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Kafeero HM, Ndagire D, Ocama P, Kato CD, Wampande E, Walusansa A, Kajumbula H, Kateete D, Ssenku JE, Sendagire H. Mapping hepatitis B virus genotypes on the African continent from 1997 to 2021: a systematic review with meta-analysis. Sci Rep 2023; 13:5723. [PMID: 37029173 PMCID: PMC10082212 DOI: 10.1038/s41598-023-32865-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
Hepatitis B virus (HBV) has ten genotypes (A-J) and over 40 sub-genotypes based on the divergence of ≥ 8% and 4 to < 8% in the complete genome respectively. These genotypes and sub-genotypes influence the disease prognosis, response to therapy and route of viral transmission. Besides, infection with mixed genotypes and recombinant genotypes has also been reported. This study aimed at mapping the de novo genotypes and correlate them with the immigration trends in order to inform future research on the underlying reasons for the relative distribution of HBV genotypes from a large sample size pooled from many primary studies. Data was extracted from 59 full research articles obtained from Scopus, PubMed, EMBASE, Willy library, African Journal Online (AJOL) and Google Scholar. Studies that investigated the genotypes, sub-genotypes, mixed genotypes and recombinant were included. The Z-test and regression were used for the analysis. The study protocol is registered with PROSPERO under the registration number CRD42022300220. Overall, genotype E had the highest pooled prevalence significantly higher than all the other genotypes (P < 0.001). By region, genotype A posted the highest pooled prevalence in eastern and southern Africa, E in west Africa and D in north Africa (P < 0.0001). Regarding the emerging genotypes B and C on the African continent, genotype B was significantly higher in south Africa than C (P < 0.001). In contrast, genotype C was significantly higher in east Africa than west Africa (P < 0.0001). The A1 and D/E were the most diverse sub-genotypes and genotype mixtures respectively. Finally, we observed a general progressive decrease in the prevalence of predominant genotypes but a progressive increase in the less dominant by region. Historical and recent continental and intercontinental migrations can provide a plausible explanation for the HBV genotype distribution pattern on the African continent.
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Affiliation(s)
- Hussein Mukasa Kafeero
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda.
| | - Dorothy Ndagire
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Ponsiano Ocama
- Department of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Charles Drago Kato
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Eddie Wampande
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Abdul Walusansa
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - David Kateete
- Department of Molecular Biology and Immunology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Jamilu E Ssenku
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Hakim Sendagire
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
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Hamida ME, Raja SM, Petros Y, Wahab M, Elkhidir IM, Achila OO, Tekle F, Berhane IY. Genotyping and sero-virological characterization of hepatitis B virus-infected blood donors in Central Eritrea. Future Virol 2022. [DOI: 10.2217/fvl-2021-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To determine the serological markers and genotype profiles of hepatitis B virus (HBV) isolates in Central Eritrea. Materials & methods: A total of 191 hepatitis B surface antigen (HBsAg)-positive sera were randomly selected for the study. ELISA was used to perform HBV seromarker screening, genotypes were determined using multiplex-nested PCR. Results: Of 191, 77.5% (148/191) were positive for HBcAb (total), among which 99.3% (147/148) and 0.7% (1/148) were positive for HBsAg and hepatitis B surface antibody, respectively. Of the 147 positive HBcAb/HBsAg, 16 (10.9%) and 131 (77.9%) were positive for HBeAg and HBeAb, respectively. A total of 73 HBV isolates were successfully genotyped: 39 (53.4%) D; 10 (13.7%) E; 6 (8.2%) A; 6 (8.2%) C/D; 4 (5.5%) C; 3 (4.1%) C/D/E; 2 (2.7%) A/D; 2 (2.7%) D/E; and 1 (1.4%) B/D. Conclusion: HBV genotype D is the predominant genotype among blood donors in Eritrea.
