward countries with intermediate endemicity (eg, Italy and Greece, with a prevalence of around 10%). CONCLUSION This impact of immigration on HDV epidemiology can be strong when HDV endemicity is high in the country of origin and low in the host country and slight when immigrants move to high or medium endemic countries.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.,Infectious Disease Unit, AORN Caserta, Caserta, Italy
| | | | - Lorenzo Onorato
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.,Infectious Disease Unit, AORN Caserta, Caserta, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mariantonietta Pisaturo
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
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22
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Karimzadeh H, Usman Z, Frishman D, Roggendorf M. Genetic diversity of hepatitis D virus genotype-1 in Europe allows classification into subtypes. J Viral Hepat 2019; 26:900-910. [PMID: 30801877 DOI: 10.1111/jvh.13086] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/24/2019] [Indexed: 01/09/2023]
Abstract
Hepatitis delta virus (HDV) is an RNA virus which leads to both acute and chronic forms of hepatitis. At present, HDV isolates have been classified into eight major genotypes distributed over different geographical regions. Recent increase in HDV sequences in Europe and worldwide has enabled us to revisit the taxonomic classification of HDV. A total of 116 large hepatitis delta antigen (L-HDAg) nucleotide sequences and 13 full-length HDV genome sequences belonging to genotype-1 from our European cohort, as well as 621 L-HDAg nucleotide sequences belonging to genotype-1 to genotype-8 retrieved from the GenBank NCBI were included in this study. All 116 isolates of our cohort and 341 of 621 isolates (60%) account for genotype-1, while the remaining 40% of isolates were unevenly distributed across genotype-2 to genotype-8. Phylogenetic analysis of 98 L-HDAg sequences selected after elimination of redundant sequences of all 737 isolates was performed to identify plausible subtypes within HDV genotype-1. Pairwise genetic distances for L-HDAg sequences were calculated to estimate the inter-genotype and inter-subtype differences. The HDV genotype-1 isolates phylogenetically formed five distinct clusters (genotype 1a-1e), each of them corresponding to a distinct geographic region. Two distinct subtypes for HDV genotype-2 and -4 (ie -2a and -2b; -4a and -4b, respectively) could be identified based on isolate sequences from GenBank. The previously defined genotype-1 to genotype-8 have an inter-genotypic difference of ≥10%, while the newly defined subtypes of genotype-1, -2 and -4 show an inter-subtype difference of ≥3% to <10% from the average diversity. In addition, we identified unique amino acid residues, known as specificity-determining positions, amongst the proposed subtypes.
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Affiliation(s)
- Hadi Karimzadeh
- Institute of Virology, Technische Universität München, Munich, Germany.,Department of Medicine II, University Hospital, LMU, Munich, Germany
| | - Zainab Usman
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Freising, Germany
| | - Dmitrij Frishman
- Department of Bioinformatics, Wissenschaftszentrum Weihenstephan, Technische Universität München, Freising, Germany.,Laboratory of Bioinformatics, RASA Research Center, St. Petersburg State Polytechnical University, Saint Petersburg, Russia
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23
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Mentha N, Clément S, Negro F, Alfaiate D. A review on hepatitis D: From virology to new therapies. J Adv Res 2019; 17:3-15. [PMID: 31193285 PMCID: PMC6526199 DOI: 10.1016/j.jare.2019.03.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023] Open
Abstract
Hepatitis delta virus (HDV) is a defective virus that requires the hepatitis B virus (HBV) to complete its life cycle in human hepatocytes. HDV virions contain an envelope incorporating HBV surface antigen protein and a ribonucleoprotein containing the viral circular single-stranded RNA genome associated with both forms of hepatitis delta antigen, the only viral encoded protein. Replication is mediated by the host cell DNA-dependent RNA polymerases. HDV infects up to72 million people worldwide and is associated with an increased risk of severe and rapidly progressive liver disease. Pegylated interferon-alpha is still the only available treatment for chronic hepatitis D, with poor tolerance and dismal success rate. Although the development of antivirals inhibiting the viral replication is challenging, as HDV does not possess its own polymerase, several antiviral molecules targeting other steps of the viral life cycle are currently under clinical development: Myrcludex B, which blocks HDV entry into hepatocytes, lonafarnib, a prenylation inhibitor that prevents virion assembly, and finally REP 2139, which is thought to inhibit HBsAg release from hepatocytes and interact with hepatitis delta antigen. This review updates the epidemiology, virology and management of HDV infection.
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Affiliation(s)
- Nathalie Mentha
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Sophie Clément
- Division of Clinical Pathology, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Francesco Negro
- Division of Clinical Pathology, Geneva University Hospitals, 1211 Geneva, Switzerland
- Division of Gastroenterology and Hepatology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Dulce Alfaiate
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
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24
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Melo Da Silva E, Kay A, Lobato C, Muwonge R, Zoulim F, Brites C, Parana R, Trepo C. Non-F HBV/HDV-3 coinfection is associated with severe liver disease in Western Brazilian Amazon. J Med Virol 2019; 91:1081-1086. [PMID: 30695106 DOI: 10.1002/jmv.25411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/02/2019] [Accepted: 01/23/2019] [Indexed: 11/11/2022]
Abstract
The clinical outcome of hepatitis B virus (HBV) infection may be related to host and viral genetic factors, as well as to the type of infection (monoinfection and coinfection). To analyze the distribution/combination of HBV/hepatitis D virus (HDV) genotypes and the associated clinical characteristics, 409 serum samples from patients with chronic HBV (94 of them coinfected by HDV) followed at the Viral Hepatitis Referral Center of Rio Branco, Brazil were enrolled. HBV DNA and HDV RNA were amplified, respectively, by polymerase chain reaction (PCR) and nested PCR using specific primers in the PreC/C region and the S gene, and by reverse-transcription PCR and seminested PCR using specific primers in the delta antigen region and sequenced. The proportion of women (56.1%) was significantly higher than males in this cohort ( P < 0.01). Women were significantly younger (39.8 years; 8-77 years) than males (44.7 years; 12-79 years; P < 0.01). Sixty-eight (18%) patients were infected with HBV-F genotype and 264 (69.8%) with HBV/non-F genotypes. Coinfection by HDV was detected in 23.9% (94 of 409) of this population and was more frequent in male (54.2%, 51 of 94) than in female patients (44.7%, 42 of 94; P = 0.015). HDV-3 was the most prevalent (88.9%) genotype. Almost 70% of HDV-3 coinfected patients were infected with HBV/non-F genotypes. Severe liver disease was diagnosed in 41 patients, 60.9% (25 of 41) of them coinfected with HDV. HBV/HDV coinfection was associated with male sex, age above 30 years, severe liver disease, and increased alanine aminotransferase levels. HBV/HDV-3 coinfection is associated with severe liver disease, in Rio Branco, Brazil.
