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Silva C, Ramos D, Quina M, Pádua E. Hepatitis B Virus Genotypes and Subgenotypes Circulating in Infected Residents in a Country with High Vaccination Rate. Viruses 2024; 16:954. [PMID: 38932246 PMCID: PMC11209455 DOI: 10.3390/v16060954] [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: 05/02/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Despite the availability of a vaccine against hepatitis B virus (HBV), this infection still causes public health problems, particularly in susceptible populations. In Portugal, universal free vaccination started in 1994, and most HBV infections are diagnosed in immigrants from high-prevalence countries. Our aim was to assess the pattern of HBV genotypes/subgenotypes in samples collected between 2017 and 2021 from a convenience sample of 70 infected residents in Portugal. The HBV pol/HBsAg region was amplified and sequenced, allowing the analysis of RT sequences submitted to phylogenetic analysis and mutations assessment. A total of 37.1% of samples were from native Portuguese, aged 25-53 years (mean: 36.7 years), and the remaining samples were from individuals born outside of Portugal. A high diversity of HBV was identified: subgenotypes A1-A3 in 41.0% (16/39); D1, D3, and D4 in 30.7% (12/39); E in 23.1% (9/39); and F4 in 2.6% (1/39). Besides genotypes A and D, Portuguese were also infected with genotypes E and F, which are prevalent in Africa and South America, respectively. Resistance mutations in RT sequences were not found. The findings provide valuable insights for updating the HBV molecular epidemiology in Portugal. However, successful strategies to prevent and control the infection are still needed in the country, especially among susceptible and vulnerable populations.
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Affiliation(s)
| | | | | | - Elizabeth Pádua
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Av. Padre Cruz, P-1649-016 Lisbon, Portugal
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Kasianchuk N, Dobrowolska K, Harkava S, Bretcan A, Zarębska-Michaluk D, Jaroszewicz J, Flisiak R, Rzymski P. Gene-Editing and RNA Interference in Treating Hepatitis B: A Review. Viruses 2023; 15:2395. [PMID: 38140636 PMCID: PMC10747710 DOI: 10.3390/v15122395] [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: 10/28/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
The hepatitis B virus (HBV) continues to cause substantial health and economic burdens, and its target of elimination may not be reached in 2030 without further efforts in diagnostics, non-pharmaceutical prevention measures, vaccination, and treatment. Current therapeutic options in chronic HBV, based on interferons and/or nucleos(t)ide analogs, suppress the virus replication but do not eliminate the pathogen and suffer from several constraints. This paper reviews the progress on biotechnological approaches in functional and definitive HBV treatments, including gene-editing tools, i.e., zinc-finger proteins, transcription activator-like effector nucleases, and CRISPR/Cas9, as well as therapeutics based on RNA interference. The advantages and challenges of these approaches are also discussed. Although the safety and efficacy of gene-editing tools in HBV therapies are yet to be demonstrated, they show promise for the revitalization of a much-needed advance in the field and offer viral eradication. Particular hopes are related to CRISPR/Cas9; however, therapeutics employing this system are yet to enter the clinical testing phases. In contrast, a number of candidates based on RNA interference, intending to confer a functional cure, have already been introduced to human studies. However, larger and longer trials are required to assess their efficacy and safety. Considering that prevention is always superior to treatment, it is essential to pursue global efforts in HBV vaccination.
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Affiliation(s)
- Nadiia Kasianchuk
- Faculty of Biology, Adam Mickiewicz University in Poznań, 61-614 Poznań, Poland
| | | | - Sofiia Harkava
- Junior Academy of Sciences of Ukraine, Regional Branch in Dnipro, 49000 Dnipro, Ukraine;
| | - Andreea Bretcan
- National College “Ienăchiță Văcărescu”, 130016 Târgoviște, Romania;
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland;
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, 41-902 Bytom, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland;
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland
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Reuter T, Gomes-Gouvea MS, Chuffi S, Duque UH, Perini W, Azevedo RS, Pinho JRR. Core Promoter and Pre-Core Variants of the Hepatitis B Virus (HBV) Are Frequent in Chronic Hepatitis B HBeAg-Negative Patients Infected by Genotypes A and D. Viruses 2023; 15:2339. [PMID: 38140580 PMCID: PMC10746983 DOI: 10.3390/v15122339] [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: 08/14/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/24/2023] Open
Abstract
In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Espírito Santo State in the southeast region. In this study, we intend to characterize the basal core promoter (BCP) and pre-core region (PC) variants and their association with clinical/epidemiological disease patterns in patients infected with genotypes A and D. The study included 116 chronic hepatitis B patients from Espírito Santo State, Southeast Brazil, infected with genotypes A and D. Basal core promoter (BCP) and pre-core mutations were analyzed in these patients. The frequency of BCP and PC mutations was compared with age, HBeAg status, HBV genotype and subgenotype, HBV-DNA level, clinical classification, and transmission route. HBeAg-negative status was found in 101 (87.1%) patients: 87 (75.0%) were infected with genotype A (A1 = 85; A2 = 2) and 29 (25.0%) were infected with genotype D (D3 = 24; D4 = 3; D2 = 2). BCP + PC variants altogether were more frequent (48.1%) in genotype D than in genotype A strains (6.0%) (p < 0.001). When this evaluation was performed considering the cases that presented only the A1762T and/or G1764A (BCP) mutations, it was observed that the frequency was higher in genotype A (67.5%) compared to genotype D (7.4%) (p < 0.001). On the other hand, considering the samples with mutations only in positions G1896A and/or G1899A (PC), the frequency was higher in genotype D (75.8%) than in genotype A (6.9%) (p < 0.001). Interestingly, HBV DNA was lower than 2000 IU/mL especially when both BCP/PC mutations were present (p < 0.001) or when only PC mutations were detected (p = 0.047), reinforcing their role in viral replication.