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Affiliation(s)
| | - Saud Mohammed Raja
- Department of Internal Medicine, Orotta College of Medicine & Health Sciences, Asmara, Eritrea
| | - Yodahi Petros
- National Animal & Plant Health Laboratory, Unit of Molecular Biology, Asmara, Eritrea
| | - Munir Wahab
- National Animal & Plant Health Laboratory, Unit of Molecular Biology, Asmara, Eritrea
| | - Isam Mohammed Elkhidir
- Department of Microbiology, University of Khartoum, Faculty of Medicine, Khartoum, Sudan
| | - Oliver Okoth Achila
- Department of Clinical Laboratory Sciences, Asmara College of Health Science (ACHS), Asmara, Eritrea
| | - Freweini Tekle
- Ministry of Health, National Health Laboratory, Asmara, Eritrea
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Athamneh RY, Arıkan A, Sayan M, Mahafzah A, Sallam M. Variable Proportions of Phylogenetic Clustering and Low Levels of Antiviral Drug Resistance among the Major HBV Sub-Genotypes in the Middle East and North Africa. Pathogens 2021; 10:1333. [PMID: 34684283 PMCID: PMC8540944 DOI: 10.3390/pathogens10101333] [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: 09/22/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/21/2022] Open
Abstract
Hepatitis B virus (HBV) infection remains a major public health threat in the Middle East and North Africa (MENA). Phylogenetic analysis of HBV can be helpful to study the putative transmission links and patterns of inter-country spread of the virus. The objectives of the current study were to analyze the HBV genotype/sub-genotype (SGT) distribution, reverse transcriptase (RT), and surface (S) gene mutations and to investigate the domestic transmission of HBV in the MENA. All HBV molecular sequences collected in the MENA were retrieved from GenBank as of 30 April 2021. Determination of genotypes/SGT, RT, and S mutations were based on the Geno2pheno (hbv) 2.0 online tool. For the most prevalent HBV SGTs, maximum likelihood phylogenetic analysis was conducted to identify the putative phylogenetic clusters, with approximate Shimodaira-Hasegawa-like likelihood ratio test values ≥ 0.90, and genetic distance cut-off values ≤ 0.025 substitutions/site as implemented in Cluster Picker. The total number of HBV sequences used for genotype/SGT determination was 4352 that represented a total of 20 MENA countries, with a majority from Iran (n = 2103, 48.3%), Saudi Arabia (n = 503, 11.6%), Tunisia (n = 395, 9.1%), and Turkey (n = 267, 6.1%). Genotype D dominated infections in the MENA (86.6%), followed by genotype A (4.1%), with SGT D1 as the most common in 14 MENA countries and SGT D7 dominance in the Maghreb. The highest prevalence of antiviral drug resistance was observed against lamivudine (4.5%) and telbivudine (4.3%). The proportion of domestic phylogenetic clustering was the highest for SGT D7 (61.9%), followed by SGT D2 (28.2%) and genotype E (25.7%). The largest fraction of domestic clusters with evidence of inter-country spread within the MENA was seen in SGT D7 (81.3%). Small networks (containing 3-14 sequences) dominated among domestic phylogenetic clusters. Specific patterns of HBV genetic diversity were seen in the MENA with SGT D1 dominance in the Levant, Iran, and Turkey; SGT D7 dominance in the Maghreb; and extensive diversity in Saudi Arabia and Egypt. A low prevalence of lamivudine, telbivudine, and entecavir drug resistance was observed in the region, with almost an absence of resistance to tenofovir and adefovir. Variable proportions of phylogenetic clustering indicated prominent domestic transmission of SGT D7 (particularly in the Maghreb) and relatively high levels of virus mobility in SGT D1.
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Affiliation(s)
- Rabaa Y. Athamneh
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia 99138, Cyprus; (R.Y.A.); (A.A.)
| | - Ayşe Arıkan
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia 99138, Cyprus; (R.Y.A.); (A.A.)
- DESAM, Near East University, Nicosia 99138, Cyprus;
| | - Murat Sayan
- DESAM, Near East University, Nicosia 99138, Cyprus;
- Clinical Laboratory, PCR Unit, Faculty of Medicine, Kocaeli University, İzmit 41380, Turkey
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 11942, Jordan;
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 11942, Jordan;
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
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Elshaer M, Elsayed E, El-Gilany AH, El-Mashad N, Mansour M. Adherence and Effectiveness of HBV Vaccination among Healthcare Workers in Egypt. Indian J Occup Environ Med 2021; 25:91-95. [PMID: 34421244 PMCID: PMC8341406 DOI: 10.4103/ijoem.ijoem_139_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/13/2020] [Accepted: 07/28/2020] [Indexed: 11/24/2022] Open
Abstract
Context: Healthcare workers (HCWs) face a potential risk of acquiring different bloodborne pathogens, by occupational exposure to contaminated blood and body fluids. Hepatitis B vaccine is a safe, effective method of conferring long-term protection against HBV infection. Aims: The study aimed to assess the adherence and effectiveness of HBV vaccination among HCWs at Gastrointestinal Surgical Center, Mansoura University, Egypt. Settings and Design: A prospective descriptive study was carried out between June 2019 and December 2019 at Gastrointestinal Surgical Center, Mansoura University, Egypt. Methods and Material: All HCWs with anti-HBs levels below 10 mIU/mL were advised to receive 3 doses of recombinant HBV vaccine, at 0, 1, and 6 months. The anti-HBs levels were checked 3 months after the third dose of the HBV vaccine. Statistical Analysis Used: Data was analyzed using the Statistical Package of Social Science (SPSS) program for windows (version 16). Results: A total of 442 healthcare providers were included. Most of them completed the 3 doses of the vaccine (81.7%), 10.2% refused the vaccine, while 0.9% and 7.2% received 1 and 2 doses, respectively. Odds of vaccination were the highest (88.1%, 273/310) among nurses (OR, 4.7; 95% CI, 2.6–5.2; P ≤ 0.001). The overall anti-HBs positivity of 97% (350/361) was observed. The main reasons for not being vaccinated included the fear of vaccine side effects 25/81 (30.9%) and lack of trust in the vaccine effectiveness 18/81 (22.2%). Conclusions: The outcome of the present study emphasizes the need to apply alternative and innovative measures to build a positive attitude toward the HBV vaccine among HCWs.