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Affiliation(s)
- Edinete Melo Da Silva
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Infectology Research Laboratory, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Alan Kay
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France
| | - Cirley Lobato
- Universidade Federal do Acre, UFAC, Rio Branco, Brazil
| | - Richard Muwonge
- International Agency for Research on Cancer, IARC/World Health Organization, WHO, Lyon, France
| | - Fabien Zoulim
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Department of Hepatology,, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Carlos Brites
- Infectology Research Laboratory, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Raymundo Parana
- Hepatology Unit, Medical School, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Christian Trepo
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Department of Hepatology,, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
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25
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Torres MC, Civetta E, D'amico C, Barbini L. Hepatitis B virus in Mar del Plata, Argentina: Genomic characterization and evolutionary analysis of subgenotype F1b. J Med Virol 2019; 91:791-802. [PMID: 30570771 DOI: 10.1002/jmv.25383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/14/2018] [Indexed: 11/07/2022]
Abstract
The aim is to describe the molecular epidemiology and perform a genomic characterization of hepatitis B virus (HBV) circulating in Mar del Plata and to identify the origin and diversification patterns of the most prevalent genotype. The S gene and the region encompassing the X gene, basal core promoter (BCP), and precore (preC) was analyzed in 56 samples. They were genotyped as: 80% F1b, 9% A2, 7% D3, and 2% D1. A recombinant F4/D2 genome was detected. The double substitution G1764A/A1762T at the BCP (reduced HBeAg expression) was found in 20% F1b, 2% A2, 2% D1, and 2% D3 samples. A unique D3 presented the G1896A substitution at the preC (HBeAg negative phenotype). A 13% of the samples showed mutations at the HBsAg "a" immunodeterminant (escape from neutralizing antibodies). Mutations at the polymerase (antiviral resistance) were found in 52% of the samples. Coalescent analysis of subgenotype F1b, the most prevalent in the city, showed that viral diversification in Mar del Plata started by year 2000. F1b was the most prevalent genotype detected, being a characteristic of actual HBV infections in Mar del Plata. Local HBV exhibit clinically relevant mutations, but a minority of them was shown to be associated to potential vaccination escape or antiviral resistance. Nevertheless, further studies are needed to determine whether any of these mutants could pose a threat to prevention, diagnosis, or treatment.
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Affiliation(s)
| | - Elida Civetta
- Unidad de Hepatología y Alcoholismo, HIGA Dr. O. Alende, Mar del Plata, Argentina
| | - Claudia D'amico
- Centro de Especialidades Médicas Ambulatorias, Unidad de Hepatología, Mar del Plata, Argentina
| | - Luciana Barbini
- Departamento de Química, FCEyN, UNMdP, Buenos Aires, Argentina
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26
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Assih M, Ouattara AK, Diarra B, Yonli AT, Compaore TR, Obiri-Yeboah D, Djigma FW, Karou S, Simpore J. Genetic diversity of hepatitis viruses in West-African countries from 1996 to 2018. World J Hepatol 2018; 10:807-821. [PMID: 30533182 PMCID: PMC6280160 DOI: 10.4254/wjh.v10.i11.807] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/10/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
The severity of hepatic pathology and the response to treatment depend on the hepatitis virus genotype in the infected host. The objective of this review was to determine the distribution of hepatitis virus genotypes in West African countries. A systematic review of the literature in PubMed, Google Scholar and Science Direct was performed to identify 52 relevant articles reporting hepatitis A, B, C, D, E and G viruses genotypes. Hepatitis B virus (HBV) genotype E with a prevalence of 90.6% (95%CI: 0.891-0.920) found in this review, is characterized by low genetic diversity. Hepatitis C virus (HCV) genotypes 1 and 2 represented 96.4% of HCV infections in West African countries, while hepatitis delta virus, hepatitis A virus, hepatitis G virus genotypes 1 and HEV genotype 3 were reported in some studies in Ghana and Nigeria. HBV genotype E is characterized by high prevalence, low genetic diversity and wide geographical distribution. Further studies on the clinical implications of HBV genotype E and HCV genotypes 1 and 2 are needed for the development of an effective treatment against this viral hepatitis in West African countries. Surveillance of the distribution of different genotypes is also needed to reduce recombination rates and prevent the emergence of more virulent viral strains.
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Affiliation(s)
- Maléki Assih
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Abdoul Karim Ouattara
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Birama Diarra
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Albert Theophane Yonli
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Tegwindé Rebeca Compaore
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast 00233, Ghana
| | - Florencia Wendkuuni Djigma
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Simplice Karou
- Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA-UL), Universite de Lome, Lome 00229, Togo
| | - Jacques Simpore
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
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27
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Cruz-Santos MD, Gomes-Gouvêa MS, Costa-Nunes JD, Malta-Romano C, Teles-Sousa M, Fonseca-Barros LM, Carrilho FJ, Paiva-Ferreira ADS, Rebello-Pinho JR. High Prevalence of Hepatitis B Subgenotype D4 in Northeast Brazil: an Ancient Relic from African Continent? Ann Hepatol 2018; 17:54-63. [PMID: 29311410 DOI: 10.5604/01.3001.0010.7535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Hepatitis B virus (HBV) infection leads to a chronic liver disease that is distributed worldwide. The characterization of HBV into genotypes/subgenotypes is not only a mere procedure for distinguishing different HBV strains around the world because determining their geographic distribution is crucial to understanding their spread across the world. MATERIAL AND METHODS We characterized different HBV genotypes and subgenotypes in five municipalities located in northeastern Maranhão, in the Brazilian north Atlantic coast. 92 HBsAg-positive individuals were submitted to PCR (polymerase chain reaction). Fifty samples were sequenced using automated Sanger sequencing and classified by phylogenetic methods. RESULTS Subgenotypes D4 and A1 were found in 42 (84%) and eight (16%) samples, respectively. To our knowledge, this is the first study to describe a high frequency of subgenotype D4 in any population. Subgenotype A1 is frequently found across Brazil, but D4 has been rarely detected and only in a few Brazilian states. This study shows the characterization of HBV subgenotypes from a population based study in the state of Maranhão, particularly in populations that do not have frequent contact with populations from other regions of the world. CONCLUSION Our findings showed a HBV subgenotype profile that probably reflect the viruses that were brought with the slave trade from Africa to Maranhão. This study also reinforces the need to evaluate the status of HBV dispersion not only in large urban centers, but also in the hinterland, to enable the implementation of effective control and treatment measures.
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Affiliation(s)
- Max D Cruz-Santos
- Laboratory of Tropical Gastroenterology and Hepatology, Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Michele S Gomes-Gouvêa
- Laboratory of Tropical Gastroenterology and Hepatology, Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Jomar D Costa-Nunes
- Center of Clinical Research, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Camila Malta-Romano
- Laboratory of Virology, LIM-52, São Paulo Institute of Tropical Medicine and Department of Infectious Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marinilde Teles-Sousa
- Center of Clinical Research, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Lena M Fonseca-Barros
- Center of Clinical Research, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Flair J Carrilho
- Laboratory of Tropical Gastroenterology and Hepatology, Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | - João R Rebello-Pinho
- Laboratory of Tropical Gastroenterology and Hepatology, Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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28
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Sousa DDD, Silva CRDS, Lima Junior WP, Barros JDA, Nascimento IADS, Souza VCD, Naveca FG, Granja F. Phylogenetic analysis and genotype distribution of Hepatitis B Virus (HBV) in Roraima, Brazil. Rev Inst Med Trop Sao Paulo 2018; 60:e35. [PMID: 30043939 PMCID: PMC6056886 DOI: 10.1590/s1678-9946201860035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022] Open
Abstract
Hepatitis B virus (HBV) infection is a serious global health problem. HBV has a
high viral genetic diversity, with 10 genotypes recognized. In Brazil, the
Roraima State is the third in the Northern region regarding the number of
hepatitis B cases. On the other hand, few data on HBV genotyping and
phylogenetic analysis are available. The purpose of this study is to
characterize the HBV genotypes circulating in Roraima State. Of the 113 chronic
hepatitis B patients enrolled in this study, 40 were HBV-DNA positive. A
fragment of 280 bp (S gene) was amplified by PCR and submitted to nucleotide
sequencing. A dataset containing the viral sequences obtained in this study,
plus 130 obtained from GenBank was used for genotyping by phylogenetic analysis.
The HBV subgenotype distribution found was A1 (62.5%), A2 (7.5%), D2, D3, D4
(2.5%), F2a (12.5%), and F3 (10%). We characterized the genotypes and
subgenotypes of HBV circulating among patients in the State of Roraima. In
addition, our study shows for the first time the HBV/F3 genotype circulating in
Brazil. In conclusion, our findings showed a high diversity of HBV genotypes in
Roraima, which is also found in other Brazilian geographical regions.
