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Anderson M, Mangogola T, Phinius BB, Mpebe G, Aimakhu CO, Choga WT, Phakedi B, Bhebhe LN, Ditshwanelo D, Baruti K, Mpofu-Dobo L, Othusitse L, Ratsoma T, Gaolathe T, Makhema J, Shapiro R, Lockman S, Moyo S, Gaseitsiwe S. Hepatitis B Virus Prevalence among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana. Microorganisms 2024; 12:1207. [PMID: 38930589 PMCID: PMC11205512 DOI: 10.3390/microorganisms12061207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: we determined the prevalence of the hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened for the hepatitis B surface antigen (HBsAg) from archived plasma samples of people without HIV (n = 2135) randomly selected from the Botswana Combination Prevention Program (BCPP) (2013-2018). We sequenced 415 bp of the surface region using BigDye sequencing chemistry. (3) Results: The median age of participants was 31 (IQR: 24-46) and 64% (1360/2135) were female. HBV prevalence was 4.0% (86/2135) [95% CI: 3.3-4.9]) and ranged between 0-9.2%. Older participants (>35 years) had increased odds of HBV positivity (OR: 1.94; 95% CI: [1.32-2.86]; p = 0.001). Thirteen samples were sequenced and seven (53.8%) were genotype A, three (23.1%) were genotype D and genotype E each. Clinically significant mutations were identified in the surface region, but no classic drug resistance mutations were identified. (4) Conclusions: We report an HBV prevalence of 4.0% (95% CI 3.3-4.9) among people without HIV in rural and peri-urban communities in Botswana with varying rates in different communities. A comprehensive national HBV program is required in Botswana to guide HBV prevention, testing and management.
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Affiliation(s)
- Motswedi Anderson
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Africa Health Research Institute, Durban 4013, South Africa
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Thabo Mangogola
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Pan-African University (Life and Earth Sciences Institute), University of Ibadan, Ibadan 200132, Nigeria;
| | - Bonolo B. Phinius
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Gorata Mpebe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Christopher O. Aimakhu
- Pan-African University (Life and Earth Sciences Institute), University of Ibadan, Ibadan 200132, Nigeria;
| | - Wonderful T. Choga
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Basetsana Phakedi
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Lynnette N. Bhebhe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Doreen Ditshwanelo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Kabo Baruti
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Linda Mpofu-Dobo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences and Biotechnology, Faculty of Sciences, Botswana International University of Science and Technology, Private Bag 16, Palapye, Botswana
| | - Lebogang Othusitse
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
| | - Tsholofelo Ratsoma
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Tendani Gaolathe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Faculty of Medicine, University of Botswana, Private Bag UB 0022, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Roger Shapiro
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Shahin Lockman
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Sikhulile Moyo
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Stellenbosch, Private Bag X1, Matieland 7602, South Africa
- School of Health Systems and Public Health, University of Pretoria, Private Bag X20, Pretoria 0028, South Africa
| | - Simani Gaseitsiwe
- Botswana Harvard Health Partnership, Private Bag BO320, Gaborone, Botswana; (M.A.); (T.M.); (B.B.P.); (G.M.); (W.T.C.); (B.P.); (L.N.B.); (D.D.); (K.B.); (L.M.-D.); (L.O.); (T.R.); (T.G.); (J.M.); (R.S.); (S.L.); (S.M.)
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Basimane-Bisimwa P, Koyaweda GW, Ngaïganam E, Vickos U, Sibiro OAD, Yambiyo BM, Sombié BS, Pélembi P, Moussa S, Bekondi C, Giles-Vernick T, Manirakiza A, Vray M, Komas NPJ. Seroprevalence and molecular characterization of viral hepatitis and HIV co-infection in the Central African Republic. PLoS One 2024; 19:e0291155. [PMID: 38722944 PMCID: PMC11081248 DOI: 10.1371/journal.pone.0291155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The Central African Republic (CAR) is one of the countries with the highest prevalence of viral hepatitis infection in the world. Coinfection with HIV increases the morbidity and mortality beyond that of mono-infection with either hepatitis or HIV. The present study describes the geographic distribution of viral hepatitis infections and molecular characterization of these viruses in the CAR. METHODOLOGY Out of 12,599 persons enrolled during the fourth Multiple Indicator Cluster Survey of 2010 in the CAR, 10,621 Dried Blood Spot (DBS) samples were obtained and stored at -20°C. Of these DBS, 4,317 samples were randomly selected to represent all regions of the CAR. Serological tests for hepatitis B, D, and C viruses were performed using the ELISA technique. Molecular characterization was performed to identify strains. RESULTS Of the 4,317 samples included, 53.2% were from men and 46.8% from women. The HBsAg prevalence among participants was 12.9% and that HBc-Ab was 19.7%. The overall prevalence of HCV was 0.6%. Co-infection of HIV/HBV was 1.1% and that of HBV/HDV was 16.6%. A total of 77 HBV, 6 HIV, and 6 HDV strains were successfully sequenced, with 72 HBV (93.5%) strains belonging to genotype E and 5 (6.5%) strains belonging to genotype D. The 6 HDV strains all belonged to clade 1, while 4 recombinants subtype were identified among the 6 strains of HIV. CONCLUSION Our study found a high prevalence of HBV, HBV/HDV and HBV/HIV co-infection, but a low prevalence of HCV. CAR remains an area of high HBV endemicity. This study's data and analyses would be useful for establishing an integrated viral hepatitis and HIV surveillance program in the CAR.