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Affiliation(s)
- Mohammed Elshaer
- Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Eman Elsayed
- Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | | | - Noha El-Mashad
- Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mostafa Mansour
- Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
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5
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Elbahrawy A, Ibrahim MK, Eliwa A, Alboraie M, Madian A, Aly HH. Current situation of viral hepatitis in Egypt. Microbiol Immunol 2021; 65:352-372. [PMID: 33990999 DOI: 10.1111/1348-0421.12916] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022]
Abstract
An estimated 8-10 million people suffer from viral hepatitis in Egypt. Hepatitis A virus (HAV) and hepatitis E virus (HEV) are the major causes of viral hepatitis in Egypt as 50% or more of the Egyptian population are already exposed to HAV infection by the age of 15. In addition, over 60% of the Egyptian population test seropositive for anti-HEV in the first decade of life. HEV mainly causes self-limiting hepatitis; however, cases of fulminant hepatitis and liver failure were reported in Egypt. Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) are the main causes of chronic hepatitis, liver cirrhosis, and liver cancer (hepatocellular carcinoma [HCC]) in Egypt. Globally, Egypt had the highest age-standardized death rate due to cirrhosis from 1990 to 2017. The prevalence rate of HBV (1.3%-1.5%) has declined after national infantile immunization. Coinfection of HBV patients with HDV is common in Egypt because HDV antibodies (IgG) vary in range from 8.3% to 43% among total HBV patients. After the conduction of multiple national programs to control HCV infection, a lower rate of HCV prevalence (4.6%) was recently reported. Data about the incidence of HCV after treatment with direct antiviral agents (DAAs) are lacking. An HCC incidence of 29/1000/year in cirrhotic patients after DAA treatment is reported. A higher rate of infiltrative pattern among HCC patients after DAA treatment is also recognized. Viral hepatitis is one of the major public health concerns in Egypt that needs more attention and funding from health policymakers.
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Affiliation(s)
- Ashraf Elbahrawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Marwa K Ibrahim
- Department of Microbial Biotechnology, Division of Genetic Engineering and Biotechnology Research, National Research Centre, Giza, Egypt.,Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ahmed Eliwa
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ali Madian
- Department of Internal Medicine, Al-Azhar University, Assiut, Egypt
| | - Hussein Hassan Aly
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
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Prevalence of hepatitis B virus genotypes among patients with liver disease in Eritrea. Sci Rep 2021; 11:11323. [PMID: 34059763 PMCID: PMC8166852 DOI: 10.1038/s41598-021-90836-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/17/2021] [Indexed: 01/15/2023] Open
Abstract
Eritrea is an East African multiethnic country with an intermediate endemicity for hepatitis B. Our aim was to establish the most prevalent genotypes of hepatitis B virus (HBV) among patients with liver disease. A total of 293 Eritrean patients with liver disease who were hepatitis B surface antigen (HBsAg) positive were enrolled. All sera were tested for liver transaminases, HBV DNA viral load, and hepatitis B seromarkers including HBsAg, anti-HBcAb (total), HBeAg, and anti-HBeAb. Those reactive for HBsAg and anti-HBc (total) were further tested for HBV genotyping. The median (interquartile range) of HBV DNA viral load and ALT levels were 3.47 (1.66) log IU/mL and 28 (15.3) IU/L, respectively. Using type-specific primer-based genotyping method, 122/293 (41.6%) could be genotyped. Irrespective of mode of occurrence, HBV genotype D (21.3%) was the predominant circulating genotype, followed by genotypes C (17.2%), E (15.6%), C/D (13.1%), and C/E (10.7%). Genotypes C/D/E (7.4%), A/D (4.9%), D/E (4.1%), A (2.5%), and B, A/E, B/E, and A/D/C (0.8%) were also present. HBV in Eritrea is comprised of a mixture of HBV genotypes. This is the first study of HBV genotyping among patients with liver disease in Eritrea.