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Affiliation(s)
- Débora Dinelly de Sousa
- Universidade Federal de Roraima, Centro de Estudos da Biodiversidade, Laboratório de Biologia Molecular, Boa Vista, Roraima, Brazil
| | - Claudiane Raquel de Sousa Silva
- Universidade Federal de Roraima, Centro de Estudos da Biodiversidade, Laboratório de Biologia Molecular, Boa Vista, Roraima, Brazil
| | - Wilson Pereira Lima Junior
- Universidade Federal de Roraima, Centro de Estudos da Biodiversidade, Laboratório de Biologia Molecular, Boa Vista, Roraima, Brazil
| | - Jacqueline de Aguiar Barros
- Departamento de Vigilância Epidemiológica, Coordenação Geral de Vigilância em Saúde, SESAU/RR, Boa Vista, Roraima, Brazil
| | | | | | - Felipe Gomes Naveca
- Fiocruz-Amazônia, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Fabiana Granja
- Universidade Federal de Roraima, Centro de Estudos da Biodiversidade, Laboratório de Biologia Molecular, Boa Vista, Roraima, Brazil
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29
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Karimzadeh H, Kiraithe MM, Kosinska AD, Glaser M, Fiedler M, Oberhardt V, Salimi Alizei E, Hofmann M, Mok JY, Nguyen M, van Esch WJE, Budeus B, Grabowski J, Homs M, Olivero A, Keyvani H, Rodríguez-Frías F, Tabernero D, Buti M, Heinold A, Alavian SM, Bauer T, Schulze Zur Wiesch J, Raziorrouh B, Hoffmann D, Smedile A, Rizzetto M, Wedemeyer H, Timm J, Antes I, Neumann-Haefelin C, Protzer U, Roggendorf M. Amino Acid Substitutions within HLA-B*27-Restricted T Cell Epitopes Prevent Recognition by Hepatitis Delta Virus-Specific CD8 + T Cells. J Virol 2018; 92:JVI.01891-17. [PMID: 29669837 PMCID: PMC6002722 DOI: 10.1128/jvi.01891-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/22/2018] [Indexed: 02/07/2023] Open
Abstract
Virus-specific CD8 T cell response seems to play a significant role in the outcome of hepatitis delta virus (HDV) infection. However, the HDV-specific T cell epitope repertoire and mechanisms of CD8 T cell failure in HDV infection have been poorly characterized. We therefore aimed to characterize HDV-specific CD8 T cell epitopes and the impacts of viral mutations on immune escape. In this study, we predicted peptide epitopes binding the most frequent human leukocyte antigen (HLA) types and assessed their HLA binding capacities. These epitopes were characterized in HDV-infected patients by intracellular gamma interferon (IFN-γ) staining. Sequence analysis of large hepatitis delta antigen (L-HDAg) and HLA typing were performed in 104 patients. The impacts of substitutions within epitopes on the CD8 T cell response were evaluated experimentally and by in silico studies. We identified two HLA-B*27-restricted CD8 T cell epitopes within L-HDAg. These novel epitopes are located in a relatively conserved region of L-HDAg. However, we detected molecular footprints within the epitopes in HLA-B*27-positive patients with chronic HDV infections. The variant peptides were not cross-recognized in HLA-B*27-positive patients with resolved HDV infections, indicating that the substitutions represent viral escape mutations. Molecular modeling of HLA-B*27 complexes with the L-HDAg epitope and its potential viral escape mutations indicated that the structural and electrostatic properties of the bound peptides differ considerably at the T cell receptor interface, which provides a possible molecular explanation for the escape mechanism. This viral escape from the HLA-B*27-restricted CD8 T cell response correlates with a chronic outcome of hepatitis D infection. T cell failure resulting from immune escape may contribute to the high chronicity rate in HDV infection.IMPORTANCE Hepatitis delta virus (HDV) causes severe chronic hepatitis, which affects 20 million people worldwide. Only a small number of patients are able to clear the virus, possibly mediated by a virus-specific T cell response. Here, we performed a systematic screen to define CD8 epitopes and investigated the role of CD8 T cells in the outcome of hepatitis delta and how they fail to eliminate HDV. Overall the number of epitopes identified was very low compared to other hepatotropic viruses. We identified, two HLA-B*27-restricted epitopes in patients with resolved infections. In HLA-B*27-positive patients with chronic HDV infections, however, we detected escape mutations within these identified epitopes that could lead to viral evasion of immune responses. These findings support evidence showing that HLA-B*27 is important for virus-specific CD8 T cell responses, similar to other viral infections. These results have implications for the clinical prognosis of HDV infection and for vaccine development.
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Affiliation(s)
- Hadi Karimzadeh
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Muthamia M Kiraithe
- University Hospital Freiburg, Department of Medicine II, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Anna D Kosinska
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
| | - Manuel Glaser
- Center for Integrated Protein Science Munich at the Department of Biosciences, Technische Universität München, Freising, Germany
| | - Melanie Fiedler
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Valerie Oberhardt
- University Hospital Freiburg, Department of Medicine II, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Elahe Salimi Alizei
- University Hospital Freiburg, Department of Medicine II, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Maike Hofmann
- University Hospital Freiburg, Department of Medicine II, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | | | | | | | - Bettina Budeus
- Department of Bioinformatics, University of Duisburg-Essen, Essen, Germany
| | - Jan Grabowski
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Maria Homs
- CIBERehd and Departments of Biochemistry/Microbiology and Hepatology, Vall d'Hebron Hospital, University Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Francisco Rodríguez-Frías
- CIBERehd and Departments of Biochemistry/Microbiology and Hepatology, Vall d'Hebron Hospital, University Autònoma de Barcelona (UAB), Barcelona, Spain
| | - David Tabernero
- CIBERehd and Departments of Biochemistry/Microbiology and Hepatology, Vall d'Hebron Hospital, University Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Buti
- CIBERehd and Departments of Biochemistry/Microbiology and Hepatology, Vall d'Hebron Hospital, University Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Andreas Heinold
- Institute of Transfusion Medicine, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tanja Bauer
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
| | - Julian Schulze Zur Wiesch
- Department of Medicine, Section of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bijan Raziorrouh
- University Hospital Munich-Grosshadern, Department of Medicine II, Munich, Germany
| | - Daniel Hoffmann
- Department of Bioinformatics, University of Duisburg-Essen, Essen, Germany
| | - Antonina Smedile
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mario Rizzetto
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Heiner Wedemeyer
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Jörg Timm
- Institute of Virology, Heinrich-Heine-University, University Hospital, Duesseldorf, Germany
| | - Iris Antes
- Center for Integrated Protein Science Munich at the Department of Biosciences, Technische Universität München, Freising, Germany
| | - Christoph Neumann-Haefelin
- University Hospital Freiburg, Department of Medicine II, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Ulrike Protzer
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
| | - Michael Roggendorf
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
- German Center for Infection Research (DZIF), Munich and Hannover Sites, Braunschweig, Germany
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Komas NP, Ghosh S, Abdou-Chekaraou M, Pradat P, Al Hawajri N, Manirakiza A, Laghoe GL, Bekondi C, Brichler S, Ouavéné JO, Sépou A, Yambiyo BM, Gody JC, Fikouma V, Gerber A, Abeywickrama Samarakoon N, Alfaiate D, Scholtès C, Martel N, Le Gal F, Lo Pinto H, Amri I, Hantz O, Durantel D, Lesbordes JL, Gordien E, Merle P, Drugan T, Trépo C, Zoulim F, Cortay JC, Kay AC, Dény P. Hepatitis B and hepatitis D virus infections in the Central African Republic, twenty-five years after a fulminant hepatitis outbreak, indicate continuing spread in asymptomatic young adults. PLoS Negl Trop Dis 2018; 12:e0006377. [PMID: 29698488 PMCID: PMC5940242 DOI: 10.1371/journal.pntd.0006377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 05/08/2018] [Accepted: 03/08/2018] [Indexed: 12/13/2022] Open
Abstract
