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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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Belaiba Z, Ayouni K, Gdoura M, Kammoun Rebai W, Touzi H, Sadraoui A, Hammemi W, Yacoubi L, Abdelati S, Hamzaoui L, Msaddak Azzouz M, Chouikha A, Triki H. Whole genome analysis of hepatitis B virus before and during long-term therapy in chronic infected patients: Molecular characterization, impact on treatment and liver disease progression. Front Microbiol 2022; 13:1020147. [PMID: 36325017 PMCID: PMC9618822 DOI: 10.3389/fmicb.2022.1020147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/15/2022] [Indexed: 07/23/2023] Open
Abstract
Hepatitis B virus (HBV) infection remains a serious public health concern worldwide despite the availability of an efficient vaccine and the major improvements in antiviral treatments. The aim of the present study is to analyze the mutational profile of the HBV whole genome in ETV non-responder chronic HBV patients, in order to investigate antiviral drug resistance, immune escape, and liver disease progression to Liver Cirrhosis (LC) or Hepatocellular Carcinoma (HCC). Blood samples were collected from five chronic hepatitis B patients. For each patient, two plasma samples were collected, before and during the treatment. Whole genome sequencing was performed using Sanger technology. Phylogenetic analysis comparing the studied sequences with reference ones was used for genotyping. The mutational profile was analyzed by comparison with the reference sequence M32138. Genotyping showed that the studied strains belong to subgenotypes D1, D7, and D8. The mutational analysis showed high genetic variability. In the RT region of the polymerase gene, 28 amino acid (aa) mutations were detected. The most significant mutations were the pattern rtL180M + rtS202G + rtM204V, which confer treatment resistance. In the S gene, 35 mutations were detected namely sP120T, sT126S, sG130R, sY134F, sS193L, sI195M, and sL216stop were previously described to lead to vaccine, immunotherapy, and/or diagnosis escape. In the C gene, 34 mutations were found. In particular, cG1764A, cC1766G/T, cT1768A, and cC1773T in the BCP; cG1896A and cG1899A in the precore region and cT12S, cE64D, cA80T, and cP130Q in the core region were associated with disease progression to LC and/or HCC. Other mutations were associated with viral replication increase including cT1753V, cG1764A/T, cC1766G/T, cT1768A, and cC1788G in the BCP as well as cG1896A and cG1899A in the precore region. In the X gene, 30 aa substitutions were detected, of which substitutions xT36D, xP46S, xA47T, xI88F, xA102V, xI127T, xK130M, xV131I, and xF132Y were previously described to lead to LC and/or HCC disease progression. In conclusion, our results show high genetic variability in the long-term treatment of chronic HBV patients causing several effects. This could contribute to guiding national efforts to optimize relevant HBV treatment management in order to achieve the global hepatitis elimination goal by 2030.
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Affiliation(s)
- Zeineb Belaiba
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
- Research Laboratory “Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health,” LR20IPT02, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Kaouther Ayouni
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
- Research Laboratory “Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health,” LR20IPT02, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Mariem Gdoura
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
- Research Laboratory “Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health,” LR20IPT02, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Wafa Kammoun Rebai
- Laboratory of Biomedical Genomics and Oncogenetics (LR16IPT05), Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Lamia Yacoubi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Salwa Abdelati
- Department of Gastroenterology, Polyclinic of CNSS, Sousse, Tunisia
| | - Lamine Hamzaoui
- Department of Gastroenterology, Hospital of Tahar Maamouri, Nabeul, Tunisia
| | | | - Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
- Research Laboratory “Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health,” LR20IPT02, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
- Research Laboratory “Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health,” LR20IPT02, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis, Tunisia
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Feindiri M, Kabbaj H, El Mzibri M, Belkadi B, Bouihat N, Filali-Maltouf A, Seffar M. Prevalence of Hepatitis B Virus Infection Markers among Patients of the Ibn Sina University Hospital Center (Rabat, Morocco). Intervirology 2021; 65:80-86. [PMID: 34518480 DOI: 10.1159/000518618] [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: 05/18/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Viral hepatitis B is a global scourge affecting millions of people worldwide. In Morocco, hepatitis B is considered a public health problem, and available data converge to consider Morocco as a country with intermediate endemicity. In the present study, we have planned to evaluate the HBV prevalence in Morocco on a large scale and to assess the prevalence of different serological markers for better management of this infection in Morocco. METHODS This study was conducted on 18,877 patients referring to the Ibn Sina University Hospital Center of Rabat, Morocco. HBV serological markers including HBsAg, HBsAb, HBeAg, HBeAb, and total HBcAb were assessed by immune-enzymatic assays. The quantification of HBV DNA was performed by real-time PCR. RESULTS The overall prevalence of positive cases for HBsAg, HBsAb, and total HBcAb was 2.47%, 27.66%, and 21.2%, respectively. From 141 patients with an isolated HBcAb serological profile (HBcAb+/HBsAb-/HBsAg-), HBV DNA was detected in 10 patients, representing a rate of 7.09%. In the present study, up to 95.78% of HBV chronic carriers were negative for HBeAg. CONCLUSION This study highlights a higher prevalence of HBsAg in the hospital-based population than the general population reported previously in Morocco and a very low HBV immunization coverage. Of particular interest, detectable HBV DNA levels in isolated HBcAb patients show that exclusive HBsAg screening cannot eliminate the risk of HBV transmission in certain cases. Many efforts are then mandatory to promote serological testing and increase the vaccination rate to limit viral dissemination for better management of this disease in Morocco.