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7
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Panicker S, Kumar CPG, Selvaraj V, Prabu R, Chandrasekar C, Valan AS, Kumar JS, Raja K. Molecular epidemiology of HBV among HIV infected individuals in Chennai, south India. Virus Res 2021; 300:198439. [PMID: 33930486 DOI: 10.1016/j.virusres.2021.198439] [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] [Received: 10/02/2020] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 12/25/2022]
Abstract
Hepatitis B is a major co-infection among people with HIV (PWHIV) worldwide. There is a paucity of data on HBV genetic diversity in India, which would be useful for targeted preventive and management interventions. To characterize the distribution of HBV genotypes and sub-genotypes, samples of 180 HIV-HBV co-infected individuals from a study previously conducted to estimate the prevalence of HBV co-infection were analyzed. Nested PCR using type-specific primers was used to identify the various HBV genotypes. Partial HBV S sequences were generated for a subset of samples using Sanger sequencing. Mutation analysis was done using the online HBVseq program. PCR based genotyping documented D (69.4 %) and A (5.6 %) to be the major genotypes in the study population. Infection with multiple genotypes was observed in 25 % co-infected individuals. D2, D5, A2, and A1 were the sub-genotypes detected. Mutations 184K and 173L were identified. HBV genotypes/ sub-genotypes play a pivotal role in the clinical outcome of chronic hepatitis B (CHB). Therefore, monitoring of CHB cases is needed to track disease progression, including early detection of hepatocellular carcinoma.
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Affiliation(s)
- S Panicker
- ICMR-National Institute of Epidemiology, Chennai, 600077, India
| | - C P Girish Kumar
- ICMR-National Institute of Epidemiology, Chennai, 600077, India.
| | - V Selvaraj
- ICMR-National Institute of Epidemiology, Chennai, 600077, India
| | - R Prabu
- ICMR-National Institute of Epidemiology, Chennai, 600077, India
| | - C Chandrasekar
- Government Hospital of Thoracic Medicine, Chennai, 600047, India
| | - A S Valan
- Government Hospital of Thoracic Medicine, Chennai, 600047, India
| | - J Suria Kumar
- Government Hospital of Thoracic Medicine, Chennai, 600047, India
| | - K Raja
- Government Hospital of Thoracic Medicine, Chennai, 600047, India
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Alshabi A, Fatima N, Marwan A, Oraibi KG, Qubaisi EA, Arif HO, Daghriri EM, Zelai NA, Ali Khan I. Epidemiology screening and genotyping analysis for Hepatitis B virus in Southwestern region of Saudi Arabia. J Infect Public Health 2021; 14:187-192. [PMID: 33486374 DOI: 10.1016/j.jiph.2020.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/13/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus (HBV) is a global human pathogen that can cause life-threatening liver disease including persistent hepatitis, cirrhosis of the liver and hepatocellular cancer. The aim of this present study was to investigate the infection of HBV epidemiology and also examine the HBsAg genotype distribution in the southwestern region of Jizan city in the Saudi Arabia. Since 2015-2018, epidemiological study has been conducted within the city premises of Jazan region. HBsAg genotyping with the molecular biology grade techniques was performed in 50 subjects. In this study, 1888 subjects in the Jazan city of the Southwestern region were diagnosed as positive for HBV. The mean age of the participants was found to be 44.5 ± 16.9 years. Over 68% of males and 31% of females participated in this epidemiological study. Approximately, 88% of Saudi nationalities were recruited with 12% involving non-Saudi subjects Genotyping analysis confirmed that 90% of subjects confirmed genotype-D and 10% confirmed genotypes A, H and E. Anova analysis could find no significant association between the genotype analysis and the clinical data (p > 0.05). The prevalence of HBV in the Jazan region was found to be high based on the clinical data from epidemiological studies conducted in the Southwestern region. Since 2015-2018, a total of 1888 samples have been found to be positive at Jazan premises. The HBsAg genotyping studies confirm in this study 90% of the genotyping-D was documented.
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Affiliation(s)
- Alkhansa Alshabi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Nuzhath Fatima
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Amany Marwan
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Khadejh G Oraibi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Ebtihal A Qubaisi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Hanan O Arif
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Elham M Daghriri
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Noran A Zelai
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7027169. [PMID: 32626758 PMCID: PMC7305551 DOI: 10.1155/2020/7027169] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/04/2020] [Accepted: 02/22/2020] [Indexed: 12/13/2022]
Abstract
Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.
