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Ding Y, Guo H, Hong X, Li Q, Miao Z, Pan Q, Zheng K, Wang W. The distinct spatiotemporal evolutionary landscape of HBV and HDV largely determines the unique epidemic features of HDV globally. Mol Phylogenet Evol 2024; 197:108114. [PMID: 38825156 DOI: 10.1016/j.ympev.2024.108114] [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: 08/21/2023] [Revised: 05/07/2024] [Accepted: 05/26/2024] [Indexed: 06/04/2024]
Abstract
Chronic infection of hepatitis B virus (HBV) and hepatitis D virus (HDV) causes the most severe form of viral hepatitis. Due to the dependence on HBV, HDV was deemed to co-evolve and co-migrate with HBV. However, we previously found that the naturally occurred HDV/HBV combinations do not always reflect the most efficient virological adaptation (Wang et al., 2021). Moreover, regions with heavy HBV burden do not always correlate with high HDV prevalence (e.g., East Asia), and vice versa (e.g., Central Asia). Herein, we systematically elucidated the spatiotemporal evolutionary landscape of HDV to understand the unique epidemic features of HDV. We found that the MRCA of HDV was from South America around the late 13th century, was globally dispersed mainly via Central Asia, and evolved into eight genotypes from the 19th to 20th century. In contrast, the MRCA of HBV was from Europe ∼23.7 thousand years ago (Kya), globally dispersed mainly via Africa and East Asia, and evolved into eight genotypes ∼1100 years ago. When HDV stepped in, all present-day HBV genotypes had already formed and its global genotypic distribution had stayed stable geographically. Nevertheless, regionalized HDV adapted to local HBV genotypes and human lineages, contributing to the global geographical separation of HDV genotypes. Additionally, a sharp increase in HDV infections was observed after the 20th century. In conclusion, HDV exhibited a distinct spatiotemporal distribution path compared with HBV. This unique evolutionary relationship largely fostered the unique epidemic features we observe nowadays. Moreover, HDV infections may continue to ramp up globally, thus more efforts are urgently needed to combat this disease.
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Affiliation(s)
- Yibo Ding
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, China
| | - Hongbo Guo
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, China.
| | - Xinfang Hong
- Second Medical Center of PLA General Hospital, Beijing, China
| | - Qiudi Li
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, China
| | - Zhijiang Miao
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
| | - Kuiyang Zheng
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, China.
| | - Wenshi Wang
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, China.
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2
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Koenig AB, Tan A, Abdelaal H, Monge F, Younossi ZM, Goodman ZD. Review article: Hepatic steatosis and its associations with acute and chronic liver diseases. Aliment Pharmacol Ther 2024; 60:167-200. [PMID: 38845486 DOI: 10.1111/apt.18059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Hepatic steatosis is a common finding in liver histopathology and the hallmark of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), whose global prevalence is rising. AIMS To review the histopathology of hepatic steatosis and its mechanisms of development and to identify common and rare disease associations. METHODS We reviewed literature on the basic science of lipid droplet (LD) biology and clinical research on acute and chronic liver diseases associated with hepatic steatosis using the PubMed database. RESULTS A variety of genetic and environmental factors contribute to the development of chronic hepatic steatosis or steatotic liver disease, which typically appears macrovesicular. Microvesicular steatosis is associated with acute mitochondrial dysfunction and liver failure. Fat metabolic processes in hepatocytes whose dysregulation leads to the development of steatosis include secretion of lipoprotein particles, uptake of remnant lipoprotein particles or free fatty acids from blood, de novo lipogenesis, oxidation of fatty acids, lipolysis and lipophagy. Hepatic insulin resistance is a key feature of MASLD. Seipin is a polyfunctional protein that facilitates LD biogenesis. Assembly of hepatitis C virus takes place on LD surfaces. LDs make important, functional contact with the endoplasmic reticulum and other organelles. CONCLUSIONS Diverse liver pathologies are associated with hepatic steatosis, with MASLD being the most important contributor. The biogenesis and dynamics of LDs in hepatocytes are complex and warrant further investigation. Organellar interfaces permit co-regulation of lipid metabolism to match generation of potentially toxic lipid species with their LD depot storage.
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Affiliation(s)
- Aaron B Koenig
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
| | - Albert Tan
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
- Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Hala Abdelaal
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
- Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Fanny Monge
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
- Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Zobair M Younossi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
- The Global NASH Council, Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Zachary D Goodman
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
- Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia, USA
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3
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Kamal H, Aleman S. Natural history of untreated HDV patients: Always a progressive disease? Liver Int 2023; 43 Suppl 1:5-21. [PMID: 36308026 DOI: 10.1111/liv.15467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 02/13/2023]
Abstract
A severe course has been described in early studies on chronic hepatitis D (CHD), with faster pace towards liver cirrhosis with subsequent high liver-related morbidity and mortality in the majority of patients. Earlier studies have included risk groups as people using intravenous drugs (PWID) or those with multiple co-morbidities. During the last decade, the epidemiological landscape of CHD has changed with domestic cases decreasing while increasing cases of CHD consisting of younger persons immigrating from endemic regions to low-endemic regions. Recently, further insights into the spectrum of the disease with an indolent disease course in a substantial proportion of persons with CHD have been gained. At diagnosis, ≥30%-50% had already established liver cirrhosis. Older age, liver cirrhosis, co-infection with HIV and lack of interferon (IFN) therapy are the main predictors of worse clinical outcome. The newly introduced and upcoming antivirals against CHD are highly anticipated, considering the historically low virological response rates to antiviral therapy. Further knowledge is needed to fully comprehend the natural course and the spectrum of this severe form of viral hepatitis. This is also to be able to evaluate the long-term effects of the new antivirals on disease progression.