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Affiliation(s)
- Mourad Feindiri
- Central Laboratory of Virology, Ibn Sina University Hospital Center/Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.,Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Hakima Kabbaj
- Central Laboratory of Virology, Ibn Sina University Hospital Center/Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Mohammed El Mzibri
- Medical and Biological Research Unit, The National Center for Energy and Nuclear Science and Technology, Rabat, Morocco,
| | - Bouchra Belkadi
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Najat Bouihat
- Central Laboratory of Virology, Ibn Sina University Hospital Center/Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Abdelkarim Filali-Maltouf
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Myriam Seffar
- Central Laboratory of Virology, Ibn Sina University Hospital Center/Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
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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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Al-Sadeq DW, Taleb SA, Zaied RE, Fahad SM, Smatti MK, Rizeq BR, Al Thani AA, Yassine HM, Nasrallah GK. Hepatitis B Virus Molecular Epidemiology, Host-Virus Interaction, Coinfection, and Laboratory Diagnosis in the MENA Region: An Update. Pathogens 2019; 8:pathogens8020063. [PMID: 31083509 PMCID: PMC6630671 DOI: 10.3390/pathogens8020063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus (HBV) is an enveloped partial double-stranded DNA virus that can cause acute and chronic hepatitis. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), 257 million people are living with HBV. Moreover, 20,900 acute hepatitis B cases were reported in 2016. Hepatitis B is highly prevalent in the African, Western Pacific, Eastern Mediterranean, South-East Asia, and European regions, respectively. Due to the high mutational rate of HBV and lack of reverse transcriptase proofreading activity, ten different genotypes with different geographical distributions have been identified. HBV pathogenesis and severity of infection depend on several host and viral factors, particularly, the genetic variability of both the host and virus. Although HBV infection is a global health concern, there is a lack of adequate studies and reports in the Middle East and North Africa (MENA) region. Here, we provide a review on HBV epidemiology, pathogenesis, host-pathogen interactions, coinfection with selected viruses, and laboratory diagnosis, focusing on studies conducted in the MENA region to determine the current situation of the HBV infection and outline the future study areas.
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Affiliation(s)
- Duaa W Al-Sadeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara A Taleb
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Roan E Zaied
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara M Fahad
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Maria K Smatti
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Balsam R Rizeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Department of Biological and Environmental Sciences, College of Arts & Sciences, Qatar University, Doha 2713, Qatar.
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Gheyath K Nasrallah
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
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Gourari S, Brichler S, Le Gal F, Abdou-Chekaraou M, Beloufa MA, Khelifa R, Djaballah H, Boufekane M, Nani A, Afredj N, Debzi N, Dény P, Gordien E, Tazir M. Hepatitis B virus and hepatitis delta virus subtypes circulating in Algeria and seroprevalence of HDV infection. J Med Virol 2018; 91:72-80. [PMID: 30168584 DOI: 10.1002/jmv.25301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 06/15/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Little is known about molecular characteristics of HBV strains circulating in Algeria and there are few data regarding HDV infection. OBJECTIVES The aim of this study is to describe the genetic diversity of HBV and HDV strains existing in Algeria and to determine the seroprevalence of HDV infection. STUDY DESIGN Plasma samples from 134 patients were analyzed by enzyme immunoassay method for HBV and HDV serological markers. Genotyping of HBV and HDV strains were performed using direct sequencing followed by phylogenetic analyses of the PreS1 and R0 region of the HBV and HDV genome respectively. RESULTS The PreS1 gene was successfully amplified in 119 patients (82 males and 37 females). Phylogenetic analysis of HBV strains revealed the presence of genotypes D (86.5%) and A2 (11.76%). The subgenotypes D are distributed as follows: HBV/D7 (43.5%), HBV/D3 (24.75%), HBV/D1 (16.8%) and HBV/D2 (14.85%). A recombinant between genotypes A, E and D was found. The seroprevalence of HDV infection among HBV carriers was less than 5.35%. Only one isolate of HDV genotype 1 was identified. CONCLUSIONS Our data indicate the predominance of HBV subgenotype D7 and a low prevalence of HDV infection.
