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Pacheco SR, Dos Santos MIMA, Stocker A, Zarife MAS, Schinoni MI, Paraná R, Dos Reis MG, Silva LK. Genotyping of HBV and tracking of resistance mutations in treatment-naïve patients with chronic hepatitis B. Infect Drug Resist 2017; 10:201-207. [PMID: 28740410 PMCID: PMC5503499 DOI: 10.2147/idr.s135420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Resistance mutation analogs to nucleos(t)ides have been described in treatment-naïve patients with chronic hepatitis B (CHB), with clinical implications. The aim of this study was to investigate primary resistance mutations and genotypes circulating in patients naïve to chronic hepatitis B, in the Northern and Northeastern regions of Brazil. METHODS We conducted a study of resistance mutations and genotypic characterization of hepatitis B virus (HBV) in 189 treatment-naïve patients chronically infected with HBV. RESULTS Drug resistance-associated mutations located in the RT domain of the P gene (rtHBV) were found in 6% of the treatment-naïve patients from the Northeastern Region. The mutations were rtA194T, rtL180M + rtM204V, rtS202I, rtM204I, and rtA181S. No patient in the Northern Region had the resistance mutation. In the gene S region, the frequency of vaccine escape mutations was 2.4% in the Northeastern Region and 8.6% in the Northern Region. CONCLUSION This information before the start of treatment may contribute to clinical decision making, reducing treatment failure and the risk of progression to cirrhosis and hepatocellular carcinoma for CHB.
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Affiliation(s)
- Sidelcina Rugieri Pacheco
- Laboratory of Pathology and Molecular Biology, Research Site Gonçalo Muniz, Foundation Oswaldo Cruz (CPqGM/Fiocruz-BA)
| | | | | | | | | | | | - Mitermayer Galvão Dos Reis
- Laboratory of Pathology and Molecular Biology, Research Site Gonçalo Muniz, Foundation Oswaldo Cruz (CPqGM/Fiocruz-BA)
| | - Luciano Kalabric Silva
- Laboratory of Pathology and Molecular Biology, Research Site Gonçalo Muniz, Foundation Oswaldo Cruz (CPqGM/Fiocruz-BA)
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Lampe E, Mello FCA, do Espírito-Santo MP, Oliveira CMC, Bertolini DA, Gonçales NSL, Moreira RC, Fernandes CAS, Nascimento HCL, Grotto RMT, Pardini MIMC, On Behalf Of The Brazilian Hepatitis B Research Group. Nationwide overview of the distribution of hepatitis B virus genotypes in Brazil: a 1000-sample multicentre study. J Gen Virol 2017. [PMID: 28631602 DOI: 10.1099/jgv.0.000789] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The influence of hepatitis B virus (HBV) genotypes in the natural history of the disease and its response to antiviral treatment have been addressed in many studies. In Brazil, studies on HBV genotype circulation have been restricted to specific population groups and states. Here, we have conducted a nationwide multicentre study with an unprecedented sample size representing all Brazilian regions in an effort to better understand the viral variants of HBV circulating among chronic carriers. Seven HBV genotypes were found circulating in Brazil. Overall, HBV/A was the most prevalent, identified in 589 (58.7 %) samples, followed by HBV/D (23.4 %) and HBV/F (11.3 %). Genotypes E, G, C and B were found in a minor proportion. The distribution of the genotypes differed markedly from the north to the south of the country. While HBV/A was the most prevalent in the North (71.6 %) and Northeast (65.0 %) regions, HBV/D was found in 78.9 % of the specimens analysed in the South region. HBV/F was the second most prevalent genotype in the Northeast region (23.5 %). It was detected in low proportions (7 to 10 %) in the North, Central-West and Southeast regions, and in only one sample in the South region. HBV/E was detected in all regions except in the South, while monoinfection with HBV/G was found countrywide, with the exception of Central-West states. Our sampling covered 24 of the 26 Brazilian states and the Federal District and is the first report of genotype distribution in seven states. This nationwide study provides the most complete overview of HBV genotype distribution in Brazil to date and reflects the origin and plurality of the Brazilian population.