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Affiliation(s)
- Habiba Kamal
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Infectious Diseases, Karolinska Institute, Stockholm, Sweden
| | - Soo Aleman
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Infectious Diseases, Karolinska Institute, Stockholm, Sweden
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4
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Montoya-Guzman M, Martinez J, Castro-Arroyave D, Rojas C, Navas MC. Epidemiology and Genetic Diversity of Hepatitis B Virus and Hepatitis Delta Virus Infection in Indigenous Communities in Colombia. Microorganisms 2023; 11:1739. [PMID: 37512911 PMCID: PMC10386745 DOI: 10.3390/microorganisms11071739] [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: 05/15/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the universal vaccination program, there are still regions and territories with a high prevalence of Hepatitis B Virus infection (HBV), such as the Amazon basin, where several indigenous communities live. Additionally, Hepatitis Delta Virus (HDV) is a defective that requires the hepatitis B surface antigen (HBsAg) for the assembly and release of de novo viral particles. Therefore, hepatitis D could be the result of HBV/HDV coinfection or HDV superinfection in individuals with chronic hepatitis B. Among the high prevalence HDV populations are indigenous communities of America. This study aims to describe and characterize the frequency of HBV and HDV infection, viral genotypes and HBV immune escape mutants in indigenous populations from different regions of Colombia. The diagnosis of hepatitis B and hepatitis D was confirmed by serological markers. Moreover, the HBV and HDV genome were amplified by PCR and RT-PCR, respectively, and, subsequently, the phylogenetic analysis was performed. We characterized 47 cases of chronic hepatitis B, 1 case of reactivation and 2 cases of occult hepatitis B infection (OBI). Furthermore, a high prevalence of HDV infection was identified in the study population (29.33%, 22/75) and the circulation of several HBV genotypes and subgenotypes (F1b, F3, F4, and D). Interestingly, this is the first report of the HDV genotype I circulation in this country. These findings demonstrated that HBV and HDV infections are still public health problems in indigenous communities in Colombia.
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Affiliation(s)
- Melissa Montoya-Guzman
- Grupo Gastrohepatología, Facultad de Medicina, Universidad de Antioquia, Calle 70 No. 52-21, Medellín 050010, Colombia
| | - Jaime Martinez
- Grupo Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Calle 70 No. 52-21, Medellín 050010, Colombia
| | - Diana Castro-Arroyave
- Grupo de Estudio en Pedagogía, Infancia y Desarrollo Humano (GEPIDH), Facultad de Educación, Universidad de Antioquia, Calle 70 No. 52-21, Medellín 050010, Colombia
| | - Carlos Rojas
- Grupo Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Calle 70 No. 52-21, Medellín 050010, Colombia
| | - Maria-Cristina Navas
- Grupo Gastrohepatología, Facultad de Medicina, Universidad de Antioquia, Calle 70 No. 52-21, Medellín 050010, Colombia
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5
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Medical Advances in Hepatitis D Therapy: Molecular Targets. Int J Mol Sci 2022; 23:ijms231810817. [PMID: 36142728 PMCID: PMC9506394 DOI: 10.3390/ijms231810817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/25/2022] Open
Abstract
An approximate number of 250 million people worldwide are chronically infected with hepatitis B virus, making them susceptible to a coinfection with hepatitis D virus. The superinfection causes the most severe form of a viral hepatitis and thus drastically worsens the course of the disease. Until recently, the only available therapy consisted of interferon-α, only eligible for a minority of patients. In July 2020, the EMA granted Hepcludex conditional marketing authorization throughout the European Union. This first-in-class entry inhibitor offers the promise to prevent the spread in order to gain control and eventually participate in curing hepatitis B and D. Hepcludex is an example of how understanding the viral lifecycle can give rise to new therapy options. Sodium taurocholate co-transporting polypeptide, the virus receptor and the target of Hepcludex, and other targets of hepatitis D therapy currently researched are reviewed in this work. Farnesyltransferase inhibitors such as Lonafarnib, targeting another essential molecule in the HDV life cycle, represent a promising target for hepatitis D therapy. Farnesyltransferase attaches a farnesyl (isoprenyl) group to proteins carrying a C-terminal Ca1a2X (C: cysteine, a: aliphatic amino acid, X: C-terminal amino acid) motif like the large hepatitis D virus antigen. This modification enables the interaction of the HBV/HDV particle and the virus envelope proteins. Lonafarnib, which prevents this envelopment, has been tested in clinical trials. Targeting the lifecycle of the hepatitis B virus needs to be considered in hepatitis D therapy in order to cure a patient from both coexisting infections. Nucleic acid polymers target the hepatitis B lifecycle in a manner that is not yet understood. Understanding the possible targets of the hepatitis D virus therapy is inevitable for the improvement and development of a sufficient therapy that HDV patients are desperately in need of.
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Silva RJS, do Nascimento RS, Oliveira-Neto JAJ, Silva FQ, Piauiense JNF, Gomes CM, Pinheiro LML, Resque RL, Pinho JRR, Kupek E, Fischer B, Machado LFA, Martins LC, Lemos JAR, Oliveira-Filho AB. Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region. Viruses 2021; 13:v13071380. [PMID: 34372586 PMCID: PMC8310228 DOI: 10.3390/v13071380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.
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Affiliation(s)
- Ronylson José S. Silva
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Raquel Silva do Nascimento
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - José Augusto J. Oliveira-Neto
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Fabricio Quaresma Silva
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
| | - Juliana Nádia F. Piauiense
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
| | - Camila Moraes Gomes
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
| | - Luiz Marcelo L. Pinheiro
- Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, PA, Brazil;
| | - Rafael Lima Resque
- Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, AP, Brazil;
| | - João Renato R. Pinho
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil;
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil;
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada;
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, SP, Brazil
| | - Luiz Fernando A. Machado
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Luísa Caricio Martins
- Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil; (J.N.F.P.); (L.C.M.)
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, PA, Brazil
| | - José Alexandre R. Lemos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil; (L.F.A.M.); (J.A.R.L.)
| | - Aldemir B. Oliveira-Filho
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (R.J.S.S.); (R.S.d.N.); (C.M.G.)
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil; (J.A.J.O.-N.); (F.Q.S.)
- Correspondence: ; Tel.: +55-91-3425-1209
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7
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Bergner LM, Orton RJ, Broos A, Tello C, Becker DJ, Carrera JE, Patel AH, Biek R, Streicker DG. Diversification of mammalian deltaviruses by host shifting. Proc Natl Acad Sci U S A 2021; 118:e2019907118. [PMID: 33397804 PMCID: PMC7826387 DOI: 10.1073/pnas.2019907118] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis delta virus (HDV) is an unusual RNA agent that replicates using host machinery but exploits hepatitis B virus (HBV) to mobilize its spread within and between hosts. In doing so, HDV enhances the virulence of HBV. How this seemingly improbable hyperparasitic lifestyle emerged is unknown, but it underpins the likelihood that HDV and related deltaviruses may alter other host-virus interactions. Here, we show that deltaviruses diversify by transmitting between mammalian species. Among 96,695 RNA sequence datasets, deltaviruses infected bats, rodents, and an artiodactyl from the Americas but were absent from geographically overrepresented Old World representatives of each mammalian order, suggesting a relatively recent diversification within the Americas. Consistent with diversification by host shifting, both bat and rodent-infecting deltaviruses were paraphyletic, and coevolutionary modeling rejected cospeciation with mammalian hosts. In addition, a 2-y field study showed common vampire bats in Peru were infected by two divergent deltaviruses, indicating multiple introductions to a single host species. One vampire bat-associated deltavirus was detected in the saliva of up to 35% of individuals, formed phylogeographically compartmentalized clades, and infected a sympatric bat, illustrating horizontal transmission within and between species on ecological timescales. Consistent absence of HBV-like viruses in two deltavirus-infected bat species indicated acquisitions of novel viral associations during the divergence of bat and human-infecting deltaviruses. Our analyses support an American zoonotic origin of HDV and reveal prospects for future cross-species emergence of deltaviruses. Given their peculiar life history, deltavirus host shifts will have different constraints and disease outcomes compared to ordinary animal pathogens.