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Affiliation(s)
- Samir Gourari
- Service de Microbiologie, CHU Mustapha, Algiers, Algeria
| | - Ségolène Brichler
- Service de Bactériologie, Virologie-Hygiène, Laboratoire associé au Centre National de Référence des Hépatites B, C et delta, Hôpital Avicenne, Bobigny, France
| | - Frédéric Le Gal
- Service de Bactériologie, Virologie-Hygiène, Laboratoire associé au Centre National de Référence des Hépatites B, C et delta, Hôpital Avicenne, Bobigny, France
| | - Mariama Abdou-Chekaraou
- Service de Bactériologie, Virologie-Hygiène, Laboratoire associé au Centre National de Référence des Hépatites B, C et delta, Hôpital Avicenne, Bobigny, France
| | | | - Rim Khelifa
- Service de Microbiologie, CHU Mustapha, Algiers, Algeria
| | | | | | | | - Nawel Afredj
- Service d'Hépatologie, CHU Mustapha, Algiers, Algeria
| | - Nabil Debzi
- Service d'Hépatologie, CHU Mustapha, Algiers, Algeria
| | - Paul Dény
- Service de Bactériologie, Virologie-Hygiène, Laboratoire associé au Centre National de Référence des Hépatites B, C et delta, Hôpital Avicenne, Bobigny, France
| | - Emmanuel Gordien
- Service de Bactériologie, Virologie-Hygiène, Laboratoire associé au Centre National de Référence des Hépatites B, C et delta, Hôpital Avicenne, Bobigny, France
| | - Mohamed Tazir
- Service de Microbiologie, CHU Mustapha, Algiers, Algeria
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Ambachew H, Zheng M, Pappoe F, Shen J, Xu Y. Genotyping and sero-virological characterization of hepatitis B virus (HBV) in blood donors, Southern Ethiopia. PLoS One 2018; 13:e0193177. [PMID: 29462187 PMCID: PMC5819820 DOI: 10.1371/journal.pone.0193177] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022] Open
Abstract
Hepatitis B virus (HBV) prevalence is highest in Sub-Saharan Africa including Ethiopia. HBV genotypes have distinct geographic distributions and play a role in course of infection and treatment management. However, in Ethiopia there is paucity of information about distribution of HBV genotypes. This study was done to determine genotype, mutation and sero-virological profiles of HBV isolates in Southern Ethiopia. Cross-sectional, laboratory based study was conducted on 103HBsAg sero-positive samples from a total of 2,237 screened blood donors. HBV serological markers and biochemical assays were done. Serum viral load was measured using quantitative real-time PCR. Partial HBV S-gene was amplified with nested PCR and sequenced. Bioinformatics tools were utilized to determine genotypes, serotypes and mutations. Of 103 HBsAg reactive serum samples, 14.6% and 70.9% were sero-positive for HBeAg and HBeAb, respectively. Ninety-eight samples gave detectable viral load with a median of 3.46(2.62-4.82) log IU/ml. HBeAg sero-positive donors carried elevated levels of viral load. Eighty five isolates were successfully amplified, sequenced and genotyped into 58 (68.2%) genotype A (HBV/A) and 27 (31.8%) genotype D (HBV/D). HBV serotypes found were adw2 (74.1%), ayw2 (24.7%), and ayw3 (1.2%). In twenty-four (28.2%) samples mutations in the major hydrophilic region (MHR) were observed. Donors infected with HBV/A had higher viral load and more frequent MHR mutation than HBV/D infected donors. This study illustrated distribution of HBV genotype A and D among blood donors in southern Ethiopia. It also demonstrated occurrence HBV variants that may influence clinical aspects of HBV infection. The study contributes in narrowing the existing gap of HBV molecular study in Ethiopia.
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Affiliation(s)
- Henock Ambachew
- Department of Clinical Laboratory, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Clinical Laboratory Diagnostics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Meijuan Zheng
- Department of Clinical Laboratory, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Clinical Laboratory Diagnostics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Faustina Pappoe
- Department of Immunology and Parasitology, Provincial Laboratory of Microbiology and Parasitology and the Key Laboratory of Zoonoses Anhui, Anhui Medical University, Hefei, Anhui, China
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jilong Shen
- Department of Clinical Laboratory Diagnostics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Immunology and Parasitology, Provincial Laboratory of Microbiology and Parasitology and the Key Laboratory of Zoonoses Anhui, Anhui Medical University, Hefei, Anhui, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Clinical Laboratory Diagnostics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Immunology and Parasitology, Provincial Laboratory of Microbiology and Parasitology and the Key Laboratory of Zoonoses Anhui, Anhui Medical University, Hefei, Anhui, China
- * E-mail:
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Analysis of HBV basal core promoter/precore gene variability in patients with HBV drug resistance and HIV co-infection in Northwest Ethiopia. PLoS One 2018; 13:e0191970. [PMID: 29408943 PMCID: PMC5800642 DOI: 10.1371/journal.pone.0191970] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background We recently reported complex hepatitis B virus (HBV) drug resistant and concomitant vaccine escape hepatitis B surface antigen (HBsAg) variants during human immunodeficiency virus (HIV) co-infection and antiretroviral therapy (ART) exposure in Ethiopia. As a continuation of this report using the HBV positive sera from the same study participants, the current study further analyzed the HBV basal core promoter (BCP)/precore (PC) genes variability in patients with HBV drug resistance (at tyrosine-methionine-aspartate-aspartate (YMDD) reverse transcriptase (RT) motifs) and HIV co-infection in comparison with HBV mono-infected counterparts with no HBV drug resistant gene variants. Materials and methods A total of 143 participants of HBV-HIV co-infected (n = 48), HBV mono-infected blood donors (n = 43) and chronic liver disease (CLD) patients (n = 52) were included in the study. The BCP/PC genome regions responsible for HBeAg expression from the EcoRI site (nucleotides 1653–1959) were sequenced and analyzed for the BCP/PC mutant variants. Results Among the major mutant variants detected, double BCP mutations (A1762T/G1764A) (25.9%), Kozak sequences mutations (nt1809-1812) (51.7%) and the classical PC mutations such as A1814C/C1816T (15.4%), G1896A (25.2%) and G1862T (44.8%) were predominant mutant variants. The prevalence of the double BCP mutations was significantly lower in HIV co-infected patients (8.3%) compared with HBV mono-infected blood donors (32.6%) and CLD patients (36.5%). However, the Kozak sequences BCP mutations and the majority of PC mutations showed no significant differences among the study groups. Moreover, except for the overall BCP/PC mutant variants, co-prevalence rates of each major BCP/PC mutations and YMDDRT motif associated lamivudine (3TC)/entecavir (ETV) resistance mutations showed no significant differences when compared with the rates of BCP/PC mutations without YMDD RT motif drug resistance gene mutations. Unlike HIV co-infected group, no similar comparison made among HBV mono-infected blood donors and CLD patients since none of them developed the YMDD RT motif associated 3TC/ETV resistance mutations. However, HBV mono-infected blood donors and CLD patients who had no any drug resistance gene variants developed comparable G1862T (60.6% vs. 65.1%) and G1896A (24.2% vs. 11.6%) PC gene mutations. Conclusion No correlation observed between the BCP/PC genome variability and the YMDD RT motif associated HBV drug resistance gene variants during HIV co-infection. Nevertheless, irrespective of HIV co-infection status, the higher records of the BCP/PC gene variability in this study setting indicate a high risk of potential HBeAg negative chronic HBV infection in Northwest Ethiopia.