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Affiliation(s)
- Tania Reuter
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Michele Soares Gomes-Gouvea
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Samira Chuffi
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Ulisses Horst Duque
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
| | - Waltesia Perini
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
| | - Raymundo Soares Azevedo
- Department of Pathology, School of Medicine, University of Sao Paulo, São Paulo 01246-903, SP, Brazil;
| | - João Renato Rebello Pinho
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
- Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
- LIM-03, Central Laboratories Division, Clinics Hospital, School of Medicine, University of Sao Paulo, São Paulo 05403-000, SP, Brazil
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Castro GM, Sosa MJ, Sicilia PE, Riberi MI, Moreno C, Cattaneo R, Debes JD, Barbás MG, Cudolá AE, Pisano MB, Ré VE. Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV. Front Med (Lausanne) 2023; 9:1057194. [PMID: 36698842 PMCID: PMC9868314 DOI: 10.3389/fmed.2022.1057194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/16/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction Genomic analysis of hepatitis B virus (HBV) identifies phylogenetic variants, which may lead to distinct biological and clinical behaviors. The satellite hepatitis D virus (HDV) may also influence clinical outcomes in patients with hepatitis B. The aim of this study was to investigate HBV genetic variants, including clinically relevant mutations, and HDV infection in acute and chronic hepatitis B patients in central Argentina. Methods A total of 217 adult HBV infected patients [acute (AHB): n = 79; chronic (CHB): n = 138] were studied; 67 were HBV/human immunodeficiency virus (HIV) coinfected. Clinical and demographic data were obtained from medical records. Serological markers were determined. Molecular detection of HBV and HDV was carried out by RT-Nested PCR, followed by sequencing and phylogenetic analysis. Results Overall, genotype (gt) F [sub-genotype (sgt) F1b] was the most frequently found. In AHB patients, the gts/sgts found were: F1b (74.7%) > A2 (13.9%) > F4 (7.6%) > C (2.5%) > A1 (1.3%). Among CHB patients: F1b (39.1%) > A2 (23.9%) > F4 (18.2%) > D (9.4%) > C and F6 (3.6% each) > A1, A3 and B2 (0.7% each). The distribution of sgt A2 and gt D was significantly different between HBV mono and HBV/HIV coinfected patients [A2: 15.9% vs. 35.7% (p < 0.05), respectively and D: 14.6% vs. 1.8% (p < 0.05), respectively]. Mutation frequency in basal core promoter/pre-Core (BCP/pC) region was 35.5% (77/217) [AHB: 20.3% (16/79), CHB: 44.2% (61/138)]. In the open reading frame (ORF) S, mutations associated with vaccine escape and diagnostic failure were detected in 7.8% of the sequences (17/217) [AHB: 3.8% (3/79), CHB: 10.1% (14/138)]. ORF-P amino acid substitutions associated with antiviral resistance were detected in 3.2% of the samples (7/217) [AHB: 1.3% (1/79), CHB 4.3%, (6/138)]. The anti-HDV seropositivity was 5.2% (4/77); one sample could be sequenced, belonging to gt HDV-1 associated with sgt HBV-D3. Discussion We detected an increase in the circulation of genotype F in Central Argentina, particularly among AHB patients, suggesting transmission advantages over the other genotypes. A low rate of mutations was detected, especially those with antiviral resistance implications, which is an encouraging result. The evidence of HDV circulation in our region, reported for the first time, alerts the health system for its search and diagnosis.
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Affiliation(s)
- Gonzalo M. Castro
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina,*Correspondence: Gonzalo M. Castro,
| | - María J. Sosa
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - Paola E. Sicilia
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - María I. Riberi
- Laboratorio de Virología, Servicio de Microbiología, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Córdoba, Argentina
| | - Claudia Moreno
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - Rodolfo Cattaneo
- Servicio de Gastroenterología, Hospital Rawson, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - José D. Debes
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - María G. Barbás
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - Analía E. Cudolá
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - María B. Pisano
- Laboratorio de Hepatitis Virales, Instituto de Virología “Dr. J. M. Vanella” (InViV)–CONICET, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba (UNC), Córdoba, Argentina
| | - Viviana E. Ré
- Laboratorio de Hepatitis Virales, Instituto de Virología “Dr. J. M. Vanella” (InViV)–CONICET, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba (UNC), Córdoba, Argentina
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