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Affiliation(s)
- Laura M Bergner
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, Scotland;
- Medical Research Center-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, Scotland
| | - Richard J Orton
- Medical Research Center-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, Scotland
| | - Alice Broos
- Medical Research Center-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, Scotland
| | - Carlos Tello
- Association for the Conservation and Development of Natural Resources, 15037 Lima, Perú
- Yunkawasi, 15049 Lima, Perú
| | - Daniel J Becker
- Department of Biology, University of Oklahoma, Norman, OK 73019
| | - Jorge E Carrera
- Departamento de Mastozoología, Museo de Historia Natural, Universidad Nacional Mayor de San Marcos, Lima 15081, Perú
- Programa de Conservación de Murciélagos de Perú, Piura 20001, Perú
| | - Arvind H Patel
- Medical Research Center-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, Scotland
| | - Roman Biek
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, Scotland
| | - Daniel G Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, Scotland;
- Medical Research Center-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, Scotland
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8
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Iwamoto M, Shibata Y, Kawasaki J, Kojima S, Li YT, Iwami S, Muramatsu M, Wu HL, Wada K, Tomonaga K, Watashi K, Horie M. Identification of novel avian and mammalian deltaviruses provides new insights into deltavirus evolution. Virus Evol 2021; 7:veab003. [PMID: 33614159 PMCID: PMC7882216 DOI: 10.1093/ve/veab003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hepatitis delta virus (HDV) is a satellite virus that requires hepadnavirus envelope proteins for its transmission. Although recent studies identified HDV-related deltaviruses in certain animals, the evolution of deltaviruses, such as the origin of HDV and the mechanism of its coevolution with its helper viruses, is unknown, mainly because of the phylogenetic gaps among deltaviruses. Here, we identified novel deltaviruses of passerine birds, woodchucks, and white-tailed deer by extensive database searches and molecular surveillance. Phylogenetic and molecular epidemiological analyses suggest that HDV originated from mammalian deltaviruses and the past interspecies transmission of mammalian and passerine deltaviruses. Further, metaviromic and experimental analyses suggest that the satellite-helper relationship between HDV and hepadnavirus was established after the divergence of the HDV lineage from non-HDV mammalian deltaviruses. Our findings enhance our understanding of deltavirus evolution, diversity, and transmission, indicating the importance of further surveillance for deltaviruses.
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Affiliation(s)
- Masashi Iwamoto
- Department of Virology II, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
- Mathematical Biology Laboratory, Department of Biology, Faculty of Sciences, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Yukino Shibata
- Graduate School of Life Science, Hokkaido University, Kita 10, Nishi 8, Kita-ku, Sapporo 060-0810, Japan
| | - Junna Kawasaki
- Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
- Department of Mammalian Regulatory Network, Graduate School of Biostudies, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
| | - Shohei Kojima
- Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
- Genome Immunobiology RIKEN Hakubi Research Team, RIKEN Center for Integrative Medical Sciences and RIKEN Cluster for Pioneering Research, 1-7-22, Suehiro-Cho, Tsurumi-Ward, Yokohama 230-0045, Japan
| | - Yung-Tsung Li
- Hepatitis Research Center, National Taiwan University Hospital, 7 Chung Shan South Road, Taipei 10002, Taiwan
| | - Shingo Iwami
- Mathematical Biology Laboratory, Department of Biology, Faculty of Sciences, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Masamichi Muramatsu
- Department of Virology II, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Hui-Lin Wu
- Hepatitis Research Center, National Taiwan University Hospital, 7 Chung Shan South Road, Taipei 10002, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 7 Chung Shan South Road, Taipei 10002, Taiwan
| | - Kazuhiro Wada
- Faculty of Science, Hokkaido University, Kita-10 Nishi-8, Kita-ku, Sapporo 060-0810, Japan
| | - Keizo Tomonaga
- Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
- Department of Mammalian Regulatory Network, Graduate School of Biostudies, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
- Department of Molecular Virology, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
| | - Koichi Watashi
- Department of Virology II, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
- Department of Applied Biological Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
| | - Masayuki Horie
- Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
- Hakubi Center for Advanced Research, Kyoto University, 53 Kawahara-cho, Shogo-in, Sakyo, Kyoto 606-8507, Japan
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9
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Abbas Z, Qadeer MA, Mandviwalla HA, Abbas M. The Severity of Hepatitis D in Young Adults of Age 18-25 Years. Cureus 2020; 12:e10855. [PMID: 33052263 PMCID: PMC7546593 DOI: 10.7759/cureus.10855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Current literature on the prevalence and characteristics of hepatitis D virus (HDV) infection in young adults is limited. This study aims to determine the disease characteristics and severity in young adults. Methods The case records of HDV RNA positive patients of age 18-25 years were analyzed. Results Out of 119 patients, 105 (88%) patients were male. HBV-DNA was detectable in 83 (70%). Hepatitis B e-antigen (HBeAg) was non-reactive in 99 (83%). Cirrhosis was identified in 45 (37.8%) individuals; nine (7.5%) were classified as Child class B or Child class C. Twenty-four (20.2%) had a Model For End-Stage Liver Disease (MELD) score of ≥10, out of these 16 had a score of 15 or more. The risk of decompensation was calculated according to the Baseline-event-anticipation (BEA) score; eight (6.7%) patients were at BEA-A (mild risk), 105 (88.2%) were at BEA-B (moderate risk), and six (5.0%) were at BEA-C (severe risk). Notable findings in patients with cirrhosis included splenomegaly, low total leucocyte counts, low platelets, high bilirubin, elevated aspartate aminotransferase, gamma-glutamyl transferase and international normalization ratio, low albumin, high AST to Platelet Ratio Index (APRI), and high BEA score. The splenic size, platelet count, and albumin levels were independently associated with cirrhosis (p < 0.001, <0.001, and 0.003). A model using a combination of platelet count, albumin, and spleen size was developed to accurately predict cirrhosis in this cohort. It had an area under the receiver operating characteristics (AUROC) of 0.935. Conclusions HDV-infected young adults, age 18-25 years, were at moderate to severe risk of disease progression. About one-third of patients had already developed cirrhosis indicating the aggressive nature of the disease.
