Genotypes and subgenotypes of hepatitis B virus circulating in an endemic area in Peru

Hepatitis B Virus (HBV) Genotypes in an Ecuadorian Population: A Preliminary Study

Chronic hepatitis B virus (HBV) infection affects 257-291 million people worldwide. The World Health Organization reported 890,000 HBV-related deaths in 2019, higher than reported previously. There are 10 HBV genotypes (A-J) subdivided into several subgenotypes that differ considerably by geography. Various virologic factors, including genotype and subgenotype, impact the odds of acquiring a chronic HBV infection, the type of treatment prescribed, and the risk of developing hepatocarcinoma. Information on the HBV genotypes and subgenotypes that circulate in Ecuador remains low. To address this gap, the current study took a preliminary look at HBV-infected human samples from this region to identify the most common genotypes and subgenotypes. Samples from 44 patients in the Andean, Coastal, and Amazon regions of Ecuador were amplified and two major genotypes were identified, genotype F (42/44; 95.5%) and genotype E (2 patients; 4.5%). The genotype F subgenotypes were F3 (35/42; 83.33%), F4 (6/42; 14.28%), and F1b (1/42, 2.39%). This is the first epidemiological study to assess the distribution of HBV genotypes in Ecuador. The findings can inform antiviral drug effectivity studies specific to HBV genotypes prevalent in South America.

Hepatitis B virus American genotypes: Pathogenic variants ?

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.

The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru - Recommendations from the Latin American Society for Travel Medicine (SLAMVI)

The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.