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Affiliation(s)
- Parvine Basimane-Bisimwa
- Institut Pasteur de Bangui, Viral Hepatitis Laboratory, Bangui, Central African Republic
- Université Evangélique en Afrique (UEA), Bukavu, Democratic Republic of Congo
- International Center Advanced for Research and Training (ICART), Bukavu, Democratic Republic of Congo
- Hôpital Général de Référence de Panzi, Bukavu, Democratic Republic of Congo
| | | | - Edgarthe Ngaïganam
- Institut Pasteur de Bangui, Viral Hepatitis Laboratory, Bangui, Central African Republic
| | - Ulrich Vickos
- Laboratory of Arbovirus, Haemorrhagic Fevers, Institut Pasteur de Bangui, Emerging Virus and Zoonosis, Bangui, Central African Republic
| | | | | | - Benjamin Seydou Sombié
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Pulchérie Pélembi
- Institut Pasteur de Bangui, Service des Retrovirus-VIH, Bangui, Central African Republic
| | - Sandrine Moussa
- Institut Pasteur de Bangui, Service des Retrovirus-VIH, Bangui, Central African Republic
| | - Claudine Bekondi
- Institut Pasteur de Bangui, Centre de Ressources Biologiques, Bangui, Central African Republic
| | - Tamara Giles-Vernick
- Institut Pasteur-Université Paris Cité, Anthropology & Ecology of Disease Emergence Unit, INSERM, Paris, France
| | - Alexandre Manirakiza
- Institut Pasteur de Bangui, Epidemiology Service, Bangui, Central African Republic
| | - Muriel Vray
- Institut Pasteur-Université Paris Cité, Unit of Epidemiology of Emergent Infections, INSERM, Paris, France
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Khan S, Anwer A, Sevak JK, Trehanpati N, Kazim SN. Cytokines Expression Compared to the Determinants of Cellular Apoptosis Prominently Attributes to the Deleterious Effects of 'A' Determinant Surface Gene Mutations in HBV Transfected Hepatoma Cell Line. Immunol Invest 2024; 53:224-240. [PMID: 38095846 DOI: 10.1080/08820139.2023.2288841] [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] [Indexed: 03/23/2024]
Abstract
BACKGROUND Previous studies have explored the role of AKT protein in anti-apoptotic/proliferative activities. However, there has been a lack of information regarding the role of Akt in association with cytokines expression in HBV-related (wild type HBV and HBV with mutations of 'a' determinant region) studies either in the case of HBV infection or in transfected hepatoma cells. The present study tries to determine the role of Akt and cytokines expression in the presence of small surface gene mutants in the hepatoma cell line. METHODS Mutations of 'a' determinant region, viz. sA128V and sG145R, were created in wild-type pHBV1.3 by site-directed mutagenesis and transfected in hepatoma cell line. Secretory levels of HBsAg in the wild type as well as in both the mutants were analyzed by ELISA. Apoptotic analysis of transfected cells was studied by flow cytometry. Expression analysis of Akt and cytokines (TNF-alpha, IL-6, and IFN-gamma) was done by qPCR. RESULTS The presence of significantly more alive cells in sG145R than sA128V transfected cells may be due to the up-regulation of the Akt gene expression. Cytokines expression was nearly similar between sA128V and wild-type pHBV1.3 transfected cells. Presence of sG145R showed dramatically high cytokines expression than sA128V and wild-type pHBV1.3. CONCLUSION Cytokines expression predominantly contributes to the detrimental effects associated with the 'a' determinant region mutations particularly sG145R mutant. It may also be inferred that mechanisms associated with cellular apoptosis apparently do not play any major role to assign the 'a' determinant small surface gene mutation(s) for their pathological outcome.