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Affiliation(s)
- Zaigham Abbas
- Gastroenterology and Hepatology, Dr. Ziauddin University Hospital Clifton, Karachi, PAK
| | - Muhammad Ali Qadeer
- Gastroenterology and Hepatology, Dr. Ziauddin University Hospital Clifton, Karachi, PAK
| | - Haider A Mandviwalla
- Gastroenterology and Hepatology, Dr. Ziauddin University Hospital Clifton, Karachi, PAK
| | - Minaam Abbas
- Gastroenterology and Hepatology, Dr. Ziauddin University Hospital Clifton, Karachi, PAK.,Gastroenterology and Hepatology, School of Clinical Medicine, University of Cambridge, Cambridge, GBR
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10
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Wu S, Zhang Y, Tang Y, Yao T, Lv M, Tang Z, Zang G, Yu Y, Chen X. Molecular epidemiology and clinical characteristics of hepatitis delta virus (HDV) infected patients with elevated transaminases in Shanghai, China. BMC Infect Dis 2020; 20:565. [PMID: 32746807 PMCID: PMC7397625 DOI: 10.1186/s12879-020-05275-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients coinfected with HBV and hepatitis D virus (HDV) have a greater risk of HCC and cirrhosis. The current study was undertaken to assess HDV genotype distribution and determine clinical characteristics of hepatitis delta virus (HDV) among HBsAg positive individuals in Shanghai. METHOD This retrospective study involved 225 serum samples from HBsAg positive hospitalized patients from October 2010 to April 2013. HDV-specific RT-nested PCR was used to amplify HDV RNA. HDV genotypes were characterized by Next-generation sequencing (NGS), followed by phylogenetic analyses. HDV/HBV co-infected patients and HBV mono-infected patients were compared clinically and virologically. RESULTS Out of the 225 HBsAg-positive serum samples with elevated transaminases, HDV-RNA was identified in 11 (4.9%) patients. The HBV loads in the HDV positive group were significantly lower than the HDV negative HBV-infected patients. The aminotransferase enzymes were significantly higher in HDV/HBV co-infected compared to HDV negative patients (P < 0.05). Phylogenetic analyses indicated that HDV-2 genotype being the predominant genotype, other HDV genotypes were not observed. HDV/HBV patients were significantly associated with a rather unfavourable clinical outcome. CONCLUSION In summary, the prevalence of HDV infection in patients with elevated transaminases is not low and the predominance of HDV genotype 2 infection in Shanghai. This finding helps us to better understand the correlation of HDV/HBV co-infection. Moreover, Next-generation sequencing (NGS) technologies provide a rapid, precise method for generating HDV genomes to define infecting genotypes.
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Affiliation(s)
- Shanshan Wu
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Yi Zhang
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Yuyan Tang
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Ting Yao
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Mengjiao Lv
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Zhenghao Tang
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Guoqing Zang
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Yongsheng Yu
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
| | - Xiaohua Chen
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
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11
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Nogueira-Lima FS, Botelho-Souza LF, Roca TP, Santos AOD, Oliveira SDC, Queiroz JADS, Santos-Alves FAGD, Salcedo JMV, Vieira DS. Phylodynamic and Phylogeographic Analysis of Hepatitis Delta Virus Genotype 3 Isolated in South America. Viruses 2019; 11:v11110995. [PMID: 31671829 PMCID: PMC6893442 DOI: 10.3390/v11110995] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/21/2019] [Indexed: 12/13/2022] Open
Abstract
The hepatitis delta virus (HDV) is a globally distributed agent, and its genetic variability allows for it to be organized into eight genotypes with different geographic distributions. In South America, genotype 3 (HDV-3) is frequently isolated and responsible for the most severe form of infection. The objective of this study was to evaluate the evolutionary and epidemiological dynamics of HDV-3 over the years and to describe its distribution throughout this continent in an evolutionary perspective. While using Bayesian analysis, with strains being deposited in the Nucleotide database, the most recent common ancestor was dated back to 1964 and phylogenetic analysis indicated that the dispersion may have started in Brazil, spreading to Venezuela and then to Colombia, respectively. Exponential growth in the effective number of infections was observed between the 1950s and 1970s, years after the first report of the presence of HDV on the continent, during the Labrea Black Fever outbreak, which showed that the virus continued to spread, increasing the number of cases decades after the first reports. Subsequently, the analysis showed a decrease in the epidemiological levels of HDV, which was probably due to the implantation of the vaccine against its helper virus, hepatitis B virus, and serological screening methods implemented in the blood banks.
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Affiliation(s)
- Felipe Souza Nogueira-Lima
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Luan Felipo Botelho-Souza
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Tárcio Peixoto Roca
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Alcione Oliveira Dos Santos
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Suyane da Costa Oliveira
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Jackson Alves da Silva Queiroz
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
| | - Fabianne Araújo Gomes Dos Santos-Alves
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Juan Miguel Villalobos Salcedo
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
| | - Deusilene Souza Vieira
- Oswaldo Cruz Foundation of Rondônia-FIOCRUZ/RO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Research Center in Tropical Medicine of Rondônia -CEPEM/RO, Porto Velho RO 76812 329, Rondônia, Brazil.
- National Institute of Epidemiology of Western Amazonia-INCT EpiAmO, Porto Velho RO 76812 245, Rondônia, Brazil.
- Postgraduate Program in Experimental Biology of the Federal University of Rondônia-PGBIOEXP/UNIR, Porto Velho RO 76801 059, Rondônia, Brazil.