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Said M, Eletreby R, Omar H, Dabees H, Abdelghafour R, El-Serafy M, Doss W. Fibro-indices versus liver stiffness for prediction of significant fibrosis in hepatitis B virus-infected Egyptian patients; a single-center experience. Expert Rev Gastroenterol Hepatol 2020; 14:221-227. [PMID: 32031424 DOI: 10.1080/17474124.2020.1723415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background: Liver fibrosis assessment is a key factor for disease management in hepatitis B virus (HBV). Several serum biomarkers have been introduced for noninvasive fibrosis assessment. This study aims to evaluate the validity of simple noninvasive indices, namely Fibrosis-4 score (FIB4), aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), Goteborg University Cirrhosis Index (GUCI), and fibrosis index in evaluation of liver fibrosis in chronic HBV.Methods: 226 patients with chronic HBV genotype D were included. FIB4, APRI, GUCI, and fibrosis index were performed. Receiver operating characteristic (ROC) curves were used to predict ≥F2 fibrosis.Results: The mean age of patients was 39.00 years and 72.27% of patients were treatment naïve. Patients with ≥F2 hepatic fibrosis had significantly higher FIB-4 (1.58 ± 1.46 vs. 1.15 ± 1.09), APRI (0.68 ± 0.71 vs. 0.43 ± 0.37), GUCI score (0.75 ± 0.94 vs. 0.42 ± 0.29) and Fibrosis index (2.18 ± 0.84 vs. 1.84 ± 0.69). All studied indices were able to diagnose ≥F2 fibrosis. APRI had the highest area under the ROC (AUROC) of 0.67. Predictivity of all indices was higher in on-treatment vs naive patients.Conclusion: FIB4, APRI, and GUCI scores are acceptable, noninvasive, and cheap simple indices that can be helpful on treatment follow-up of fibrosis regression in the setting of low socioeconomic conditions compared to the relatively expensive fibroscan modality.
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Affiliation(s)
- Mohamed Said
- Hepatology and Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Rasha Eletreby
- Hepatology and Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Heba Omar
- Hepatology and Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Hossam Dabees
- Hepatology and Endemic Medicine, Medical National Institute, Damnhour, Egypt
| | - Reem Abdelghafour
- Hepatology and Endemic Medicine, Medical National Institute, Damnhour, Egypt
| | - Magdy El-Serafy
- Hepatology and Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Wahid Doss
- Hepatology and Endemic Medicine Department, Cairo University, Cairo, Egypt
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Soliman AR, Ahmed RM, Soliman M, Abdallah A, Zayed B. The effect of co-infection with hepatitis B and hepatitis C viruses on the prevalence of proteinuria and loss of renal function: a single-center experience. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2018. [DOI: 10.4103/ejim.ejim_51_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Said E, Agawy WE, Ahmed R, Hassany M, Ahmed A, Fouad H, Baiumy H. Serum Vitamin D Levels in Treatment-naïve Chronic Hepatitis B Patients. J Transl Int Med 2017; 5:230-234. [PMID: 29340280 DOI: 10.1515/jtim-2017-0038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background and Objectives According to the demographic health survey conducted in 2015, Egypt had 10% documented prevalence of anti-HBc positive patients aged 1-59 and 1% viremic patients amongst the population in the same age group, with a domination of genotype D. Several studies claimed the possible role of vitamin D deficiency in hepatitis B virus (HBV) replication and disease progression. Patients and Methods Serum vitamin D levels [25(OH D3] were assessed in 96 HBeAg negative non-cirrhotic chronic HBV patients and 25 healthy subjects classified as following: Group I: 48 chronic HBV patients with persistently normal ALT levels and HBV DNA level < 2000 IU/mL for ≥ 6 months; Group II: 48 chronic HBV patients with CHB with persistently elevated ALT and HBV DNA level ≥ 2000 IU/mL for ≥ 6 months; and Group III: 25 apparently healthy subjects with normal liver enzymes and negative hepatitis viral markers were taken as the control group. Results Vitamin D was much more deficient in group II than in group I and group III being 11.55 ± 3.97 ng/mL, 15.03 ± 3.45, 27.00 ± 6.76 ng/mL (P < 0.001), respectively, and a strong negative correlation was observed between vitamin D levels and HBV DNA levels (P = 0.043) in groups I and II. Conclusion The current study showed high HBV DNA replication in patients with vitamin D deficiency suggesting the antimicrobial immunomodulatory role of vitamin D.