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Kheirabad AK, Farshidfar G, Nasrollaheian S, Gouklani H. Prevalence and Characteristics of Precore Mutation in Iran and Its Correlation with Genotypes of Hepatitis B. Electron Physician 2017; 9:4114-4123. [PMID: 28607644 PMCID: PMC5459281 DOI: 10.19082/4114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 11/03/2016] [Indexed: 01/05/2023] Open
Abstract
Introduction Mutation of the HBV precore gene prevents the production of HBeAg, which is an important target for immune responses. Distribution of this mutation varies along with frequency of HBV genotypes in accordance with geographic and ethnic variations. The general objective of this study was to evaluate the prevalence and characteristics of precore mutation in Iran and its correlation with genotypes of hepatitis B. Methods In this cross-sectional study, viral DNA of 182 Iranian hepatitis B surface antigen positive patients who were admitted to Bandar Abbas Blood Transfusion Organization in 2012 and 2013 was retrieved from their serum samples. HBeAg, anti-HBe, and anti-HBc IgM diagnostic tests were performed using ELISA kits. Precore and Pre-S regions were amplified using specific primers and PCR thereafter to determine the genotypes; precore mutation, PCR, and restriction fragment length polymorphism (RFLP) methods also were applied. SPSS version 12 was used for data analysis by Mann–Whitney U test, Fisher’s exact probability test, and t-test. Results A total of 62 patients (34.1%) had precore mutation (A1896G), and genotype D was the predominant genotype in these patients, which was followed by an unknown genotype that was suspected for genotype B. Interestingly, the relationships between precore mutation and HBeAg (p=0.037) and genotype D (p=0.005) were significant; however, no correlation was observed between this mutation and acute or chronic hepatitis and sex of patients. Conclusion This study found high prevalence of precore mutations in southern Iran, which was significantly associated with HBeAg and genotype D.
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Affiliation(s)
- Ali Kargar Kheirabad
- Ph.D., Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Farshidfar
- Ph.D., Department of Biochemistry, School of Medicine, Hormozgan University of Medical Sciences, Iran
| | | | - Hamed Gouklani
- Ph.D., Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Hepatitis B virus precore G1896A mutation in chronic liver disease patients with HBeAg negative serology from North India. Saudi J Biol Sci 2016; 25:1257-1262. [PMID: 30505167 PMCID: PMC6252005 DOI: 10.1016/j.sjbs.2016.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/14/2016] [Accepted: 05/03/2016] [Indexed: 02/08/2023] Open
Abstract
Hepatitis B with precore stop codon mutation is related with severe liver damage in HBeAg negative patients. It is of utmost importance to screen the G1896A precore mutation. The study was designed to assess the impact of G1986A mutations in patients with different clinical spectra of the liver disease by PCR–LCR. 210 HBV positive patients with HBeAg negative serology of different kind of liver diseases (AVH = 72, FH = 21, CH = 79, Cirrhosis = 20 and HCC = 18) were screened. Patients were screened for the presence or absence of precore G1896A mutation by PCR–LCR. Direct nucleotide sequencing was done to confirm the results of LCR. Precore mutant in HCC was 94.4% (17/18), 85.7% (18/21) in FH, 60% (12/20) in liver cirrhosis, 48.1% (38/79) in chronic hepatitis and 27.7% (20/72) in AVH cases. The serum ALT level was statistically significant between HBeAg negative WT and G1896A mutants in chronic hepatitis cases. ALT level and HBV DNA level was slightly raised in the pre core mutant but and was not significant. Genotype D had a higher prevalence (79.5%) as compared to genotype A (20.5%). The mutations detected by PCR–LCR were in 100% concordance with direct sequencing. The exceptionally high prevalence of G1896A in FH and HCC demonstrates that the precore mutants are strongly associated with the progression of liver diseases in patients with HBeAg negative serology. The findings are also suggestive of screening HBV precore G1896A mutation particularly in HBeAg negative cases. The precore G1896A mutation increases proportionately in severe form of liver diseases. LCR can be a suitable tool for screening of G1896A mutations.