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12
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Coppola N, Alessio L, Onorato L, Sagnelli C, Sagnelli E, Pisaturo M. HDV infection in immigrant populations. J Med Virol 2019; 91:2049-2058. [PMID: 31429940 DOI: 10.1002/jmv.25570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/10/2019] [Indexed: 12/16/2022]
Abstract
AIMS Little data have been published so far on the epidemiological aspects of hepatitis D virus (HDV) infection in immigrant populations and even poorer is the information on the virological, phylogenetic, and clinical aspects of this infection in these populations. This review article, aimed primarily at physicians caring for immigrants, summarizes the information available on HDV infection and analyzes data on this topic concerning the immigrant populations. METHODS AND RESULTS The prevalence of HDV infection in HBsAg-positive immigrants varies according to the country of origin. For example, in immigrants from sub-Saharan Africa, this prevalence is higher in those born in Equatorial Guinea (24.4%) than those from other African countries (10.3%). The epidemiological impact of HDV infection linked to migratory flows is a function of the different endemicity between countries of origin and countries in which a new existence has been established. This impact is high when immigrants from areas endemic to HDV infection (eg, Equatorial Guinea) settle in areas of low endemicity (eg, Germany or England, with a prevalence of around 4%), while the impact is lesser or nonexistent if the migratory flows are directed toward countries with intermediate endemicity (eg, Italy and Greece, with a prevalence of around 10%). CONCLUSION This impact of immigration on HDV epidemiology can be strong when HDV endemicity is high in the country of origin and low in the host country and slight when immigrants move to high or medium endemic countries.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.,Infectious Disease Unit, AORN Caserta, Caserta, Italy
| | | | - Lorenzo Onorato
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.,Infectious Disease Unit, AORN Caserta, Caserta, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mariantonietta Pisaturo
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
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13
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Rasche A, Sander AL, Corman VM, Drexler JF. Evolutionary biology of human hepatitis viruses. J Hepatol 2019; 70:501-520. [PMID: 30472320 PMCID: PMC7114834 DOI: 10.1016/j.jhep.2018.11.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/09/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023]
Abstract
Hepatitis viruses are major threats to human health. During the last decade, highly diverse viruses related to human hepatitis viruses were found in animals other than primates. Herein, we describe both surprising conservation and striking differences of the unique biological properties and infection patterns of human hepatitis viruses and their animal homologues, including transmission routes, liver tropism, oncogenesis, chronicity, pathogenesis and envelopment. We discuss the potential for translation of newly discovered hepatitis viruses into preclinical animal models for drug testing, studies on pathogenesis and vaccine development. Finally, we re-evaluate the evolutionary origins of human hepatitis viruses and discuss the past and present zoonotic potential of their animal homologues.
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Affiliation(s)
- Andrea Rasche
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany,German Center for Infection Research (DZIF), Germany
| | - Anna-Lena Sander
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany
| | - Victor Max Corman
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany,German Center for Infection Research (DZIF), Germany
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany; German Center for Infection Research (DZIF), Germany.
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14
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Melo Da Silva E, Kay A, Lobato C, Muwonge R, Zoulim F, Brites C, Parana R, Trepo C. Non-F HBV/HDV-3 coinfection is associated with severe liver disease in Western Brazilian Amazon. J Med Virol 2019; 91:1081-1086. [PMID: 30695106 DOI: 10.1002/jmv.25411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/02/2019] [Accepted: 01/23/2019] [Indexed: 11/11/2022]
Abstract
The clinical outcome of hepatitis B virus (HBV) infection may be related to host and viral genetic factors, as well as to the type of infection (monoinfection and coinfection). To analyze the distribution/combination of HBV/hepatitis D virus (HDV) genotypes and the associated clinical characteristics, 409 serum samples from patients with chronic HBV (94 of them coinfected by HDV) followed at the Viral Hepatitis Referral Center of Rio Branco, Brazil were enrolled. HBV DNA and HDV RNA were amplified, respectively, by polymerase chain reaction (PCR) and nested PCR using specific primers in the PreC/C region and the S gene, and by reverse-transcription PCR and seminested PCR using specific primers in the delta antigen region and sequenced. The proportion of women (56.1%) was significantly higher than males in this cohort ( P < 0.01). Women were significantly younger (39.8 years; 8-77 years) than males (44.7 years; 12-79 years; P < 0.01). Sixty-eight (18%) patients were infected with HBV-F genotype and 264 (69.8%) with HBV/non-F genotypes. Coinfection by HDV was detected in 23.9% (94 of 409) of this population and was more frequent in male (54.2%, 51 of 94) than in female patients (44.7%, 42 of 94; P = 0.015). HDV-3 was the most prevalent (88.9%) genotype. Almost 70% of HDV-3 coinfected patients were infected with HBV/non-F genotypes. Severe liver disease was diagnosed in 41 patients, 60.9% (25 of 41) of them coinfected with HDV. HBV/HDV coinfection was associated with male sex, age above 30 years, severe liver disease, and increased alanine aminotransferase levels. HBV/HDV-3 coinfection is associated with severe liver disease, in Rio Branco, Brazil.
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Affiliation(s)
- Edinete Melo Da Silva
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Infectology Research Laboratory, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Alan Kay
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France
| | - Cirley Lobato
- Universidade Federal do Acre, UFAC, Rio Branco, Brazil
| | - Richard Muwonge
- International Agency for Research on Cancer, IARC/World Health Organization, WHO, Lyon, France
| | - Fabien Zoulim
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Department of Hepatology,, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Carlos Brites
- Infectology Research Laboratory, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Raymundo Parana
- Hepatology Unit, Medical School, Hospital Universitário Professor Edgard Santos, HUPES/UFBA, Salvador, Brazil
| | - Christian Trepo
- Institut National de la Santé et de la Recherche Medicale, INSERM U1052, Lyon, France.,Department of Hepatology,, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
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15
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Oliveira MSD, Silva RPM, Valle SDCND, Figueiredo END, Fram D. Chronic hepatitis B and D: prognosis according to Child-Pugh score. Rev Bras Enferm 2018; 70:1048-1053. [PMID: 28977233 DOI: 10.1590/0034-7167-2016-0205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/17/2017] [Indexed: 01/27/2023] Open
Abstract
Objective: compare chronic hepatitis B patients to those superinfected with hepatitis D virus, according to Child-Pugh score regarding disease severity. Method: retrospective descriptive study, performed with 59 patients followed in the ambulatory, of which 22 (37.3%) were chronically infected with hepatitis B virus (Group HBV) and 37 (62.7%) superinfected with Delta virus (Group HBV+HDV); variables of sex, age and items of Child-Pugh score were collected by consulting medical records. Results: out of the patients, 57.6% were male, with a mean age of 30.5 years. Score A, which indicates lesser severity, was found in 100% of group HBV and 78.4% of group HBV+HDV. Score B, which indicates greater severity, was found only in group HBV+HDV in 21.6% of the patients. Conclusion: by means of the Child-Pugh score, it was observed that patients with superinfection by HDV tended to present a worse prognosis. Objetivo: comparar os pacientes com hepatite B crônica com superinfectados pelo vírus D segundo escore de Child-Pugh quanto à gravidade da doença. Método: estudo descritivo retrospectivo, realizado com 59 pacientes acompanhados em ambulatório, sendo 22 (37,3%) cronicamente infectados pelo vírus da hepatite B (Grupo VHB) e 37 (62,7%) com superinfecção por vírus Delta (Grupo VHB+VHD); foram coletadas variáveis quanto ao sexo, idade e referentes ao escore de Child-Pugh por meio de consulta a prontuários. Resultados: entre os pacientes 57,6% era do sexo masculino, com idade média de 30,5 anos. O escore A, que indica menor gravidade, foi encontrado em 100% do grupo VHB e 78,4% do grupo VHB+VHD. O escore B, que indica maior gravidade, foi encontrado apenas no grupo VHB+VHD em 21,6% dos pacientes. Conclusão: por meio do escore de Child-Pugh, observou-se que os pacientes com superinfecção por VHD tendem a apresentar pior prognóstico.