Hepatitis delta virus (HDV) increases morbidity in Hepatitis B virus (HBV)-infected patients. In the mid-eighties, an outbreak of HDV fulminant hepatitis (FH) in the Central African Republic (CAR) killed 88% of patients hospitalized in Bangui. We evaluated infections with HBV and HDV among students and pregnant women, 25 years after the fulminant hepatitis (FH) outbreak to determine (i) the prevalence of HBV and HDV infection in this population, (ii) the clinical risk factors for HBV and/or HDV infections, and (iii) to characterize and compare the strains from the FH outbreak in the 1980s to the 2010 HBV–HDV strains. We performed a cross sectional study with historical comparison on FH-stored samples (n = 179) from 159 patients and dried blood-spots from volunteer students and pregnant women groups (n = 2172). We analyzed risk factors potentially associated with HBV and HDV. Previous HBV infection (presence of anti-HBc) occurred in 345/1290 students (26.7%) and 186/870 pregnant women (21.4%)(p = 0.005), including 110 students (8.8%) and 71 pregnant women (8.2%), who were also HBsAg-positive (p = 0.824). HDV infection occurred more frequently in pregnant women (n = 13; 18.8%) than students (n = 6; 5.4%) (p = 0.010). Infection in childhood was probably the main HBV risk factor. The risk factors for HDV infection were age (p = 0.040), transfusion (p = 0.039), and a tendency for tattooing (p = 0.055) and absence of condom use (p = 0.049). HBV-E and HDV-1 were highly prevalent during both the FH outbreak and the 2010 screening project. For historical samples, due to storage conditions and despite several attempts, we could only obtain partial HDV amplification representing 25% of the full-length genome. The HDV-1 mid-eighties FH-strains did not form a specific clade and were affiliated to two different HDV-1 African subgenotypes, one of which also includes the 2010 HDV-1 strains. In the Central African Republic, these findings indicate a high prevalence of previous and current HBV-E and HDV-1 infections both in the mid-eighties fulminant hepatitis outbreak and among asymptomatic young adults in 2010, and reinforce the need for universal HBV vaccination and the prevention of HDV transmission among HBsAg-positive patients through blood or sexual routes. In the Central African Republic (CAR), due to 20 years of conflict, the health system has been disorganized. This could contribute to maintenance of high transmission levels of Hepatitis B Virus (HBV) and its satellite Hepatitis Delta Virus (HDV). This work studies the evolution of both infections 25 years after a fulminant hepatitis (FH) outbreak occurring in the mid-1980s associated with HDV superinfection. In young asymptomatic adults, the results show that both HBV and HDV were still actively circulating in CAR in 2010. Indeed, more than one third of HBV-infected individuals were chronic HBV carriers. Furthermore, HDV infection could be spreading among 10% of them through blood and sexual transmission. The past FH outbreak and contemporary infections were both associated with heterogeneous HDV-1 strains, combined with HBV-E. Vaccination against HBV was uncommon among pregnant women and students, even among medical students. The study constitutes warning signals to help CAR health-care reconstruction and underlines the importance of HBV vaccination. The high level of HBV infection creates a background for HDV superinfection. Neonatal HBV vaccination is needed, together with vaccination of unprotected populations. Awareness of health authorities as well as the general public would help reduce HBV and HDV infections.
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Affiliation(s)
- Narcisse Patrice Komas
- Laboratoire des hépatites virales, Institut Pasteur de Bangui, Bangui, Central African Republic
- * E-mail: (NPK); (PD)
| | - Sumantra Ghosh
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Mariama Abdou-Chekaraou
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
| | - Pierre Pradat
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Center for Clinical Research, Croix-Rousse Hospital, Lyon, France
- Hospices Civils de Lyon, Lyon, France/Université de Lyon I, Lyon, France
| | | | - Alexandre Manirakiza
- Service d’Épidémiologie, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Gina Laure Laghoe
- Laboratoire des hépatites virales, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Claudine Bekondi
- Laboratoire des hépatites virales, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Ségolène Brichler
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
| | - Jean-Omer Ouavéné
- Service de Médecine Interne, Hôpital de l’Amitié, Avenue Indépendance, Bangui, Central African Republic
| | - Abdoulaye Sépou
- Service de Gynécologie Obstétrique, Hôpital Communautaire de Bangui, Avenue des Martyrs, Bangui, Central African Republic
| | - Brice Martial Yambiyo
- Service d’Épidémiologie, Institut Pasteur de Bangui, Bangui, Central African Republic
| | | | - Valentin Fikouma
- Centre de Traitement Ambulatoire de l’Hôpital Communautaire de Bangui, Bangui, Central African Republic
| | - Athénais Gerber
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
| | | | - Dulce Alfaiate
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Caroline Scholtès
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Hospices Civils de Lyon, Lyon, France/Université de Lyon I, Lyon, France
- Laboratoire de Virologie, Croix-Rousse Hospital, Lyon, France
| | - Nora Martel
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Frédéric Le Gal
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
| | - Hugo Lo Pinto
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Ikram Amri
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Olivier Hantz
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - David Durantel
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Jean-Louis Lesbordes
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Emmanuel Gordien
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
| | - Philippe Merle
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Hospices Civils de Lyon, Lyon, France/Université de Lyon I, Lyon, France
| | - Tudor Drugan
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Trépo
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Hospices Civils de Lyon, Lyon, France/Université de Lyon I, Lyon, France
| | - Fabien Zoulim
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Hospices Civils de Lyon, Lyon, France/Université de Lyon I, Lyon, France
| | - Jean-Claude Cortay
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Alan Campbell Kay
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Paul Dény
- INSERM, U1052, UMR CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Service de Microbiologie Clinique, Hôpital Avicenne, Groupe des Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique–Hôpitaux de Paris, Bobigny, France, Université Paris 13/Sorbonne Paris Cité, UFR Santé Médecine Biologie Humaine, Bobigny, France
- * E-mail: (NPK); (PD)
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Oliveira MSD, Valle SDCND, Souza RMD, Silva RPM, Figueiredo END, Taminato M, Fram D. Evidências científicas sobre a hepatite Delta no Brasil: revisão integrativa da literatura. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Resumo Objetivo: Descrever o nível de evidência científica sobre a infecção por vírus da hepatite Delta (VHD) no Brasil. Métodos: Revisão integrativa da literatura, com buscas realizadas nas bases de dados do Medical Literature Analysis and Retrieval System Online, Literatura Latino-americana e do Caribe em Ciências da Saúde, Scientific Eletronic Library Online e Scopus, com análise centrada no nivelamento do rigor metodológico de acordo com o modelo de Melnyk e Fineout-Overholt. Resultados: A busca revelou uma média de duas publicações por ano no intervalo entre 1987 e 2017. Foram selecionados 33 artigos, tendo a maioria (91%) apresentado nível de evidência VI. As publicações ficaram concentradas em periódicos da área de medicina tropical (46%) e virologia (15%). Dos trabalhos, 85% tinha profissional médico com autor e o delineamento mais encontrado foi o descritivo/transversal (69,6%). Conclusão: A produção científica sobre a infecção por VHD no Brasil está centrada em estudos de prevalência, mostrando-se incipiente quanto à produção de estudos com delineamentos mais rígidos como ensaios clínicos.
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Botelho-Souza LF, Vasconcelos MPA, Dos Santos ADO, Salcedo JMV, Vieira DS. Hepatitis delta: virological and clinical aspects. Virol J 2017; 14:177. [PMID: 28903779 PMCID: PMC5597996 DOI: 10.1186/s12985-017-0845-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023] Open
Abstract
There are an estimated 400 million chronic carriers of HBV worldwide; between 15 and 20 million have serological evidence of exposure to HDV. Traditionally, regions with high rates of endemicity are central and northern Africa, the Amazon Basin, eastern Europe and the Mediterranean, the Middle East and parts of Asia. There are two types of HDV/HBV infection which are differentiated by the previous status infection by HBV for the individual. Individuals with acute HBV infection contaminated by HDV is an HDV/HBV co-infection, while individuals with chronic HBV infection contaminated by HDV represent an HDV/HBV super-infection. The appropriate treatment for chronic hepatitis delta is still widely discussed since it does not have an effective drug. Alpha interferon is currently the only licensed therapy for the treatment of chronic hepatitis D. The most widely used drug is pegylated interferon but only approximately 25% of patients maintain a sustained viral response after 1 year of treatment. The best marker of therapeutic success would be the clearance of HBsAg, but this data is rare in clinical practice. Therefore, the best way to predict a sustained virologic response is the maintenance of undetectable HDV RNA levels.