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Croagh CM, Desmond PV, Bell SJ. Genotypes and viral variants in chronic hepatitis B: A review of epidemiology and clinical relevance. World J Hepatol 2015; 7:289-303. [PMID: 25848459 PMCID: PMC4381158 DOI: 10.4254/wjh.v7.i3.289] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/04/2014] [Accepted: 12/29/2014] [Indexed: 02/06/2023] Open
Abstract
The Hepatitis B Virus (HBV) has a worldwide distribution and is endemic in many populations. It is constantly evolving and 10 genotypic strains have been identified with varying prevalences in different geographic regions. Numerous stable mutations in the core gene and in the surface gene of the HBV have also been identified in untreated HBV populations. The genotypes and viral variants have been associated with certain clinical features of HBV related liver disease and Hepatocellular carcinoma. For example Genotype C is associated with later hepatitis B e antigen (HBeAg) seroconversion, and more advanced liver disease. Genotype A is associated with a greater risk of progression to chronicity in adult acquired HBV infections. Genotype D is particularly associated with the precore mutation and HBeAg negative chronic hepatitis B (CHB). The genotypes prevalent in parts of West Africa, Central and South America, E, F and H respectively, are less well studied. Viral variants especially the Basal Core Promotor mutation is associated with increased risk of fibrosis and cancer of the liver. Although not currently part of routine clinical care, evaluation of genotype and viral variants may provide useful adjunctive information in predicting risk about liver related morbidity in patients with CHB.
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Affiliation(s)
- Catherine Mn Croagh
- Catherine MN Croagh, Paul V Desmond, Sally J Bell, Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria 3065, Australia
| | - Paul V Desmond
- Catherine MN Croagh, Paul V Desmond, Sally J Bell, Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria 3065, Australia
| | - Sally J Bell
- Catherine MN Croagh, Paul V Desmond, Sally J Bell, Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria 3065, Australia
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12
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Zhand S, Karami C, Hosseinzadeh Adli A, Tabarraei A, Khodabakhshi B, Moradi A. Correlation Between Hepatitis B G1896A Precore Mutations and HBeAg in Chronic HBV Patients. Jundishapur J Microbiol 2015; 8:e17126. [PMID: 25825644 PMCID: PMC4376977 DOI: 10.5812/jjm.17126] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 07/14/2014] [Accepted: 09/27/2014] [Indexed: 02/06/2023] Open
Abstract
Background: Hepatitis B virus (HBV) infection is an important health concern worldwide, with critical outcomes. Hepatitis B e antigen (HBeAg) negative chronic hepatitis B is frequently caused by a mutation (G1896A) in the hepatitis B virus (HBV) precore (PC) reading frame, which creates a stop codon, causing premature termination of the HBe protein. Objectives: This study aimed to investigate the G1896A PC mutation and its effect on HBeAg detection in chronic HBV patients. Patients and Methods: In this study, 120 chronic HBV patients neither vaccinated or who had benefited from immunoglobulin therapy, were recruited. The HBV-DNA was extracted from plasma and polymerase chain reaction (PCR) was performed. Positive PCR products were subjected to automated sequencing. The HBV serological markers [hepatitis B s antigen (HBsAg), HBeAg] were tested. Results: One hundred out of 120 (83.3%) patients were HBeAg negative and 100% were HBsAg positive. The comparison of nucleotide sequences with the reference sequence (Accession number: AB033559) in HBeAg negative patients showed that there was a high rate of mutations in G1896A (93.18%). Conclusions: This study indicates that the rate of G1896A mutation at the PC region among HBeAg negative patients, in the Golestan province of Iran, was similar to the average rate encountered in other parts of Iran. The PC stop codon mutation was detected in 93.18% of HBeAg negative patients. Further studies with larger sample sizes are required to elucidate the exact role of these mutations in the clinical course of chronic HBV infection.
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Affiliation(s)
- Sareh Zhand
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Chiman Karami
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Ahmad Hosseinzadeh Adli
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Alijan Tabarraei
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Behnaz Khodabakhshi
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Abdolvahab Moradi
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
- Corresponding author: Abdolvahab Moradi, Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-9111772107, Fax: + 98-1714440225, E-mail:
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13
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Ouneissa R, Bahri O, Ben Yahia A, Touzi H, Azouz MM, Ben Mami N, Triki H. Evaluation of PCR-RFLP in the Pre-S Region as Molecular Method for Hepatitis B Virus Genotyping. HEPATITIS MONTHLY 2013; 13:e11781. [PMID: 24348634 PMCID: PMC3842526 DOI: 10.5812/hepatmon.11781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/01/2013] [Accepted: 10/06/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a public health problem in developing countries. HBV genotypes play major role in the evolution of infection since they were involved in different clinical presentations and response to treatment. OBJECTIVES This study was conducted to evaluate the efficiency of restriction fragment length polymorphism (RFLP) analysis for HBV genotyping. PATIENTS AND METHODS We investigated 98 samples collected from patients chronically infected with HBV. HBV genotypes were determined by analysis of patterns obtained after amplification in Pre-S region and digestion of the amplicon by two endonucleases AvaII and DpnII. Obtained results were confirmed by partial sequencing in the same region. RESULTS Two different HBV genotypes were detected in this study, Genotype D (in 95. 9%) and Genotype A (in 4.1%). Seventy-four samples (75.5%) were successfully genotyped with RFLP analysis and all classified as genotype D. The remaining 24 samples (24.5%) which were un-genotyped by RFLP analysis, were classified by partial sequencing of the pre-S region as HBV genotype D (20 samples, 20.4%) and genotype A (4 samples, 4.1%). Atypical profiles were significantly associated with advanced liver disease (P = 0.001) as well as older age (P < 0.05). CONCLUSIONS Several previous studies used PCR-RFLP to genotype HBV; however, we showed the high risk to obtain atypical profiles, especially in advanced stages of chronic infection, with as results difficulties to genotype the virus. These profiles resulted from the accumulation of mutations during natural course of infection resulting in a modification in restriction sites for enzymes. So, we recommended completing the investigation by partial sequencing to confirm obtained results.