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Affiliation(s)
- Marcelo Siqueira de Oliveira
- Universidade Federal de São Paulo, Paulista Nursing School, Postgraduate Program in Nursing. São Paulo, Brazil.,Universidade Federal do Acre, Multidisciplinary Center of Cruzeiro do Sul. Cruzeiro do Sul, Acre, Brazil
| | | | | | | | - Dayana Fram
- Universidade Federal de São Paulo, Paulista Nursing School, Department of Clinical and Surgical Nursing. São Paulo, Brazil
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16
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Abstract
Hepatitis D caused by the hepatitis delta virus (HDV) is a serious health problem in many regions of the world. A total of 546 HBV-infected patients were enrolled from 2013 to 2015 and classified clinically into the subgroups of chronic hepatitis B (CHB, n = 191), liver cirrhosis (LC, n = 147) and hepatocellular carcinoma (HCC, n = 208). The patients were screened for HDV-RNA by nested PCR assays. HDV genotypes were assessed by direct sequencing, followed by phylogenetic analysis. HDV-RNA was identified in 13% (71/546) of HBV-infected patients. The highest HDV prevalence was found in the LC group (19.7%), followed by the HCC (12%) and CHB (8.9%) groups (P = 0.017). HDV/HBV coinfections were significantly associated with a rather unfavourable clinical outcome, in particular with LC development compared to HBV monoinfection. Phylogenetic analyses indicated that the genotype HDV1 was, with a prevalence of 91%, by far the most common genotype in Vietnam, followed by HDV2 with 9%. Other HDV genotypes were not observed. In accordance with previous data obtained a decade ago, our results confirm a continuing high prevalence of HDV infection in hepatitis B patients in northern Vietnam with the HDV1 genotype still being the predominant genotype. HDV nucleic acid testing to minimize the associated risk should be considered.
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17
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Baig S, Abidi SH, Azam Z, Majid S, Khan S, Khanani MR, Ali S. Evolution of HBV S-gene in the backdrop of HDV co-infection. J Med Virol 2018; 90:1328-1336. [PMID: 29663447 DOI: 10.1002/jmv.25200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 03/22/2018] [Indexed: 12/15/2022]
Abstract
HBV-HDV co-infected people have a higher chance of developing cirrhosis, fulminant hepatitis, and hepatocellular carcinoma (HCC) compared to those infected only with HBV. The present study was conducted to investigate HBV genotypes and phylogeny among HBV mono-infected and HBV-HDV co-infected patients, as well as analyze mutations in the surface gene of HBV in mono-infected and co-infected patients. A total of 100 blood samples (50 co-infected with HBV and HDV, and 50 mono-infected with HBV only) were collected for this study. HBV DNA was extracted from patient sera and partial surface antigen gene was amplified from HBV genome using polymerase chain reaction. HBV S gene was sequenced from 49 mono-infected and 36 co-infected patients and analyzed to identify HBV genotypes and phylogenetic patterns. Subsequently, HBV S amino acid sequences were analyzed for mutational differences between sequences from mono- and co-infected patients. HBV genotype D was predominantly found in both mono-infected as well as co-infected patients. Phylogenetic analysis showed the divergence of HBV sequences, between mono- and co-infected patients, into two distinct clusters. HBV S gene mutation analysis revealed certain mutations in HBV-HDV co-infected subjects to be distinct from those found in mono-infected patients. This might indicate the evolution of HBV S gene under selection pressures generated from HDV coinfection.
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Affiliation(s)
- Samina Baig
- Department of Microbiology, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed H Abidi
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Zahid Azam
- National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - Shahid Majid
- National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - Saeed Khan
- Department of Pathology and Dow Institute of Biotechnology and Biomedical Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad R Khanani
- Department of Pathology and Dow Institute of Biotechnology and Biomedical Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Ali
- Department of Biomedical Sciences, Nazarbayev School of Medicine, Nazarbayev University, Astana, Kazakhstan.,Department of Pathology, Dow University of Health Sciences, Karachi, Pakistan
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18
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Wranke A, Pinheiro Borzacov LM, Parana R, Lobato C, Hamid S, Ceausu E, Dalekos GN, Rizzetto M, Turcanu A, Niro GA, Lubna F, Abbas M, Ingiliz P, Buti M, Ferenci P, Vanwolleghem T, Hayden T, Dashdorj N, Motoc A, Cornberg M, Abbas Z, Yurdaydin C, Manns MP, Wedemeyer H, Hardtke S. Clinical and virological heterogeneity of hepatitis delta in different regions world-wide: The Hepatitis Delta International Network (HDIN). Liver Int 2018; 38:842-850. [PMID: 28963781 DOI: 10.1111/liv.13604] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/19/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Chronic hepatitis D (delta) is a major global health burden. Clinical and virological characteristics of patients with hepatitis D virus (HDV) infection and treatment approaches in different regions world-wide are poorly defined. METHODS The Hepatitis Delta International Network (HDIN) registry was established in 2011 with centres in Europe, Asia, North- and South America. Here, we report on clinical/ virological characteristics of the first 1576 patients with ongoing or past HDV infection included in the database until October 2016 and performed a retrospective outcome analysis. The primary aim was to investigate if the region of origin was associated with HDV replication and clinical outcome. RESULTS The majority of patients was male (n = 979, 62%) and the mean age was 36.7 years (range 1-79, with 9% of patients younger than 20 years). Most patients were HBeAg-negative (77%) and HDV-RNA positive (85%). Cirrhosis was reported in 48.7% of cases which included 13% of patients with previous or ongoing liver decompensation. Hepatocellular carcinoma (HCC) developed in 30 patients (2.5%) and 44 (3.6%) underwent liver transplantation. Regions of origin were independently associated with clinical endpoints and detectability of HDV RNA. Antiviral therapy was administered to 356 patients with different treatment uptakes in different regions. Of these, 264 patients were treated with interferon-a and 92 were treated with HBV-Nucs only. CONCLUSIONS The HDIN registry confirms the severity of hepatitis delta but also highlights the heterogeneity of patient characteristics and clinical outcomes in different regions. There is an urgent need for novel treatment options for HDV infection.
