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Zitha T, Chen CY, Mudawi H, Hussein W, Mukhtar M, Shigidi M, Yousif MEA, Ali MA, Glebe D, Kramvis A. Molecular characterization and genotyping of hepatitis C virus from Sudanese end-stage renal disease patients on haemodialysis. BMC Infect Dis 2022; 22:848. [PMCID: PMC9661773 DOI: 10.1186/s12879-022-07833-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Hepatitis C virus (HCV) is a global public health problem, with ~ 11 million people in Africa infected. There is incomplete information on HCV in Sudan, particularly in haemodialysis patients, who have a higher prevalence compared to the general population. Thus, our objectives were to genotype and molecularly characterize HCV isolated from end-stage renal disease haemodialysis patients.
Methods
A total of 541 patients were recruited from eight haemodialysis centres in Khartoum and screened for anti-HCV. Viral loads were determined using in-house real-time PCR in seropositive patients. HCV was genotyped and subtyped using sequencing of amplicons of 5′ untranslated (UTR) and non-structural protein 5B (NS5B) regions, followed by phylogenetic analysis of corresponding sequences.
Results
The HCV seroprevalence in the study was 17% (93/541), with HCV RNA-positive viremic rate of 7% (40/541). A low HCV load, with a mean of 2.85 × 104 IU/ml and a range of 2.95 × 103 to 4.78 × 106 IU/ml, was detected. Phylogenetic analyses showed the presence of genotypes 1, 3, 4, and 5 with subtypes 1a, 1b, 1 g, 3a, 4a, 4 l, 4 m, 4 s, and 4t. Sequences of HCV from the same haemodialysis units, clustered in similar genotypes and subtypes intimating nosocomial infection.
Conclusion
HCV infection is highly prevalent in haemodialysis patients from Sudan, with phylogenetic analysis intimating nosocomial infection. HCV genotyping is useful to locate potential transmission chains and to enable individualized treatment using highly effective direct-acting antivirals (DAAs).
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Wongjarupong N, Yonli AT, Nagalo BM, Djigma FW, Somda SK, Hassan MA, Mohamed EA, Sorgho AP, Compaore TR, Soubeiga ST, Kiendrebeogo I, Sanou M, Diarra B, Yang H, Chen C, Ouattara AK, Zohoncon TM, Martinson JJ, Buetow K, Chamcheu JC, Antwi SO, Borad MJ, Simpore J, Roberts LR. Characteristics of Patients With Chronic Hepatitis B Virus Infection With Genotype E Predominance in Burkina Faso. Hepatol Commun 2020; 4:1781-1792. [PMID: 33305149 PMCID: PMC7706297 DOI: 10.1002/hep4.1595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
Hepatitis B virus (HBV) genotype E (HBV-E) accounts for the majority of chronic hepatitis B (CHB) infections in West Africa. We aimed to determine factors associated with HBV-E-induced hepatocellular carcinoma (HCC) in West Africa. Data on patients from Burkina Faso who were hepatitis B surface antigen positive (HBsAg+) and had CHB were analyzed. HBV viral load and hepatitis B e antigen (HBeAg) status were measured in 3,885 individuals with CHB without HCC (CHB HCC-) and 59 individuals with CHB with HCC (CHB HCC+). HBV genotyping was performed for 364 subjects with CHB HCC- and 41 subjects with CHB HCC+. Overall, 2.5% of the CHB HCC- group was HBeAg+ compared with 0% of the CHB HCC+ group. Of the 364 patients who were CHB HCC- with available genotyping, the frequencies of HBV genotypes E and C/E were 70.3% and 12.9%, respectively. Age (odds ratio [OR] for older age, 1.08; 95% confidence interval [CI], 1.06-1.10 per 1-year increase in age), male sex (OR, 2.03; 95% CI, 1.11-3.69), and HBV viremia (OR, 1.48; 95% CI, 1.31-1.67 per 1 log10 IU/mL) were each associated with HCC diagnosis. Patients with genotype E had a lower HBeAg prevalence (6.3% vs. 14.9%), lower HBV viral load, and higher prevalence of cirrhosis (14.5% vs. 4.8%) than patients with genotype C/E. Conclusion: HBV-E is the most common circulating strain (70.3%) in West African patients. HCC was associated with older age, male sex, and high HBV viral load. It is expected that these results will further inform guidance on clinical management of HBV infection in West Africa.