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Affiliation(s)
- Rim Ouneissa
- Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, Tunisia
| | - Olfa Bahri
- Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, Tunisia
- Corresponding author: Olfa Bahri, Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, BP 1002, Tunisia. Tel: +216-98334999, Fax: +216-71791833, E-mail:
| | - Ahlem Ben Yahia
- Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, Tunisia
| | | | - Nabyl Ben Mami
- Department of Gastroenterology, Hospital La Rabta, Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, Institute Pasteur de Tunis, Tunis, Tunisia
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14
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Ezzikouri S, Pineau P, Benjelloun S. Hepatitis B virus in the Maghreb region: from epidemiology to prospective research. Liver Int 2013; 33:811-9. [PMID: 23530901 DOI: 10.1111/liv.12135] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/28/2013] [Indexed: 12/21/2022]
Abstract
Hepatitis B virus (HBV) represents an important health problem in the Maghreb countries, Algeria, Libya, Mauritania, Morocco and Tunisia, but no detailed synthesis of its epidemiology is available. In this review, we systematically searched for data about HBV in the Maghreb in peer-reviewed databases and included in our analysis works written in English and French, as well as institutional reports and regional conference meeting abstracts. We estimated national and regional prevalence of chronic HBV infection. In addition, we discuss molecular features of the viral strains circulating in the region. Data analysis suggests that in the Maghreb region HBs antigen carriage concerns 1.8-4.9% of the population for an estimated number of 2.7 million persons. Genotype D, subtype D7, is predominant and mutations in the precore region of HBV genome are highly prevalent. This epidemiological situation requires obviously widespread active interventions for prevention and control. In addition, anti-hepatitis B vaccination programme should be applied with the utmost discipline in the five countries considered in this present review. This systematic review will, hopefully, increase knowledge at disposal of Public Health authorities, enabling better resource allocation and healthcare delivery. The present synthesis intends to stimulate policies aiming at preventing the spread of HBV, keeping in mind that eradication of the virus from Maghrebi populations should be the ultimate objective of Public Health authorities.
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Affiliation(s)
- Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco.
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15
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Ouneissa R, Bahri O, Alaya-Bouafif NB, Chouaieb S, Ben Yahia A, Sadraoui A, Hammami W, Filali N, Azzouz MM, Mami NB, Triki H. Frequency and clinical significance of core promoter and precore region mutations in Tunisian patients infected chronically with hepatitis B. J Med Virol 2013; 84:1719-26. [PMID: 22997074 DOI: 10.1002/jmv.23394] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Genetic variability of hepatitis B virus (HBV) in the C gene and its association with the different stages of chronic liver disease has been studied inadequately with controversial results. The objectives of the current study were to determine the frequency of core promoter and precore mutations in chronic hepatitis B in Tunisia and to evaluate their impact on viral replication and disease progression. Sequencing was performed in upstream regulatory sequence (URS), pre-core (PreC) and basal core promoter (BCP) regions for 123 chronic infected patients by HBV genotype D at different status of disease. Mutations were detected in 98.4% of cases, affecting URS, BCP and Pre-C in 95.1%, 95.9% and 87.8% respectively. Multi-mutations increased significantly from asymptomatic carrier to advanced liver disease status. G1896A (74.8%), G1764A/T/C (71.5%), G1899A (54.4%) and T1678C (52%) were the most common. Special attention should be paid to A1703T, T1678C/G-A1703T, and A1652G-A1679G mutations probably specific of Tunisians sequences; they were observed in 40.6%, 41.5% and 30.1% respectively. A1679G/C, T1753C/G/A, A1762T/G and A1762T-G1764A were more prevalent in older patients. High DNA levels were associated with G1899A or G1764T/C-C1766G-C1799G and advanced liver disease with mutations at positions 1762, 1764 and/or 1899 alone or in double or triple mutations. It was also shown that substitutions at nucleotides 1762, 1764 and 1899 have an impact on the disease progression. It is the first report for specific mutations in the URS region for genotype D. It should be completed by studying eventual correlation with clinical progression and the response to treatment.