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Affiliation(s)
- Anika Wranke
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Lourdes M Pinheiro Borzacov
- Research Centre for Tropical Medicine of Rondônia - CEPEM/SESAU, Federal University of Rondônia, Rondônia, Brazil
| | - Raymundo Parana
- Hepatology Centre of the University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Saeed Hamid
- Department of Hepatogastroenterology, Aga Khan University, Karachi, Pakistan
| | - Emanoil Ceausu
- Infectious Diseases, Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - Mario Rizzetto
- Department of Internal Medicine - Gastroenterology, University of Torino, Torino, Italy
| | - Adela Turcanu
- State University of Medicine "Nicolae Testemitanu", Chisinau, Republic of Moldova
| | - Grazia A Niro
- Divisione di Gastroenterologia, Ospedale Generale Regionale "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Farheen Lubna
- Department of Hepatogastroenterology, Aga Khan University, Karachi, Pakistan
| | - Minaam Abbas
- Ziauddin University Hospital Karachi, Karachi, Pakistan
| | | | - Maria Buti
- Liver Unit, Valle d'Hebron University Hospital and Ciberhed del Instituto CarlosIII, Barcelona, Spain
| | - Peter Ferenci
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Thomas Vanwolleghem
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Tonya Hayden
- Centres for Disease Control and Prevention/Div of viral hepatitis, Atlanta, USA
| | | | - Adriana Motoc
- Infectious Diseases, Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Markus Cornberg
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), HepNet Study-House, Hannover, Germany
| | - Zaigham Abbas
- Ziauddin University Hospital Karachi, Karachi, Pakistan
| | | | - Michael P Manns
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), HepNet Study-House, Hannover, Germany
| | - Heiner Wedemeyer
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), HepNet Study-House, Hannover, Germany
| | - Svenja Hardtke
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Centre for Infection Research (DZIF), HepNet Study-House, Hannover, Germany
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Elzouki AN, Bashir SM, Elahmer O, Elzouki I, Alkhattali F. Prevalence and risk factors of hepatitis D virus infection in patients with chronic hepatitis B infection attending the three main tertiary hospitals in Libya. Arab J Gastroenterol 2017; 18:216-219. [PMID: 29241726 DOI: 10.1016/j.ajg.2017.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/13/2017] [Accepted: 11/14/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND STUDY AIMS Globally, More than 350 million individuals are chronically infected with hepatitis B virus (HBV), and >20 million of them are co-infected with hepatitis D virus (HDV). The aim of this study was to determine the pattern of HDV infection in patients with chronic hepatitis B in three main tertiary hospitals in Tripoli and Benghazi, Libya. PATIENTS AND METHODS This cross sectional and descriptive study was conducted on 162 patients with chronic hepatitis B positive for more than six months) who were followed up at hepatitis clinics of the three main tertiary hospitals in Tripoli city (88 patients from Tripoli Medical Centre and Tripoli Central Hospital) and Benghazi city (74 patients from Aljomhoria Hospital) during the period from January 2010 to June 2012. HBV and HDV markers were detected by enzyme linked fluorescent assay (ELFA) or enzyme-linked immunosorbent assay and HBV-DNA was quantified by real-time PCR techniques. RESULTS The mean age of patients was 36,92 ± 15,35. One hundred and three (63.6%) of them were males and 59 (36,4%) were females. Four patients (2,5%) were tested positive for anti-HD antibodies, all of them have had clinical and/or histological diagnosis of cirrhosis. In multivariable regression analysis, age (p = .04), elevation of serum ALT (p = .03), elevation of serum AST (p = .04), and presence of cirrhosis (p = .003) were significantly related to HDV seropositivity. CONCLUSION Although the study demonstrated that Libya has low to moderate prevalence of HDV (2,5%), it is important for policy makers and health care providers to continue the preventive measures for HDV spread, and HBV prevention program including utilization of HBV vaccine. Furthermore, it is imperative to screen chronic HBV patients for HDV for close observation for early diagnosis of subsequent development of liver cirrhosis. Moreover, further epidemiologic and genetic studies are needed to explore the trend for HDV infection in Libya.
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Affiliation(s)
| | - Saleh M Bashir
- Department of Biomedical Engineering, School of Engineering and Applied Science, Tripoli, Libya
| | - Omar Elahmer
- National Center for Disease Control, Tripoli, Libya
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Oliveira MSD, Valle SDCND, Souza RMD, Silva RPM, Figueiredo END, Taminato M, Fram D. Evidências científicas sobre a hepatite Delta no Brasil: revisão integrativa da literatura. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Resumo Objetivo: Descrever o nível de evidência científica sobre a infecção por vírus da hepatite Delta (VHD) no Brasil. Métodos: Revisão integrativa da literatura, com buscas realizadas nas bases de dados do Medical Literature Analysis and Retrieval System Online, Literatura Latino-americana e do Caribe em Ciências da Saúde, Scientific Eletronic Library Online e Scopus, com análise centrada no nivelamento do rigor metodológico de acordo com o modelo de Melnyk e Fineout-Overholt. Resultados: A busca revelou uma média de duas publicações por ano no intervalo entre 1987 e 2017. Foram selecionados 33 artigos, tendo a maioria (91%) apresentado nível de evidência VI. As publicações ficaram concentradas em periódicos da área de medicina tropical (46%) e virologia (15%). Dos trabalhos, 85% tinha profissional médico com autor e o delineamento mais encontrado foi o descritivo/transversal (69,6%). Conclusão: A produção científica sobre a infecção por VHD no Brasil está centrada em estudos de prevalência, mostrando-se incipiente quanto à produção de estudos com delineamentos mais rígidos como ensaios clínicos.
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21
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Jaramillo CM, de La Hoz F, Porras A, di Filippo D, Choconta-Piraquive LA, Payares E, Montes N, Navas MC. Characterization of hepatitis B virus in Amerindian children and mothers from Amazonas State, Colombia. PLoS One 2017; 12:e0181643. [PMID: 29016603 PMCID: PMC5634536 DOI: 10.1371/journal.pone.0181643] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 07/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hepatitis B Virus (HBV) infection is a worldwide public health problem. In the 1980's a highly effective and safe vaccine against HBV was developed, although breakthrough infection still occasionally occurs because of the emergence of escape mutants. The aim of this study was to identify HBV genotypes and escape mutants in children and their mothers in Amerindian communities of the Amazonas State, Southern Colombia. METHODS Blood specimens collected from children and mothers belonging to 37 Amerindian communities in Amazonas state, were screened for HBsAg and anti-HBc using ELISA. The partial region containing the S ORF was amplified by nested PCR, and amplicons were sequenced. The phylogenetic analysis was performed using the MEGA 5.05 software. RESULTS Forty-six children (46/1275, 3.6%) and one hundred and seventy-seven mothers (177/572, 30.9%) were tested positive for the anti-HBc serological marker. Among them, 190 samples were tested for viral genome detection; 8.3% (2/31) serum samples obtained from children and 3.1% (5/159) from mothers were positive for the ORF S PCR. The predominant HBV genotype in the study population was F, subgenotype F1b; in addition, subgenotype F1a and genotype A were also characterized. Two HBV escape mutants were identified, G145R, reported worldwide, and W156*; this stop codon was identified in a child with occult HBV infection. Other mutations were found, L109R and G130E, located in critical positions of the HBsAg sequence. CONCLUSIONS This study aimed to characterize the HBV genotype F, subgenotypes F1b and F1a, and genotype A in Amerindian communities and for the first time escape mutants in Colombia. Further investigations are necessary to elucidate the frequency and the epidemiological impact of the escape mutants in the country.