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Affiliation(s)
- Saniya Khan
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
| | - Ayesha Anwer
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
| | - Jayesh Kumar Sevak
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Nirupama Trehanpati
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Syed Naqui Kazim
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
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Osasona OG, Oguntoye OO, Arowosaye AO, Abdulkareem LO, Adewumi MO, Happi C, Folarin O. Patterns of hepatitis b virus immune escape and pol/rt mutations across clinical cohorts of patients with genotypes a, e and occult hepatitis b infection in Nigeria: A multi-centre study. Virulence 2023; 14:2218076. [PMID: 37262110 DOI: 10.1080/21505594.2023.2218076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/27/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023] Open
Abstract
Hepatitis B virus (HBV) immune escape and Pol/RT mutations account for HBV immunoprophylactic, therapeutic, and diagnostic failure globally. Little is known about circulating HBV immune escape and Pol/RT mutants in Nigeria. This study focused on narrowing the knowledge gap of the pattern and prevalence of the HBV mutants across clinical cohorts of infected patients in southwestern Nigeria. Ninety-five enrollees were purposively recruited across clinical cohorts of HBV-infected patients with HBsAg or anti-HBc positive serological outcome and occult HBV infection. Total DNA was extracted from patients' sera. HBV S and Pol gene-specific nested PCR amplification was carried out. The amplicons were further sequenced for serotypic, genotypic, phylogenetic, and mutational analysis. HBV S and Pol genes were amplified in 60 (63.2%) and 19 (20%) of HBV isolates, respectively. All the sixty HBV S gene and 14 of 19 Pol gene sequences were exploitable. The ayw4 serotype was predominant (95%) while ayw1 serotype was identified in 5% of isolates. Genotype E predominates in 95% of sequences, while genotype A, sub-genotype A3 was observed in 5%. Prevalence of HBV IEMs in the "a" determinant region was 29%. Commonest HBV IEM was S113T followed by G145A and D144E. The Pol/RT mutations rtV214A and rtI163V among others were identified in this study. This study provided data on the occurrence of existing and new HBV IEMs and Pol gene mutations in Nigeria.
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Affiliation(s)
- Oluwadamilola G Osasona
- African Centre of Excellence for the Genomics of Infectious Diseases, Redeemers University, Ede, Nigeria
| | | | - Abiola O Arowosaye
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Lukman O Abdulkareem
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Moses O Adewumi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Christian Happi
- African Centre of Excellence for the Genomics of Infectious Diseases, Redeemers University, Ede, Nigeria
| | - Onikepe Folarin
- African Centre of Excellence for the Genomics of Infectious Diseases, Redeemers University, Ede, Nigeria
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Konopleva MV, Belenikin MS, Shanko AV, Bazhenov AI, Kiryanov SA, Tupoleva TA, Sokolova MV, Pronin AV, Semenenko TA, Suslov AP. Detection of S-HBsAg Mutations in Patients with Hematologic Malignancies. Diagnostics (Basel) 2021; 11:diagnostics11060969. [PMID: 34072185 PMCID: PMC8228241 DOI: 10.3390/diagnostics11060969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 01/04/2023] Open
Abstract
Multiple studies of hepatitis B virus (HBV) genetic variability and its relationship with the disease pathogenesis are currently ongoing, stemming from growing evidence of the clinical significance of HBV mutations. It is becoming increasingly evident that patients with hematologic malignancies may be particularly prone to a higher frequency of such mutations. The present report is the first extensive study of the prevalence of escape mutations in S-HBsAg, performed using isolates from 59 patients from hospital hematology departments with diagnoses of leukemia (n = 32), lymphoma (n = 20), multiple myeloma (n = 3), and non-tumor blood diseases (n = 4). The isolates were serologically examined for the presence of HBV markers and sequenced using either next-generation sequencing (NGS) or Sanger sequencing. Occult hepatitis B was found in 5.1% of cases. Genetic analysis of the region corresponding to S-HBsAg demonstrated an exceptionally high mutation frequency in patients with leukemias (93.4%) and lymphomas (85.0%), along with the prominent mutation heterogeneity. Additionally, more than 15 mutations in one sample were found in patients with leukemias (6.3% of cases) and lymphomas (5.0% of cases). Most of the mutations were clinically significant. The study analyzes the mutation profile of HBV in different oncohematological diseases and the frequency of individual mutations. The data strongly suggest that the NGS method, capable of detecting minor populations of HBV mutations, provides a diagnostic advantage, lays the foundation for the development of screening methods, and allows for the study of the virological and pathogenetic aspects of hepatitis B.
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Affiliation(s)
- Maria V. Konopleva
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | - Maxim S. Belenikin
- Laboratory of Molecular Medical Diagnostics, Moscow Institute of Physics and Technology, State University, 141701 Dolgoprudny, Russia;
| | - Andrei V. Shanko
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | - Alexey I. Bazhenov
- State Budget Institution “Research Institute of Emergency Medicine Named After N.V. Sklifosovsky” of the Moscow Department of Healthcare, 129010 Moscow, Russia;
| | - Sergei A. Kiryanov
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | | | - Maria V. Sokolova
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | - Alexander V. Pronin
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | - Tatyana A. Semenenko
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
| | - Anatoly P. Suslov
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N.F. Gamaleya” of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (M.V.K.); (A.V.S.); (S.A.K.); (M.V.S.); (A.V.P.); (T.A.S.)
- Correspondence:
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