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Affiliation(s)
- Luan Felipo Botelho-Souza
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil.
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil.
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil.
| | | | - Alcione de Oliveira Dos Santos
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
| | - Juan Miguel Villalobos Salcedo
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
| | - Deusilene Souza Vieira
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
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Chevaliez S, Pawlotsky JM. Hepatitis Viruses. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Identification of a new hepatitis B virus recombinant D2/D3 in the city of São Paulo, Brazil. Arch Virol 2016; 162:457-467. [PMID: 27787680 DOI: 10.1007/s00705-016-3122-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/13/2016] [Indexed: 02/07/2023]
Abstract
Two hundred forty million people are chronically infected with hepatitis B virus (HBV) worldwide. The rise of globalization has facilitated the emergence of novel HBV recombinants and genotypes. We evaluated HBV genotypes and recombinants, mutations associated with resistance to antivirals (AVs), progression of hepatic illness, and inefficient hepatitis B vaccination responses in chronically infected individuals in the city of São Paulo, Brazil. Forty-five full-length and 24 partial-length sequences were obtained. The genotype distribution was as follows: A (66.7%), D (15.9%), F (11.6%) and C (4.3%). We describe a new recombinant (D2/D3), confirmed through next-generation sequencing (NGS) and reconstruction of the quasispecies sequences in silico. Primary resistance and major vaccine escape mutations were not found. We did, however, find mutations in the S region that might may be related to HBV antigenicity changes, as well as Pre-S deletions. The precore/core mutations A1762T + G1764A (40.9%) were found mostly in genotypes A and D, and G1896A (29.55%) was more frequent in genotype D than in genotype A. The genotypic distribution reflects the history of Brazilian immigration. This is the first description of recombination between genotypes D2 and D3 in Brazil. It is also the first confirmation through NGS and reconstruction of the quasispecies in silico. However, little is known about the response to treatment of recombinants. This demonstrates the need for molecular epidemiology studies involving the analysis of full-length HBV sequences.
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Lempp FA, Ni Y, Urban S. Hepatitis delta virus: insights into a peculiar pathogen and novel treatment options. Nat Rev Gastroenterol Hepatol 2016; 13:580-9. [PMID: 27534692 DOI: 10.1038/nrgastro.2016.126] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic hepatitis D is the most severe form of viral hepatitis, affecting ∼20 million HBV-infected people worldwide. The causative agent, hepatitis delta virus (HDV), is a unique human pathogen: it is the smallest known virus; it depends on HBV to disseminate its viroid-like RNA; it encodes only one protein (HDAg), which has both structural and regulatory functions; and it replicates using predominantly host proteins. The failure of HBV-specific nucleoside analogues to suppress the HBV helper function, and the limitations of experimental systems to study the HDV life cycle, have impeded the development of HDV-specific drugs. Thus, the only clinical regimen for HDV is IFNα, which shows some efficacy but long-term virological responses are rare. Insights into the receptor-mediated entry of HDV, and the observation that HDV assembly requires farnesyltransferase, have enabled novel therapeutic strategies to be developed. Interference with entry, for example through blockade of the HBV-HDV-specific receptor sodium/taurocholate cotransporting polypeptide NTCP by Myrcludex B, and inhibition of assembly by blockade of farnesyltransferase using lonafarnib or nucleic acid polymers such as REP 2139-Ca, have shown promising results in phase II studies. In this Review, we summarize our knowledge of HDV epidemiology, pathogenesis and molecular biology, with a particular emphasis on possible future developments.
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Affiliation(s)
- Florian A Lempp
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Im Neuenheimer Feld 345, 69120 Heidelberg, Germany
| | - Yi Ni
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Im Neuenheimer Feld 345, 69120 Heidelberg, Germany.,German Center for Infection Research (DZIF), Heidelberg Partner Site, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Stephan Urban
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Im Neuenheimer Feld 345, 69120 Heidelberg, Germany.,German Center for Infection Research (DZIF), Heidelberg Partner Site, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
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Cicero MF, Pena NM, Santana LC, Arnold R, Azevedo RG, Leal ÉDS, Diaz RS, Komninakis SV. Is Hepatitis Delta infections important in Brazil? BMC Infect Dis 2016; 16:525. [PMID: 27686363 PMCID: PMC5041555 DOI: 10.1186/s12879-016-1856-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 09/20/2016] [Indexed: 12/18/2022] Open
Abstract
Background The Hepatitis Delta Virus (HDV) can increase the incidence of fulminant hepatitis. For this infection occurs, the host must also be infected with Hepatitis B Virus. Previous studies demonstrated the endemicity and near exclusivity of this infection in the Amazon region, and as a consequence of the difficulty in accessing this area we used dried blood spots (DBS) in sample collection. The aims of this study were to investigate the presence of recombination, to analyze the epidemiology, ancestry and evolutionary pressures on HDV in Brazil. Methods Blood samples from 50 individuals were collected using dried-blood spots (DBS 903, Whatman), and sent via regular mail to Retrovirology Laboratory from Federal University of São Paulo, where the samples were processed. In the analysis the following software were used: PhyML, RDP, BEAST, jModelTest and CODEML. Results Our results confirm the prevalence of HDV-3 in the Amazon region of Brazil, with the absence of inter-genotypic recombination. It was identified a positive selection in probable epitopes of HDV on B lymphocytes that might indicate that the virus is changing to escape the humoral response of the host. The analysis of the time of the most common ancestor demonstrated the exponential growth of this virus in late 1970s that lasted until 1995, after which it remained constant. It was also observed a probable founder effect in two cities, which demonstrate the need to focus on prevention methods against HBV/HDV infection. Conclusion We confirmed the prevalence of HDV-3 in the Amazon region of Brazil, without inter-genotypic recombination. The analysis of the time of the most common ancestor showed that this infection remain constant in the studied area. Taking into account the probable founder effect established in the cities of Rio Branco and Porto Velho, a focus on preventive methods is recommended against these infections.
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Affiliation(s)
- Maira Ferreira Cicero
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Nathalia Mantovani Pena
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Luiz Claudio Santana
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Rafael Arnold
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Rafael Gonçalves Azevedo
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Élcio de Souza Leal
- Institute of Biological Sciences, Federal University of Pará, 01 Augusto Corrêa Street, Belém, Pará, Brazil
| | - Ricardo Sobhie Diaz
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil
| | - Shirley Vasconcelos Komninakis
- Retrovirology Laboratory, Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, São Paulo, Brazil. .,School of Medicine of ABC (FMABC), Clinical Immunology Laboratory, 821 Príncipe de Gales Avenue, Santo André, São Paulo, Brazil.
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Quizhpe E, Ñauta G, Córdoba-Doña JA, Teran E. Five-Year Eradication of Hepatitis B Infection After an Outreach Immunization Program in the Waorani Population in the Ecuadorian Amazon. Am J Trop Med Hyg 2016; 95:670-3. [PMID: 27382082 PMCID: PMC5014276 DOI: 10.4269/ajtmh.16-0248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/24/2016] [Indexed: 11/07/2022] Open
Abstract
In Waorani communities of the Amazon basin of Ecuador, hepatitis B (HB) surface antigen was found in 14% of asymptomatic persons. The aim of this study was to identify the Waorani population in Ecuador and obtain an epidemiologically adequate coverage of vaccination against hepatitis B virus (HBV) among them. Between February and September 2010, three vaccination campaigns were completed as part of a collaborative activity between the Ecuadorian Ministry of Public Health and the community leaders in the intervention areas. In addition, in 10 of the 22 Waorani communities, during first contact, a questionnaire about risk factors for HBV infection was administered. A total of 16 Waorani communities were registered before the beginning of this intervention, but during the actual process, six additional communities were identified. In total, 1,251 community members were registered, 92.7% of which received all three doses of the vaccine. Among them, 83% of survey respondents reported having been vaccinated, but only 22% were able to show proof. Only 1% of respondents were intravenous drug users, whereas 22% had at least one tattoo. All self-identified as heterosexual, but only 32% reported using condoms during sexual intercourse. By March 2015, no new cases of HB were been reported in any of the Waorani communities. Herein, we report the importance of intersectoral collaboration to strengthen health interventions in an isolated population like the Waorani area.