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Affiliation(s)
| | - Albert Theophane Yonli
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | | | - Florencia Wendkuuni Djigma
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Sosthene Kounpielime Somda
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | | | - Essa A. Mohamed
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMN
| | - Abel Pegdwende Sorgho
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Tegwinde Rebeca Compaore
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Serge Theophile Soubeiga
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Isabelle Kiendrebeogo
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Mahamoudou Sanou
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Birama Diarra
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Hwai‐I Yang
- Genomics Research CenterAcademia SinicaTaipeiTaiwan
| | | | - Abdoul K. Ouattara
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Théodora M. Zohoncon
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Jeremy J. Martinson
- Division of Infectious Diseases and MicrobiologyUniversity of PittsburghPittsburghPA
| | - Kenneth Buetow
- Computational Sciences and Informatics Program for Complex Adaptive SystemArizona State UniversityTempeAZ
| | | | - Samuel O. Antwi
- Department of Health Sciences ResearchMayo ClinicJacksonvilleFL
| | - Mitesh J. Borad
- Division of Hematology and Medical OncologyMayo Clinic HospitalPhoenixAZ
| | - Jacques Simpore
- Department of Biochemistry and MicrobiologyPietro Annigonni Biomolecular Research CenterOuagadougouBurkina FasoWest Africa
| | - Lewis R. Roberts
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMN
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Mak D, Babb de Villiers C, Chasela C, Urban MI, Kramvis A. Analysis of risk factors associated with hepatocellular carcinoma in black South Africans: 2000-2012. PLoS One 2018; 13:e0196057. [PMID: 29718992 PMCID: PMC5931658 DOI: 10.1371/journal.pone.0196057] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/05/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aims of this study were to determine the prevalence of risk factors associated with hepatocellular carcinoma (HCC) in black adult South Africans and to estimate the size of the associated risks. METHODS A case-control analysis of 150 black South African patients (aged 18-75 years) with HCC-who were a subset of patients recruited for the Johannesburg Cancer Case Control Study 2000 to 2012-was undertaken. The association between this tumour and hepatitis B/C virus infections, and human immunodeficiency virus (HIV) mono- and co-infections was investigated. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, year of diagnosis, marital status, place of birth and selected modifiable risk factors were calculated. RESULTS HCC was significantly associated with a rural birthplace (p<0.05), being male and living in an urban area for 14 years or less. The Odds Ratio (OR) for HCC increased significantly with HBV DNA+/HBsAg+ (OR 34.5; CI:16.26-73.13), HBV DNA+/HBsAg- (OR 3.76; CI:1.79-7.92), HBV DNA level >2000 IU/ml (OR 8.55; CI:3.00-24.54) to ≥200,000 (OR 16.93; CI:8.65-33.13), anti-HCV (OR 8.98; CI:3.59-22.46), HBV DNA+/HIV+ co-infection (OR 5.36; CI:2.59-11.11), but not with HBV DNA-/HIV+ (OR 0.34; CI:0.14-0.85). We did not find a synergistic interaction between HBV and HIV. Modifiable risk factors (alcohol consumption, tobacco smoking, number of sexual partners, diabetes and hormonal contraceptive use) were nonsignificant. DISCUSSION A considerable portion of the HCC burden in Johannesburg and surrounding provinces falls on rural migrants to urban areas, most of whom are men. The HBV will continue to contribute to HCC incidence in older age-groups and in others who missed vaccination. Although we did not find an increased risk for HCC in HIV positive individuals this may change as life expectancy increases due to greater access to antiretroviral therapies, necessitating the addition of hepatitis virus screening to preventive medical care.
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Affiliation(s)
- Daniel Mak
- Hepatitis Virus Diversity Research Unit (HVDRU), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chantal Babb de Villiers
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles Chasela
- Epidemiology and Strategic Information (ESI), HIV/AIDS, STIS and TB (HAST), Human Sciences Research Council (HSRC), Pretoria, South Africa
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Right to Care, EQUIP HEALTH, Centurion, South Africa
| | - Margaret I. Urban
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit (HVDRU), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Clinical Characteristics of Chronic Hepatitis B Virus Infection in Immigrants from Sub-Saharan Africa. HEPATITIS MONTHLY 2016. [DOI: 10.5812/hepatmon.41781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Construction of replication competent plasmids of hepatitis B virus subgenotypes A1, A2 and D3 with authentic endogenous promoters. J Virol Methods 2014; 203:54-64. [PMID: 24681050 DOI: 10.1016/j.jviromet.2014.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 03/14/2014] [Accepted: 03/18/2014] [Indexed: 12/13/2022]
Abstract
Hepatitis B virus (HBV) is hyperendemic to southern Africa, with genotype A of HBV being the predominant genotype, and subgenotype A1 prevailing. Infection with this subgenotype is associated with rapid disease progression, and high frequency of hepatocellular carcinoma development. The objectives of our study was to construct recombinant 1.28 mer replication competent HBV DNA plasmids of subgenotypes A1, A2 and D3 containing authentic endogenous HBV promoters and to follow their replication in vitro after transfection of Huh7 cells. We found that subgenotype D3 replicated at a lower level, as measured by HBsAg and HBV DNA levels, when compared to cells transfected with genotype A. There was no difference in the intracellular and extracellular HBsAg between cells transfected with subgenotypes A1 or A2. Cells transfected with subgenotype A1 had higher levels of intracellular replicative intermediates and HBcAg, and lower extracellular expression of HBeAg from days 1 to 3, when compared to cells transfected with subgenotype A2. In conclusion, the generation of these replication competent clones is an important step in the functional characterization of subgenotypes of HBV circulating in Africa and their comparison to strains circulating in other geographical regions of the world.