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Affiliation(s)
- Elisabeth Lampe
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Francisco C A Mello
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Cintia M C Oliveira
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Dennis A Bertolini
- Laboratório de Imunologia Clínica, Departamento de Análise Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, PR, Brazil
| | - Neiva S L Gonçales
- Laboratório do Grupo de Estudo das Hepatites, UNICAMP, Campinas, SP, Brazil
| | - Regina C Moreira
- Laboratório de Hepatites, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | | | - Rejane M T Grotto
- Universidade Estadual Paulista (Unesp), Faculdade de Ciências Agronômicas (FCA), Campus de Botucatu, Botucatu, SP, Brazil.,Universidade Estadual Paulista (Unesp), Faculdade de Medicina (FMB), Divisão Hemocentro, Laboratório de Biologia Molecular, Campus de Botucatu, Botucatu, SP, Brazil
| | - Maria Inês M C Pardini
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina (FMB), Divisão Hemocentro, Laboratório de Biologia Molecular, Campus de Botucatu, Botucatu, SP, Brazil
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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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Castilho MDC, Oliveira CMCD, Gimaque JBDL, Leão JDT, Braga WSM. Epidemiology and molecular characterization of hepatitis B virus infection in isolated villages in the Western Brazilian Amazon. Am J Trop Med Hyg 2012; 87:768-74. [PMID: 22908032 PMCID: PMC3516333 DOI: 10.4269/ajtmh.2012.12-0083] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 07/21/2012] [Indexed: 12/15/2022] Open
Abstract
Individuals from three isolated, rural communities in the western Brazilian Amazon were evaluated for serological markers of hepatitis B virus (HBV) infection, HBV genotype, and the presence of risk factors for infection and transmission. Of the 225 individuals studied, 79.1% had serological evidence of HBV infection; 10.2% individuals were chronic carriers for HBV surface antigen (HBsAg-positive). Analysis of risk factors indicates that HBV is transmitted mainly horizontally within the family from a chronic "active" carrier for hepatitis B "e" antigen (HBeAg-positive), though a strong possibility of vertical transmission remains. The predominance of HBV genotype F, with a higher genomic similarity between the isolates, indicated a relatively recent introduction of HBV, from a common source, to the area. This study sheds light on the HBV epidemiology in the Brazilian Amazon region and highlights the need for greater emphasis on HBV control and immunization programs.
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Affiliation(s)
- Márcia da Costa Castilho
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Gerência de Virologia, Universidade do Estado do Amazonas, Programa de Pós-Graduação em Doenças Tropicais e Infecciosas Manaus, Amazonas, Brazil.
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Alvarado-Mora MV, Santana RAF, Sitnik R, Ferreira PRA, Mangueira CLP, Carrilho FJ, Pinho JRR. Full-length genomic sequence of hepatitis B virus genotype C2 isolated from a native Brazilian patient. Mem Inst Oswaldo Cruz 2012; 106:495-8. [PMID: 21739039 DOI: 10.1590/s0074-02762011000400017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/09/2011] [Indexed: 12/18/2022] Open
Abstract
The hepatitis B virus (HBV) is among the leading causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma. In Brazil, genotype A is the most frequent, followed by genotypes D and F. Genotypes B and C are found in Brazil exclusively among Asian patients and their descendants. The aim of this study was to sequence the entire HBV genome of a Caucasian patient infected with HBV/C2 and to infer the origin of the virus based on sequencing analysis. The sequence of this Brazilian isolate was grouped with four other sequences described in China. The sequence of this patient is the first complete genome of HBV/C2 reported in Brazil.
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Affiliation(s)
- Mónica Viviana Alvarado-Mora
- Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Haddad R, Martinelli ADLC, Uyemura SA, Yokosawa J. Hepatitis B virus genotyping among chronic hepatitis B patients with resistance to treatment with lamivudine in the City of Ribeirão Preto, State of São Paulo. Rev Soc Bras Med Trop 2011; 43:224-8. [PMID: 20563485 DOI: 10.1590/s0037-86822010000300002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 12/10/2009] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Lamivudine is a nucleoside analogue that is used clinically for treating chronic hepatitis B infection. However, the main problem with prolonged use of lamivudine is the development of viral resistance to the treatment. Mutations in the YMDD motif of the hepatitis B virus DNA polymerase gene have been associated with resistance to drug therapy. So far, there have not been many studies in Brazil reporting on genotype-dependent development of resistance to lamivudine. Thus, the aim of the present study was to determine the possible correlation between a certain genotype and increased development of resistance to lamivudine among chronic hepatitis B patients. METHODS HBV DNA in samples from 50 patients under lamivudine treatment was amplified by means of conventional PCR. Samples were collected at Hospital das Clínicas, FMRP-USP. The products were then sequenced and phylogenetic analysis was performed. RESULTS Phylogenetic analysis revealed that 29 (58%) patients were infected with genotype D, 20 (40%) with genotype A and one (2%) with genotype F. Mutations in the YMDD motif occurred in 20% of the patients with genotype A and 27.6% of the patients with genotype D. CONCLUSIONS Despite the small number of samples, our results indicated that mutations in the YMDD motif were 1.38 times more frequent in genotype D than in genotype A.
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Affiliation(s)
- Rodrigo Haddad
- Regional Blood Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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Randle CP, Pickett KM. The conflation of ignorance and knowledge in the inference of clade posteriors. Cladistics 2010; 26:550-559. [DOI: 10.1111/j.1096-0031.2009.00301.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Hepatitis B virus (HBV) is one of the most widely distributed viruses that infect humankind. Distinct clinical and virological characteristics of the HBV-infection have been reported in different geographical parts of the world and are increasingly associated with genetic diversity of the infecting virus. HBV is classified into genotypes and subgenotypes that are associated with ethnicity and geography. The genetic diversity of HBV in its various aspects has been the subject of extensive investigations during the last few decades. Since molecular epidemiology research tools have become widely available, the number of new publications in this field has grown exponentially. This review summarises the recent publications on the geographical distribution of genetic variants of HBV, and proposes updated criteria for the identification of new genotypes and subgenotypes of the virus.
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Affiliation(s)
- Fuat Kurbanov
- Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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