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Affiliation(s)
- Ebada Said
- Department of Hepatology, Gastroenterology and Infectious Diseases Benha Faculty of Medicine, Benha University, Banha, Egypt
| | - Waleed El Agawy
- Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
| | - Rehab Ahmed
- Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
| | - Mohamed Hassany
- Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
| | - Amal Ahmed
- Department of Biochemistry and Molecular Biology, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
| | - Hanan Fouad
- Department of Internal Medicine, El Kanater General Hospital, Al Qalyubia, Egypt
| | - Hosam Baiumy
- Department of Hepatology, Gastroenterology and Infectious Diseases Benha Faculty of Medicine, Benha University, Banha, Egypt
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El-Folly RF, Maher M. MM, R. Abdelkader A. Thyroid dysfunction in chronic viral hepatitis [B and C]; An Egyptian pilot study. EGYPTIAN LIVER JOURNAL 2016. [DOI: 10.1097/01.elx.0000520136.24876.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Relation between hepatitis B viral load and liver fibrosis assessed using transient elastography in patients with chronic hepatitis B virus infection. EGYPTIAN LIVER JOURNAL 2016. [DOI: 10.1097/01.elx.0000520135.03138.d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Hussein WM, Anwar WA, Attaleb M, Mazini L, Försti A, Trimbitas RD, Khyatti M. A review of the infection-associated cancers in North African countries. Infect Agent Cancer 2016; 11:35. [PMID: 27512409 PMCID: PMC4979152 DOI: 10.1186/s13027-016-0083-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/09/2016] [Indexed: 02/08/2023] Open
Abstract
Cancer is typically classified as a leading non-communicable disease; however, infectious agents, such as Helicobacter pylori (H. pylori), hepatitis B virus (HBV), hepatitis C virus (HCV) and human papilloma virus (HPV), contribute significantly to the pathogenesis of various cancers. Less developed countries, including countries of the North African (NA) region, endure the highest burden of infection-related cancers. The five most common infection-associated cancers in NA in order of incidence are bladder cancer, cervical cancer, liver cancer, stomach cancer, and nasopharyngeal carcinoma. This review aims to outline the epidemiologic pattern of infection-associated cancers in five NA countries (namely: Morocco, Algeria, Tunisia, Libya and Egypt) highlighting the similarities and differences across the region. The present study employed an initial literature review of peer-reviewed articles selected from PubMed, ScienceDirect and World Health Organization (WHO) databases based on key word searches without restriction on publication dates. Original research articles and reports written in French, as well as data from institutional reports and regional meeting abstracts were also included in this extensive review. Egypt, Libya, Tunisia, Algeria and Morocco were selected to be the focus of this review.
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Affiliation(s)
- Wafaa Mohamed Hussein
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Wagida A Anwar
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Mohammed Attaleb
- Biology and Medical Research Unit, National Center of Energy, Sciences and Nuclear Technics, Rabat, Morocco
| | - Loubna Mazini
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany ; Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | | | - Meriem Khyatti
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
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Abu Zeid WM, Ramadan DI, Shemis MA. Prevalence of mutations within major hydrophilic region of hepatitis B virus and their correlation with genotypes among chronically infected patients in Egypt. Arab J Gastroenterol 2016; 17:34-40. [PMID: 27055927 DOI: 10.1016/j.ajg.2016.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/03/2016] [Accepted: 03/08/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND STUDY AIMS Mutations within the major hydrophilic region (MHR) of the hepatitis B surface antigen (HBsAg) have been reported in relation to viral persistence by evasion from vaccine and immunotherapy, severity of liver disease and lack of detection by commercial kits. The aim of this study was to elucidate the circulation of hepatitis B virus (HBV) genotypes, subgenotypes and serotypes in Egypt, with recognition of the pattern and prevalence of MHR mutations possibly occurring during the course of the disease. PATIENTS AND METHODS Eighty-eight samples from patients with chronic HBV infection were included in the study. The surface protein-encoding gene (S gene) in the HBV genome was subjected to amplification and partial sequencing. RESULTS Based on phylogenetic analysis, only genotype D was found circulating among patients. The majority of isolates belonged to subgenotype D3 (86.3%), followed by D7 (8%), then D5 (3.4%) and lastly D1 (2.3%). Two subtypes were identified: ayw2 (97%) and ayw3 (2%). The 'w' sub-determinant was not defined in one isolate (1%). A significant proportion of patients (13/88, 14.8%) exhibited mutations in the MHR, 10 of whom harboured mutations in the 'a' determinant region and three outside. The first loop comprised four patients with three mutations (P127S, P127T and Y134F). The second loop contained six patients, all with one mutation, S143L, which was most frequently encountered in this study (6.8%). CONCLUSIONS We conclude that genotype D, subgenotype D3 and HBsAg subtype ayw2 are the most common types circulating in Egypt, which account for 100%, 86.3% and 97% of the population, respectively, with a moderate degree of MHR mutations.