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Affiliation(s)
- Rim Ouneissa
- Laboratory of Clinical Virology, Institut Pasteur de Tunis, Tunis, Tunisia
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16
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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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Ayari R, Lakhoua-Gorgi Y, Bouslama L, Safar I, Kchouk FH, Aouadi H, Jendoubi-Ayed S, Najjar T, Ayed K, Abdallah TB. Investigation of DNA sequence in the Basal core promoter, precore, and core regions of hepatitis B virus from Tunisia shows a shift in genotype prevalence. HEPATITIS MONTHLY 2012; 12:e6191. [PMID: 23346148 PMCID: PMC3549613 DOI: 10.5812/hepatmon.6191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 09/01/2012] [Accepted: 10/02/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND In this study, we evaluated the prevalence of the most common mutations occurring in Enhancer II (EnhII), Basal Core Promoter (BCP), Precore (PC), and Core (C) regions of hepatitis B virus (HBV) genome. OBJECTIVES We also investigated the correlation between HBV variants, their genotypes, and patients' HBe antigen (HBeAg: soluble shape of the capsid antigen) status. PATIENTS AND METHODS We retrieved viral DNA from 40 serum samples of Tunisian patients positive for hepatitis B surface antigen (HBsAg) and HBV DNA, amplified the above mentioned regions using specific primers, and sequenced the corresponding PCR (polymerase chain reaction) products. For further analysis purpose, the patients were divided into two groups: Group1 including 34 HBeAg-negative patients and Group2 with 6 HBeAg-positive patients. RESULTS Twenty-one patients (52.5%) showed PC G1896A mutation and 11 (27.5%) carried A1762T/G1764A double mutations. These mutations were more frequent in HBeAg-negative patients than that in HBeAg-positive ones. Indeed, 58.8% of patients bearing G1896A mutation were HBeAg-negative while 16.7% were positive. In patients bearing T1762/A1764 double mutation, 29.4% were positive and 16.7% were negative. In addition, the A1896 mutation was restricted to HBV isolates that had wild-type T1858, while C1858 was rather linked to the occurrence of T1762/A1764 mutation. Interestingly, this study revealed a high frequency of genotype E. This frequency was important as compared to that of genotype D known to be predominant in the country as delineated in previous studies. CONCLUSIONS Previous results supported and showed that HBV strains present in Tunisia belonging to genotype D and, to a lesser extent, to genotype E, were prone to mutations in BCP/ PC regions. This observation was more obvious in HBV isolates from asymptomatic chronic carriers (AsC). The high mutational rates observed in our study might result from a mechanism of viral escape that plays an important role in the loss of HBeAg.
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Affiliation(s)
- Rym Ayari
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
- Corresponding author: Rym Ayari, Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia. Tel.: +216-25462623, Fax: +216-71561156, E-mail:
| | - Yousr Lakhoua-Gorgi
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Lamjed Bouslama
- Borj Cedria Center for Biotechnology, Hammam Lif, Tunis, Tunisia
| | - Imen Safar
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Fatma Houissa Kchouk
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Houda Aouadi
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Saloua Jendoubi-Ayed
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Taoufik Najjar
- Department Gastro-Enterology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Kaled Ayed
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Taieb Ben Abdallah
- Laboratory of Immunology Research Center, Kidney Transplantation and Immunopathology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
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Hannachi N, Fredj NB, Bahri O, Thibault V, Ferjani A, Gharbi J, Triki H, Boukadida J. Molecular analysis of HBV genotypes and subgenotypes in the Central-East region of Tunisia. Virol J 2010; 7:302. [PMID: 21050489 PMCID: PMC2989323 DOI: 10.1186/1743-422x-7-302] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 11/04/2010] [Indexed: 12/17/2022] Open
Abstract
Background In Tunisia, country of intermediate endemicity for Hepatitis B virus (HBV) infection, most molecular studies on the virus have been carried out in the North of the country and little is known about other regions. The aim of this study was to determine HBV genotype and subgenotypes in Central-East Tunisia. A total of 217 HBs antigen positive patients were enrolled and determination of genotype was investigated in 130 patients with detectable HBV DNA. HBV genotyping methods were: PCR-RFLP on the pre-S region, a PCR using type-specific primers in the S region (TSP-PCR) and partial sequencing in the pre-S region. Results Three genotypes (D, B and A) were detected by the PCR-RFLP method and two (D and A) with the TSP-PCR method, the concordance between the two methods was 93%. Sequencing and phylogenetic analysis of 32 strains, retrieved the same genotype (D and A) for samples with concordant results and genotype D for samples with discordant results. The sequences of discordant genotypes had a restriction site in the pre-S gene which led to erroneous result by the PCR-RFLP method. Thus, prevalence of genotype D and A was 96% and 4%, respectively. Phylogenetic analysis showed the predominance of two subgenotypes D1 (55%) and D7 (41%). Only one strain clustered with D3 subgenotype (3%). Conclusions Predominance of subgenotype D7 appears to occur in northern regions of Africa with transition to subgenotype D1 in the East of the continent. HBV genetic variability may lead to wrong results in rapid genotyping methods and sequence analysis is needed to clarify atypical results.
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Affiliation(s)
- Naila Hannachi
- Laboratoire de Microbiologie-Immunologie, UR02SP13, Hôpital Farhat Hached, Sousse, Tunisia.
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Abdou Chekaraou M, Brichler S, Mansour W, Le Gal F, Garba A, Dény P, Gordien E. A novel hepatitis B virus (HBV) subgenotype D (D8) strain, resulting from recombination between genotypes D and E, is circulating in Niger along with HBV/E strains. J Gen Virol 2010; 91:1609-20. [PMID: 20147517 DOI: 10.1099/vir.0.018127-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Niger is a west African country that is highly endemic for hepatitis B virus (HBV) infection. The seroprevalence for HBV surface antigen (HBsAg) is about 20%; however, there are no reports on the molecular epidemiology of HBV strains spreading in Niger. In the present study, HBV isolates from the sera of 58 consecutive, asymptomatic, HBsAg-positive blood donors were characterized. Genotype affiliation was determined by amplification, sequencing and phylogenetic analysis of the preS1, polymerase/reverse transcriptase (RT/Pol) and precore (preC)/C regions. The first series of results revealed that different genomic fragments clustered with different genotypes on phylogenetic trees, suggesting recombination events. Twenty-four complete genomic sequences were obtained by amplification and sequencing of seven overlapping regions covering the whole genome, and were studied by extensive phylogenetic analysis. Among them, 20 (83.3%) were classified unequivocally as genotype E (HBV/E). The remaining four (16.7%) clustered on a distinct branch within HBV/D with strong bootstrap and posterior probability values. Complete molecular characterization of these four strains was achieved by the Simplot program, bootscanning analysis and cloning experiments, and enabled us to identify an HBV/D-E recombinant that formed a new HBV/D subgenotype spreading in Niger, tentatively named D8. Moreover, 20 new complete HBV/E nucleotide sequences were determined that exhibited higher genetic variability than is generally described in Africa. One was found to be a recombinant containing HBV/D sequences in the preS2 and RT/Pol regions. Taken together, these data suggest that, in Niger, genetic variability of HBV strains is still evolving, probably reflecting ancient endemic HBV infection.