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Affiliation(s)
- Edy Quizhpe
- Ministerio de Salud Pública del Ecuador, Quito, Ecuador
| | - Gladys Ñauta
- Ministerio de Salud Pública del Ecuador, Quito, Ecuador
| | - Juan Antonio Córdoba-Doña
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden. Consejería de Salud, Junta de Andalucía, Cádiz, Spain
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador.
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The hepatitis delta genotype 8 in Northeast Brazil: The North Atlantic slave trade as the potential route for infection. Virus Res 2016; 224:6-11. [PMID: 27515509 DOI: 10.1016/j.virusres.2016.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 12/18/2022]
Abstract
Hepatitis Delta virus (HDV) is not well known, even though HDV and Hepatitis B virus (HBV) co-infection leads to severe forms of acute and chronic liver diseases. HDV is endemic in the Western Amazon region. Recently, the HDV genotype 8 was found in chronic patients followed at the center for liver studies in the Northeast Brazil, Maranhão. Previous studies suggested that this genotype was introduced in Maranhão during the slave trade. The presence of HDV in that study, which was done outside the Amazon region, led us to investigate whether the virus is found infecting individuals in other regions of Maranhão as well. Thus, we screened ninety-two HBsAg positive individuals from five Municipalities of Maranhão for anti-HD antibody and eight were found positive (8.7%). These eight positive individuals were submitted to polymerase chain reaction (PCR) to investigate active HDV infection. Half of them were positive for a fragment sequence of the delta antigen; their sequence samples were submitted to genotype characterization by phylogenetic analysis. All sequences clustered in a unique branch of the tree separated from the other branch described in Africa. Our study confirmed the presence of HDV-8 in Maranhão. These infected individuals had no evidence of contact with African people. Furthermore, we found individuals infected with HDV-8 in two more different municipalities. More studies like ours are urgent because the co-infection HBV/HDV is more difficult to treat. Identification of the endemic regions and implementation of healthy policies for preventing this infection are urgent in this region.
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Godoy BA, Gomes-Gouvêa MS, Zagonel-Oliveira M, Alvarado-Mora MV, Salzano FM, Pinho JRR, Fagundes NJR. High prevalence of HBV/A1 subgenotype in native south Americans may be explained by recent economic developments in the Amazon. INFECTION GENETICS AND EVOLUTION 2016; 43:354-63. [PMID: 27267305 DOI: 10.1016/j.meegid.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 12/15/2022]
Abstract
Native American populations present the highest prevalence of Hepatitis B Virus (HBV) infection in the Americas, which may be associated to severe disease outcomes. Ten HBV genotypes (A–J) have been described, displaying a remarkable geographic structure, which most likely reflects historic patterns of human migrations. In this study, we characterize the HBV strains circulating in a historical sample of Native South Americans to characterize the historical viral dynamics in this population. The sample consisted of 1070 individuals belonging to 38 populations collected between 1965 and 1997. Presence of HBV DNA was checked by quantitative real-time PCR, and determination of HBV genotypes and subgenotypes was performed through sequencing and phylogenetic analysis of a fragment including part of HBsAg and Pol coding regions (S/Pol). A Bayesian Skyline Plot analysis was performed to compare the viral population dynamics of HBV/A1 strains found in Native Americans and in the general Brazilian population. A total of 109 individuals were positive for HBV DNA (~ 10%), and 70 samples were successfully sequenced and genotyped. Subgenotype A1 (HBV/A1), related to African populations and the African slave trade, was the most prevalent (66–94%). The Skyline Plot analysis showed a marked population expansion of HBV/A1 in Native Americans occurring more recently (1945–1965) than in the general Brazilian population. Our results suggest that historic processes that contributed to formation of HBV/A1 circulating in Native American are related with more recent migratory waves towards the Amazon basin, which generated a different viral dynamics in this region.
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Affiliation(s)
- Bibiane A Godoy
- Genetics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Michele S Gomes-Gouvêa
- Laboratory of Tropical Gastroenterology and Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Marcelo Zagonel-Oliveira
- Genetics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; VIZLab - Advanced Visualization Laboratory, UNISINOS, São Leopoldo, RS, Brazil
| | - Mónica V Alvarado-Mora
- Laboratory of Tropical Gastroenterology and Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Francisco M Salzano
- Genetics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - João R R Pinho
- Laboratory of Tropical Gastroenterology and Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Nelson J R Fagundes
- Genetics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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Complete Genome Sequence of a Hepatitis D Virus Genotype 1 Strain Isolated in Guangdong, China. GENOME ANNOUNCEMENTS 2015; 3:3/6/e01505-15. [PMID: 26701082 PMCID: PMC4691656 DOI: 10.1128/genomea.01505-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Here, we report the first complete genome sequence of a hepatitis D virus genotype 1 strain, GZ37, isolated in Guangzhou, Guangdong Province, China, in 2014. The sequence information provided here will help us understand the molecular epidemiology of hepatitis D virus and contribute to disease control in mainland China.
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di Filippo Villa D, Cortes-Mancera F, Payares E, Montes N, de la Hoz F, Arbelaez MP, Correa G, Navas MC. Hepatitis D virus and hepatitis B virus infection in Amerindian communities of the Amazonas state, Colombia. Virol J 2015; 12:172. [PMID: 26497287 PMCID: PMC4619413 DOI: 10.1186/s12985-015-0402-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/12/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In Colombia, cases of Hepatitis D virus (HDV) infection have been officially described since 1985 mainly in Amerindian population from Sierra Nevada de Santa Marta (North Caribbean Coast), Uraba (North West), and Amazon (South East). The last official report of a clinical case of HDV infection in Colombia was registered in 2005. OBJECTIVES The aims of this study were to identify cases of HDV and/or Hepatitis B virus (HBV) infection in asymptomatic Amerindians from Amazonas state, South East Colombia, and to describe the circulating viral genotypes in this population. STUDY DESIGN The study population was recruited in 19 Amerindian communities in the Amazonas state. Individuals over 18 years old were screened by rapid test for Hepatitis B surface Antigen (HBsAg). Blood samples obtained from individuals positives for HBsAg in the rapid-test assay were analyzed for HBsAg, anti-HBc, anti-HDV IgM/IgG by ELISA. The detection of HBV DNA and HDV RNA was performed by PCR amplification. The viral genotype was determined by sequencing and phylogenetic analysis. RESULTS A total of 23/861 individuals were positive for HBsAg detection by rapid test. Serological and/or molecular markers of HDV infection were demonstrated in 43.5 % (10/23) of samples from Amerindians. The phylogenetic analysis demonstrated the exclusive circulation of HBV subgenotype F1b of and HDV 3 in this population. CONCLUSIONS A high frequency of HBV/HDV infection was found in Amerindian population from Amazonas State, Colombia (43.5 %, 10/23). Nine cases were identified in a population of 861 asymptomatic Amerindian individuals; one symptomatic case (with diagnosis of end-stage hepatic disease) was also identified in the study. The circulation of HDV 3 and HBV subgenotype F1b suggests a constant flow of these viral genotypes as a result of the interaction of the Amerindian populations from Amazon basin. Further studies are necessary to confirm whether HBV subgenotype F1b is the prevalent in the population from South East region in Colombia.