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Affiliation(s)
| | - Dalia I Ramadan
- Department of Clinical and Chemical Pathology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
| | - Mohamed A Shemis
- Department of Biochemistry & Molecular Biology, Theodor Bilharz Research Institute, Giza, Egypt
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Abdelnabi Z, Saleh N, Baraghithi S, Glebe D, Azzeh M. Subgenotypes and mutations in the s and polymerase genes of hepatitis B virus carriers in the West Bank, palestine. PLoS One 2014; 9:e113821. [PMID: 25503289 PMCID: PMC4264744 DOI: 10.1371/journal.pone.0113821] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 10/31/2014] [Indexed: 12/17/2022] Open
Abstract
The mutation rate and genetic variability of hepatitis B virus (HBV) are crucial factors for efficient treatment and successful vaccination against HBV. Until today, genetic properties of this virus among the Palestinian population remain unknown. Therefore, we performed genetic analysis of the overlapping S and polymerase genes of HBV, isolated from 40 Palestinian patients' sera. All patients were HBsAg positive and presented with a viral load above 105 HBV genome copies/ml. The genotyping results of the S gene demonstrated that HBV D1 was detected in 90% of the samples representing the most prominent subgenotype among Palestinians carrying HBV. Various mutations existed within the S gene; in five patients four known escape mutations including the common G145R and D144E were found. Furthermore, a ratio of 4.25 of non-synonymous to synonymous mutations in the S gene indicated a strong selection pressure on the HBs antigen loops of HBV strains circulating in those Palestinian patients. Although all patients were treatment-naïve, with the exception of one, several mutations were found in the HBV polymerase gene, but none pointed to drug resistance. The study presented here is the first report to address subgenotypes and mutation analyses of HBV S and polymerase genes in Palestine.
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Affiliation(s)
- Zakeih Abdelnabi
- Virology Research Laboratory, Medical Research Center, Al-Quds University, Abu Dies-East Jerusalem, Palestine
| | - Niveen Saleh
- Virology Research Laboratory, Medical Research Center, Al-Quds University, Abu Dies-East Jerusalem, Palestine
| | - Sabri Baraghithi
- Al-Makassed Islamic Charitable Hospital (MICH) Central Laboratory, East Jerusalem, Palestine
| | - Dieter Glebe
- Institute of Medical Virology, Justus-Liebig University Giessen, National Reference Center for Hepatitis B and D Viruses, German Center for Infection Research (DZIF), Biomedical Research Center, Giessen, Germany
| | - Maysa Azzeh
- Virology Research Laboratory, Medical Research Center, Al-Quds University, Abu Dies-East Jerusalem, Palestine
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Ou C, Zheng HP, Su JJ, Cao J, Li GJ, Li LQ. Effect of Ginkgo biloba extract on the expressions of Cox-2 and GST-Pi in rats with hepatocellular carcinoma risk. Afr Health Sci 2014; 14:37-48. [PMID: 26060456 DOI: 10.4314/ahs.v14i1.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common and aggressive cancers worldwide, and the pathogenesis is complicated at present. There iare few effective therapeutic measures, and novel therapeutic strategies are urgently required to improve clinical outcome. Ginkgo biloba extract (EGb) is reported to have an anti-cancer activity. OBJECTIVES To explore the effect of EGb on expressions of cyclooxygenase-2 (Cox-2) and glutathione S-transferase Pi (GST-Pi) in the pathogenesis of HCC. METHODS 120 Wistar rats were divided into three groups at random: normal control group (control group), HCC risk group without treatment (HCC risk group), HCC risk group treated with EGb (EGb group); n=40, respectively. The HCC risk in rat was induced by aflatoxin B1 injection. At the end of 13-week, 33-week, 53-week and 73-week, 10 rats in each group were killed and the relevant samples were collected. RESULTS The mRNA and protein expressions of Cox-2 and GST-Pi were measured by real-time reverse transcription polymerase chain reaction, immunohistochemical analysis and western-blot. When compared with those in the control group in 73-week, the mRNA and protein expressions of GST-Pi in EGb group were weaker than those in HCC risk group in 73-week. However, the mRNA and protein expressions of Cox-2 in HCC risk group were increased than that of control group, and there was no statistical difference for mRNA and protein expressions of Cox-2 between HCC risk group and EGb group. CONCLUSION EGb can regulate the expression of GST-Pi, but it does not seem to have an effect on Cox-2 expression in the liver of HCC risk rats.