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Affiliation(s)
- Mariama Abdou Chekaraou
- Service de Bactériologie, Virologie, Hygiène, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, UFR Santé Médecine Biologie Humaine, Université Paris 13, Bobigny, France
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Abstract
Hepatitis B virus (HBV) is one of the most widely distributed viruses that infect humankind. Distinct clinical and virological characteristics of the HBV-infection have been reported in different geographical parts of the world and are increasingly associated with genetic diversity of the infecting virus. HBV is classified into genotypes and subgenotypes that are associated with ethnicity and geography. The genetic diversity of HBV in its various aspects has been the subject of extensive investigations during the last few decades. Since molecular epidemiology research tools have become widely available, the number of new publications in this field has grown exponentially. This review summarises the recent publications on the geographical distribution of genetic variants of HBV, and proposes updated criteria for the identification of new genotypes and subgenotypes of the virus.
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Affiliation(s)
- Fuat Kurbanov
- Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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21
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Hannachi N, Bahri O, Mhalla S, Marzouk M, Sadraoui A, Belguith A, Triki H, Boukadida J. Hépatite virale B chez les femmes enceintes tunisiennes : facteurs de risque et intérêt de l’étude de la réplication virale en cas d’antigène HBe négatif. ACTA ACUST UNITED AC 2009; 57:e43-7. [DOI: 10.1016/j.patbio.2008.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 04/16/2008] [Indexed: 12/29/2022]
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Meldal BHM, Moula NM, Barnes IHA, Boukef K, Allain JP. A novel hepatitis B virus subgenotype, D7, in Tunisian blood donors. J Gen Virol 2009; 90:1622-1628. [PMID: 19339480 DOI: 10.1099/vir.0.009738-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Tunisia is a medium-level epidemic country for hepatitis B virus (HBV). This study characterizes, for the first time, full genome HBV strains from Tunisia. Viral load quantification and phylogenetic analyses of full genome or pre-S/S sequences were performed on 196 hepatitis B surface antigen (HBsAg)-positive plasma samples from Tunisian blood donors. The median viral load was 64.65 IU ml(-1) (range<5-7.7x10(8) IU ml(-1)) and 89% of samples had viral loads below 10,000 IU ml(-1). Fifty-nine strains formed a novel subgenotype D7, 41 strains clustered in subgenotype D1, seven strains in subgenotype A2 and one strain in genotype C. The novel subgenotype D7 was defined by maximum Bayesian posterior probability, a genetic divergence from other HBV/D subgenotypes by >4% and a stronger HBV/E signal in the X to core genes than subgenotype D1. In conclusion, HBV/D is dominant in asymptomatic Tunisian HBsAg carriers and a novel subgenotype, D7, was the most common subgenotype found in this population.
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Affiliation(s)
- Birgit H M Meldal
- Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CB2 0PT, UK
| | | | - If H A Barnes
- Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CB2 0PT, UK
| | | | - Jean-Pierre Allain
- Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CB2 0PT, UK
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Khelifa F, Thibault V. [Characteristics of hepatitis B viral strains in chronic carrier patients from North-East Algeria]. ACTA ACUST UNITED AC 2008; 57:107-13. [PMID: 18835106 DOI: 10.1016/j.patbio.2008.07.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 07/04/2008] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The goal of the study was to determine the characteristics of chronic hepatitis B virus (HBV) infections in the north-east part of Algeria. Chronic HBV infection remains a global public health issue and Algeria is considered as an intermediate prevalence area. Improving our knowledge on the epidemiology of this infection is a prerequisite to adopt the best preventive and curative strategy. MATERIAL AND METHODS We have studied 75 chronic hepatitis B patients from north-east Algeria. The characteristics of HBV strains were determined by use of serological and molecular testing. Genes encoding part of the precore, the surface and the polymerase were sequenced and phylogenetically analyzed. RESULTS Median age of the patients was 35 years and 80% of them had normal transaminase level. Liver histological lesions were identified in 63% of the patients who benefited from a liver biopsy and 21% of them had cirrhosis. Median viral replication was 3.9 Log IU/ml and 87% of patients had a "precore" mutant serological profile without HBe Ag. Genotype D was predominant (93%) followed by genotype A (5%) and E for one patient. Algerian strains clustered independently from other genotype D reference sequences, suggesting a possible new D subtype. Within the "precore" region, only 16% of the strains did not show any mutation at positions 1762/1764 and 1896. CONCLUSION In this original set of patients from north Algeria, the virologic characteristics of HBV are comparable to what has been described in other Mediterranean countries. Our study raises several important aspects with regard to the prevention and treatment of chronic hepatitis B in Algeria.
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Affiliation(s)
- F Khelifa
- Laboratoire d'hygiène de la Wilaya, institut Pasteur d'Algérie, cité Daksi, Constantine, Algérie.
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