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Ayub A, Ashfaq UA, Haque A. HBV induced HCC: major risk factors from genetic to molecular level. BIOMED RESEARCH INTERNATIONAL 2013; 2013:810461. [PMID: 23991421 PMCID: PMC3749539 DOI: 10.1155/2013/810461] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 07/09/2013] [Indexed: 12/15/2022]
Abstract
Hepatocellular carcinoma (HCC) is a deadly and emerging disease leading to death in Asian countries. High hepatitis B virus (HBV) load and chronic hepatitis B (CHB) infection increase the risk of developing HCC. HBV is a DNA virus that can integrate DNA into host genome thereby increase the yield of transactivator protein HBxAg that may deregulate many pathways involving in metabolism of cells. Several monogenic and polygenic risk factors are also involved in HCC development. This review summarizes the mechanism involved in HCC development and discusses some promising therapies to make HCC curative.
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Affiliation(s)
- Ambreen Ayub
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad (GCUF), Faisalabad 38000, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad (GCUF), Faisalabad 38000, Pakistan
| | - Asma Haque
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad (GCUF), Faisalabad 38000, Pakistan
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Abstract
Hepatitis B virus (HBV) is a hepatotropic DNA virus. The HBV genome is prone to variations. Based on genomic variations, HBV is divided into ten genotypes, many subgenotypes and quasispecies. These genotypes, subgenotypes and quasispecies have distinct race and geographic distribution and have been associated with outcome of HBV infection, disease progression and treatment.
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Kew MC. Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virus-induced hepatocellular carcinoma. ACTA ACUST UNITED AC 2010; 58:273-7. [PMID: 20378277 DOI: 10.1016/j.patbio.2010.01.005] [Citation(s) in RCA: 195] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 01/27/2010] [Indexed: 12/11/2022]
Affiliation(s)
- M C Kew
- Department of Medicine, University of Cape Town, Cape Town, South Africa.
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Kew MC. Hepatocellular carcinoma in African Blacks: Recent progress in etiology and pathogenesis. World J Hepatol 2010; 2:65-73. [PMID: 21160975 PMCID: PMC2999270 DOI: 10.4254/wjh.v2.i2.65] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 01/14/2010] [Accepted: 01/21/2010] [Indexed: 02/06/2023] Open
Abstract
Occult hepatitis B virus (HBV) infection was shown to be present in 75% of Black Africans with hepatocellular carcinoma (HCC) in whom the tumor was hitherto not thought to be caused by chronic HBV infection. The association between chronic HBV infection and the development of the tumor is thus even closer than was originally thought. HBV viral load was found to be significantly higher in patients with HCC than in Black African controls. As in other populations, HBV e antigen-positive patients with hepatocellular carcinoma had significantly higher viral loads than patients negative for this antigen. The significance of this finding is discussed. The risk for HCC development with genotype A of HBV, the predominant genotype in African isolates, has not been investigated. Genotype A was shown to be 4.5 times more likely than other genotypes to cause HCC in Black Africans, and tumours occurred at a significantly younger age. Increasing numbers of patients with human immunodeficiency virus (HIV) and HBV co-infection are being reported to develop HCC. A preliminary case/control comparison supports the belief that HIV co-infection enhances the hepatocarcinogenic potential of HBV. A study from The Gambia provides the first evidence that dietary exposure to aflatoxin B(1) may cause cirrhosis and that this may play a contributory role in the pathogenesis of aflatoxin-induced HCC. An animal model has provided experimental support for the clinical evidence that dietary iron overload in the African is directly hepatocarcinogenic, in addition to causing the tumor indirectly through the development of cirrhosis.
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Affiliation(s)
- Michael C Kew
- Michael C Kew, Department of Medicine, Groote Schuur Hospital, Old Main Building, K Floor, Main Road, Observatory 7935, Cape Town, South Africa
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