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Affiliation(s)
- Chao Ou
- Department of Experimental Pathology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Province 530021, China
| | - Hai-Ping Zheng
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province 530021, China
| | - Jian-Jia Su
- Department of Experimental Pathology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Province 530021, China
| | - Ji Cao
- Department of Experimental Pathology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Province 530021, China
| | - Guo-Jian Li
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province 530021, China
| | - Le-Qun Li
- Department of Hepatobiliary Surgery , The Affiliated Tumor Hospital of Guangxi Medical University, Nanning Guangxi Province 530021, China
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Habil FE, Mahdi WKM, Abdelwahab SF, Abdel-Hamid M. Hepatitis B virus genotype D predominates HBsAg-positive egyptian blood donors and is mainly associated with a negative HBeAg serostatus. Intervirology 2013; 56:278-83. [PMID: 23887183 DOI: 10.1159/000353105] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 04/30/2013] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Hepatitis B virus (HBV) infection is a global health burden. In this regard, Egypt has an intermediate HBV seroprevalence. HBV is classified into ten different genotypes (A-J) with different geographic distributions. Genotype D is the most prevalent in the Middle East. Limited data are available about HBV genotyping among Egyptian blood donors, particularly in Upper Egypt. We examined the seroprevalence of HBV among 12,000 blood donors attending the blood transfusion services center in Minia Governorate, Upper Egypt. METHODS HBsAg and HBeAg were examined by ELISA while HBV-DNA was examined by PCR. HBV genotyping was conducted by restriction fragment length polymorphism. RESULTS HBsAg was detected in 237 donors (1.98%). The HBV-DNA of 50 donors with the highest HBsAg OD was examined for the HBV genotype. All 50 DNA-positive samples were of genotype D. 82% of the DNA-positive donors were males, coinciding with their representation in the cohort. ALT levels were normal in 88% of genotyped subjects, while 84% of them were HBeAg negative. CONCLUSION Taken together, these data indicate that HBV genotype D is the predominant genotype among HBsAg-positive blood donors in Upper Egypt and was in >80% of the subjects associated with a negative HBeAg serostatus.
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A meta-analysis of the relationship between glutathione S-transferases gene polymorphism and hepatocellular carcinoma in Asian population. Mol Biol Rep 2012; 39:10383-93. [PMID: 23053942 DOI: 10.1007/s11033-012-1917-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 10/01/2012] [Indexed: 12/19/2022]
Abstract
The results from the published studies on the association between glutathione S-transferases (GST) gene polymorphism and hepatocellular carcinoma (HCC) in Asian population are still conflicting. GSTM1, GSTT1 and GSTP1 are the mainly mutant sites reported at present. This meta-analysis was performed to evaluate the relationship between GST gene polymorphism and HCC risk in Asians. Association studies were identified from the databases of PubMed, Embase, Cochrane Library and CBM-disc (China Biological Medicine Database) on February 1, 2012, and eligible investigations were synthesized using meta-analysis method. Results were expressed with odds ratios (OR) for dichotomous data, and 95 % confidence intervals (CI) were also calculated. Twenty-five investigations were identified for the analysis of association between polymorphic deletion of GSTM1 and HCC, consisting of 3,547 patients with HCC and 6,132 controls. There was a marked association between GSTM1 null genotype and HCC susceptibility (OR 1.48, 95 % CI 1.19-1.85, P = 0.0004). GSTM1 null genotype was associated with HCC risk in Chinese. Furthermore, null genotype of GSTT1 was associated with HCC susceptibility in Asians. For the GSTM1-GSTT1 interaction analysis, the dual null genotype of GSTM1/GSTT1 was significantly associated with HCC susceptibility in Asian population. However, GSTP1 ile105 val gene polymorphism was not associated with HCC risk in Asian population. In conclusion, GSTM1/GSTT1 null genotype is associated with the HCC susceptibility. However, GSTP1 gene polymorphism is not associated with HCC risk.
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Baha W, Ennaji MM, Lazar F, Melloul M, El Fahime E, El Malki A, Bennani A. HBV genotypes prevalence, precore and basal core mutants in Morocco. INFECTION GENETICS AND EVOLUTION 2012; 12:1157-62. [DOI: 10.1016/j.meegid.2012.04.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 04/14/2012] [Accepted: 04/25/2012] [Indexed: 02/06/2023]
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