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Affiliation(s)
- Diana di Filippo Villa
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia. .,Present Address: Facultad de Investigación Judicial, Forenses y Salud, Tecnologico de Antioquia, Medellín, Colombia.
| | - Fabian Cortes-Mancera
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia. .,Grupo de Investigación e Innovación Biomedica, Instituto Tecnológico Metropolitano, Medellin, Colombia.
| | - Edra Payares
- Laboratorio Departamental de Salud Publica de Amazonas, Leticia, Colombia.
| | - Neyla Montes
- Coordinacion de Salud Publica, Alcaldia de Puerto Nariño, Amazonas, Colombia.
| | - Fernando de la Hoz
- Instituto Nacional de Salud, Bogota, Colombia and Grupo de Epidemiología y Evaluación en Salud Pública, Universidad Nacional, Bogota, Colombia.
| | - Maria Patricia Arbelaez
- Grupo de Epidemiologia, Facultad de Salud Pública, Universidad de Antioquia, Medellin, Colombia.
| | - Gonzalo Correa
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia.
| | - Maria-Cristina Navas
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia.
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Giersch K, Dandri M. Hepatitis B and Delta Virus: Advances on Studies about Interactions between the Two Viruses and the Infected Hepatocyte. J Clin Transl Hepatol 2015; 3:220-9. [PMID: 26623269 PMCID: PMC4663204 DOI: 10.14218/jcth.2015.00018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/11/2015] [Accepted: 07/12/2015] [Indexed: 12/14/2022] Open
Abstract
The mechanisms determining persistence of hepatitis B virus (HBV) infection and long-term pathogenesis of HBV-associated liver disease appear to be multifactorial. Although viral replication can be efficiently suppressed by the antiviral treatments currently available, viral clearance is generally not achieved since HBV has developed unique replication strategies, enabling persistence of its genome within the infected hepatocytes. Moreover, no direct antiviral therapy exists for the more than 15 million people worldwide that are also coinfected with the hepatitis delta virus (HDV), a defective virus that needs the HBV envelope proteins for propagation. The limited availability of robust HBV and HDV infection systems has hindered the understanding of the complex network of virus-virus and virus-host interactions that are established in the course of infection and slowed down progress in drug development. Since chronic HBV/HDV coinfection leads to the most severe form of chronic viral hepatitis, elucidation of the molecular mechanisms regulating virus-host interplay and pathogenesis are urgently needed. This article summarizes the current knowledge regarding the interactions among HBV, HDV, and the infected target cell and discusses the dependence of HDV on HBV activity and possible future therapeutic approaches.
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Affiliation(s)
- Katja Giersch
- Department of Internal Medicine, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maura Dandri
- Department of Internal Medicine, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel site, Germany
- Correspondence to: Maura Dandri, Department of Internal Medicine, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany. Tel: +49-40741052949, Fax: +49-40741057232, E-mail:
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Mello FMMAD, Kuniyoshi ASO, Lopes AF, Gomes-Gouvêa MS, Bertolini DA. Hepatitis B virus genotypes and mutations in the basal core promoter and pre-core/core in chronically infected patients in southern Brazil: a cross-sectional study of HBV genotypes and mutations in chronic carriers. Rev Soc Bras Med Trop 2015; 47:701-8. [PMID: 25626648 DOI: 10.1590/0037-8682-0158-2014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/11/2014] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION In Brazil, little data exist regarding the distribution of genotypes in relation to basal core promoter (BCP) and precore/core mutations among chronic hepatitis B virus (HBV) carriers from different regions of the country. The aim of this study was to identify HBV genotypes and the frequency of mutations at the BCP and precore/core region among the prevalent genotypes in chronic carriers from southern Brazil. METHODS Nested-polymerase chain reaction (nested-PCR) products amplified from the S-polymerase gene, BCP and precore/core region from 54 samples were sequenced and analyzed. RESULTS Phylogenetic analysis of the S-polymerase gene sequences showed that 66.7% (36/54) of the patients were infected with genotype D (D1, D2, D3), 25.9% (14/54) with genotype A (A1, A2), 5.6% (3/54) with subgenotype C2, and 2% (1/54) with genotype E. A comparison of virological characteristics showed significant differences between genotypes A, C and D. The comparison between HBeAg status and the G1896A stop codon mutation in patients with genotype D revealed a relationship between HBV G1896A precore mutants and genotype D and hepatitis B e antigen (HBeAg) seroconversion. Genotype D had a higher prevalence of the G1896A mutation and the presence of a thymine at position 1858. Genotype A was associated with a higher prevalence of the G1862T mutation and the presence of a cytosine at position 1858. CONCLUSIONS HBV genotype D (D3) is predominant in HBV chronic carriers from southern Brazil. The presence of mutations in the BCP and precore/core region was correlated with the HBV genotype and HBeAg negative status.
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Affiliation(s)
| | | | - André Fanhani Lopes
- Laboratório de Virologia Clínica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, PR
| | - Michele Soares Gomes-Gouvêa
- Laboratório de Gastroenterologia Tropical do Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Dennis Armando Bertolini
- Laboratório de Virologia Clínica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, PR
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Mina T, Amini-Bavil-Olyaee S, Tacke F, Maes P, Van Ranst M, Pourkarim MR. Genomic Diversity of Hepatitis B Virus Infection Associated With Fulminant Hepatitis B Development. HEPATITIS MONTHLY 2015; 15:e29477. [PMID: 26288637 PMCID: PMC4533131 DOI: 10.5812/hepatmon.29477v2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 05/25/2015] [Indexed: 12/11/2022]
Abstract
CONTEXT After five decades of Hepatitis B Virus (HBV) vaccine discovery, HBV is still a major public health problem. Due to the high genetic diversity of HBV and selective pressure of the host immune system, intra-host evolution of this virus in different clinical manifestations is a hot topic of research. HBV infection causes a range of clinical manifestations from acute to chronic infection, cirrhosis and hepatocellular carcinoma. Among all forms of HBV infection manifestations, fulminant hepatitis B infection possesses the highest fatality rate. Almost 1% of the acutely infected patients develop fulminant hepatitis B, in which the mortality rate is around 70%. EVIDENCE ACQUISITION All published papers deposited in Genbank, on the topic of fulminant hepatitis were reviewed and their virological aspects were investigated. In this review, we highlight the genomic diversity of HBV reported from patients with fulminant HBV infection. RESULTS The most commonly detected diversities affect regulatory motifs of HBV in the core and S region, indicating that these alterations may convert the virus to an aggressive strain. Moreover, mutations at T-cell and B-cell epitopes located in pre-S1 and pre-S2 proteins may lead to an immune evasion of the virus, likely favoring a more severe clinical course of infection. Furthermore, point and frame shift mutations in the core region increase the viral replication of HBV and help virus to evade from immune system and guarantee its persistence. CONCLUSIONS Fulminant hepatitis B is associated with distinct mutational patterns of HBV, underlining that genomic diversity of the virus is an important factor determining its pathogenicity.
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Affiliation(s)
- Thomas Mina
- Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Samad Amini-Bavil-Olyaee
- Department of Molecular Microbiology and Immunology, Harlyne J. Norris Cancer Research Tower, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank Tacke
- Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany
| | - Piet Maes
- Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Marc Van Ranst
- Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Mahmoud Reza Pourkarim
- Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
- Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion Medicine, Tehran, IR Iran
- Corresponding Author: Mahmoud Reza Pourkarim, Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, P. O. Box: BE-3000, Leuven, Belgium. Tel: +32-16332145, Fax: +32-16332141, E-mail:
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Braga WSM, de Oliveira CMC, de Araújo JR, Castilho MDC, Rocha JM, Gimaque JBDL, Silva MLCR, Vasconcelos HL, Ramasawmy R, Paraná R. Chronic HDV/HBV co-infection: predictors of disease stage---a case series of HDV-3 patients. J Hepatol 2014; 61:1205-11. [PMID: 24905491 DOI: 10.1016/j.jhep.2014.05.041] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/26/2014] [Accepted: 05/27/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Chronic HDV/HBV co-infection is perhaps the most intriguing amongst all viral hepatitis. Only few studies focus deeply on this topic, particularly with patients infected with HDV-3. This study aimed to identify predictors of advanced disease, examining a cross-sectional data of 64 patients. METHODS Histological grading was used to characterize the disease stages and viral loads were tested as predictors of necroinflammatory activity and fibrosis. RESULTS We identified three HDV/HBV co-infection patterns: patients with predominant HDV replication (56.3%), patients with similar viral loads of both viruses (40.6%), and patients with predominant HBV replication (3.1%). Mean HDV-RNA showed a positive trend regarding inflammatory activity and grade of fibrosis. HDV viral load correlated positively with serum levels of liver enzymes and inversely with platelets count. HBV viral load showed no correlation with any of the above parameters. Advanced fibrosis was associated with age, splenomegaly, and HDV viral load of more than 2 log10. Multiple logistic regression confirmed the independent effect of HDV viral predominance. Advanced necroinflammatory activity was independently associated with HDV viral load and splenomegaly. CONCLUSIONS HDV may possibly play an important and direct role in the establishment of necroinflammatory activity and fibrosis. Data show an indigenous HDV genotype, HDV-3, similar to those described in the Amazon region.
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Affiliation(s)
| | - Cintia Mara Costa de Oliveira
- Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Multidisciplinar Center, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - José Ribamar de Araújo
- Anatomopatology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Marcia da Costa Castilho
- Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Joelma Martins Rocha
- Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | | | - Heline Lira Vasconcelos
- Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Rajendranath Ramasawmy
- Virology Department, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Nilton Lins University, Manaus, Amazonas, Brazil
| | - Raymundo Paraná
- Gastroenterology Unit, Federal University of Bahia, Salvador, Bahia, Brazil
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Kay A, Melo da Silva E, Pedreira H, Negreiros S, Lobato C, Braga W, Muwonge R, Dény P, Reis M, Zoulim F, Trepo C, D'Oliveira A, Salcedo JM, Schinoni MI, Parana R. HBV/HDV co-infection in the Western Brazilian Amazonia: an intriguing mutation among HDV genotype 3 carriers. J Viral Hepat 2014; 21:921-4. [PMID: 25040045 DOI: 10.1111/jvh.12267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 04/24/2014] [Indexed: 12/09/2022]
Abstract
HDV infection still remains a serious public health problem in Amazonia. There are few data regarding the biomolecular aspects of HBV/HDV co-infection in this region. We studied 92 patients HBsAg(+) /anti-HDV IgG(+) followed at the Hepatitis Referral Centers of Porto Velho (RO), Rio Branco and Cruzeiro do Sul (AC), Brazil, from March 2006 to March 2007 for whom the HDV and/or the HBV genotype could be determined. The HDV genotype could be determined in 90 patients, while the HBV genotypes could be positively determined in 74. HBV subgenotype F2 is the most prevalent (40.2%), followed by the subgenotypes A1 (15.2%) and D3 (8.7%), while 16.4% were other subgenotypes or genotypes, 4.3% were discordant and 15.2% were unamplifiable. Surprisingly, HDV genotype 3 (HDV-3) was found in all of the HBV/HDV-infected patients that could be genotyped for HDV, confirming that HDV-3 can associate with non-F HBV genotypes. However, a HDV-3 mutant was found in 29.3% of patients and was more frequently associated with non-F HBV genotypes (P < 0.001) than were nonmutant strains, suggesting that the mutation may facilitate association of HDV-3 with non-F HBV genotypes.
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Affiliation(s)
- A Kay
- INSERM, U1052, Lyon, France
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Huang CR, Lo SJ. Hepatitis D virus infection, replication and cross-talk with the hepatitis B virus. World J Gastroenterol 2014; 20:14589-14597. [PMID: 25356023 PMCID: PMC4209526 DOI: 10.3748/wjg.v20.i40.14589] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 05/12/2014] [Accepted: 06/23/2014] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis remains a worldwide public health problem. The hepatitis D virus (HDV) must either coinfect or superinfect with the hepatitis B virus (HBV). HDV contains a small RNA genome (approximately 1.7 kb) with a single open reading frame (ORF) and requires HBV supplying surface antigens (HBsAgs) to assemble a new HDV virion. During HDV replication, two isoforms of a delta antigen, a small delta antigen (SDAg) and a large delta antigen (LDAg), are produced from the same ORF of the HDV genome. The SDAg is required for HDV replication, whereas the interaction of LDAg with HBsAgs is crucial for packaging of HDV RNA. Various clinical outcomes of HBV/HDV dual infection have been reported, but the molecular interaction between HBV and HDV is poorly understood, especially regarding how HBV and HDV compete with HBsAgs for assembling virions. In this paper, we review the role of endoplasmic reticulum stress induced by HBsAgs and the molecular pathway involved in their promotion of LDAg nuclear export. Because the nuclear sublocalization and export of LDAg is regulated by posttranslational modifications (PTMs), including acetylation, phosphorylation, and isoprenylation, we also summarize the relationship among HBsAg-induced endoplasmic reticulum stress signaling, LDAg PTMs, and nuclear export mechanisms in this review.
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Azarbahra M, Tajbakhsh E, Momtaz H. Phylogenetic analysis of hepatitis delta virus isolated from HBsAg positive patients in Shahrekord, Iran. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60593-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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49
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Pourkarim MR, Amini-Bavil-Olyaee S, Kurbanov F, Van Ranst M, Tacke F. Molecular identification of hepatitis B virus genotypes/subgenotypes: revised classification hurdles and updated resolutions. World J Gastroenterol 2014; 20:7152-68. [PMID: 24966586 PMCID: PMC4064061 DOI: 10.3748/wjg.v20.i23.7152] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/28/2013] [Accepted: 01/02/2014] [Indexed: 02/06/2023] Open
Abstract
The clinical course of infections with the hepatitis B virus (HBV) substantially varies between individuals, as a consequence of a complex interplay between viral, host, environmental and other factors. Due to the high genetic variability of HBV, the virus can be categorized into different HBV genotypes and subgenotypes, which considerably differ with respect to geographical distribution, transmission routes, disease progression, responses to antiviral therapy or vaccination, and clinical outcome measures such as cirrhosis or hepatocellular carcinoma. However, HBV (sub)genotyping has caused some controversies in the past due to misclassifications and incorrect interpretations of different genotyping methods. Thus, an accurate, holistic and dynamic classification system is essential. In this review article, we aimed at highlighting potential pitfalls in genetic and phylogenetic analyses of HBV and suggest novel terms for HBV classification. Analyzing full-length genome sequences when classifying genotypes and subgenotypes is the foremost prerequisite of this classification system. Careful attention must be paid to all aspects of phylogenetic analysis, such as bootstrapping values and meeting the necessary thresholds for (sub)genotyping. Quasi-subgenotype refers to subgenotypes that were incorrectly suggested to be novel. As many of these strains were misclassified due to genetic differences resulting from recombination, we propose the term "recombino-subgenotype". Moreover, immigration is an important confounding facet of global HBV distribution and substantially changes the geographic pattern of HBV (sub)genotypes. We therefore suggest the term "immigro-subgenotype" to distinguish exotic (sub)genotypes from native ones. We are strongly convinced that applying these two proposed terms in HBV classification will help harmonize this rapidly progressing field and allow for improved prophylaxis, diagnosis and treatment.
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High prevalence of hepatitis B virus subgenotypes A1 and D4 in Maranhão state, Northeast Brazil. INFECTION GENETICS AND EVOLUTION 2014; 24:68-75. [DOI: 10.1016/j.meegid.2014.03.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/21/2014] [Accepted: 03/10/2014] [Indexed: 12/13/2022]
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