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Affiliation(s)
- Carlos Mario Jaramillo
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellin, Colombia
| | - Fernando de La Hoz
- Grupo de Epidemiologia y Evaluación en Salud Pública, Universidad Nacional, Bogota, Colombia
| | - Alexandra Porras
- Grupo de Epidemiologia y Evaluación en Salud Pública, Universidad Nacional, Bogota, Colombia
| | - Diana di Filippo
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellin, Colombia
| | | | - Edra Payares
- Laboratorio Departamental de Salud Publica del Amazonas, Leticia, Colombia
| | - Neyla Montes
- Coordinacion Salud Publica, Alcaldia de Puerto Nariño, Puerto Nariño, Colombia
| | - Maria-Cristina Navas
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellin, Colombia
- * E-mail:
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22
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Botelho-Souza LF, Vasconcelos MPA, Dos Santos ADO, Salcedo JMV, Vieira DS. Hepatitis delta: virological and clinical aspects. Virol J 2017; 14:177. [PMID: 28903779 PMCID: PMC5597996 DOI: 10.1186/s12985-017-0845-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023] Open
Abstract
There are an estimated 400 million chronic carriers of HBV worldwide; between 15 and 20 million have serological evidence of exposure to HDV. Traditionally, regions with high rates of endemicity are central and northern Africa, the Amazon Basin, eastern Europe and the Mediterranean, the Middle East and parts of Asia. There are two types of HDV/HBV infection which are differentiated by the previous status infection by HBV for the individual. Individuals with acute HBV infection contaminated by HDV is an HDV/HBV co-infection, while individuals with chronic HBV infection contaminated by HDV represent an HDV/HBV super-infection. The appropriate treatment for chronic hepatitis delta is still widely discussed since it does not have an effective drug. Alpha interferon is currently the only licensed therapy for the treatment of chronic hepatitis D. The most widely used drug is pegylated interferon but only approximately 25% of patients maintain a sustained viral response after 1 year of treatment. The best marker of therapeutic success would be the clearance of HBsAg, but this data is rare in clinical practice. Therefore, the best way to predict a sustained virologic response is the maintenance of undetectable HDV RNA levels.
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Affiliation(s)
- Luan Felipo Botelho-Souza
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil.
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil.
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil.
| | | | - Alcione de Oliveira Dos Santos
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
| | - Juan Miguel Villalobos Salcedo
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
| | - Deusilene Souza Vieira
- Laboratório de Virologia Molecular - FIOCRUZ - RONDÔNIA, Rua da Beira, 7671 - BR 364, Km 3,5 Bairro Lagoa, CEP: 76812, Porto Velho, RO, CEP: 76812-329, Brazil
- Ambulatório de Hepatites Virais, Fundação Oswaldo Cruz Rondônia e Centro de Pesquisa em Medicina Tropical - CEPEM, Avenida Guaporé, 215, anexo Hospital CEMETRON, Agenor M de Carvalho, Porto Velho, RO, CEP: 76812-329, Brazil
- Programa de Pós-Graduação em Biologia Experimental - PGBioExp, Rodovia Br-364, KM 9, CAMPUS UNIR, Porto Velho, RO, CEP: 76801-974, Brazil
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Nguyen HM, Sy BT, Trung NT, Hoan NX, Wedemeyer H, Velavan TP, Bock CT. Prevalence and genotype distribution of hepatitis delta virus among chronic hepatitis B carriers in Central Vietnam. PLoS One 2017; 12:e0175304. [PMID: 28403190 PMCID: PMC5389633 DOI: 10.1371/journal.pone.0175304] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/23/2017] [Indexed: 02/07/2023] Open
Abstract
Hepatitis D virus (HDV) infection plays an important role in liver diseases. However, the molecular epidemiology and impact of HDV infection in chronic hepatitis B (CHB) remain uncertain in Vietnam. This cross-sectional study aimed to investigate the prevalence and genotype distribution of HDV among HBsAg-positive patients in Central Vietnam. 250 CHB patients were tested for HDV using newly established HDV-specific RT-PCR techniques. HDV genotypes were determined by direct sequencing. Of the 250 patients 25 (10%) had detectable copies of HDV viral RNA. HDV-2 was predominant (20/25; 80%) followed by HDV-1 (5/25; 20%). Proven HDV genotypes share the Asian nomenclature. Chronic hepatitis B patients with concomitant HDV-1 showed higher HBV loads as compared to HDV-2 infected patients [median log10 (HBV-DNA copies/ml): 8.5 vs. 4.4, P = 0.036]. Our findings indicate that HDV infection is highly prevalent and HDV-2 is predominant in Central Vietnam. The data will add new information to the management of HBsAg-positive patients in a highly HBV endemic region to in- or exclude HDV infection in terms of diagnostic and treatment options.
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Affiliation(s)
- Hung Minh Nguyen
- Center for Molecular Biology, Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- * E-mail: (CTB); (HMN)
| | - Bui Tien Sy
- Department of Molecular Biology, 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Thanh Trung
- Center for Molecular Biology, Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
| | - Nghiem Xuan Hoan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Heiner Wedemeyer
- German Center for Infection Research, Department for Gastroenterology, Hepatology, and Endocrinology, Medical School Hannover, Hannover, Germany
| | - Thirumalaisamy P. Velavan
- Center for Molecular Biology, Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - C-Thomas Bock
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
- * E-mail: (CTB); (HMN)
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Analysis of hepatitis B virus genotypes by restriction fragment length polymorphism. BIOMEDICA 2015; 36:79-88. [DOI: 10.7705/biomedica.v36i0.2976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Indexed: 12/15/2022]
Abstract
<p><strong>Introducción.</strong> Se han descrito diez genotipos (A-J) del virus de la hepatitis B (HBV) que están distribuidos en todos los continentes. Una de las técnicas utilizadas para determinar el genotipo viral es el análisis del polimorfismo de longitud de los fragmentos de restricción, un método simple y económico, pero con algunas limitaciones.<br /><strong>Objetivo.</strong> El objetivo inicial del estudio fue identificar el genotipo del HBV mediante RFLP en muestras de suero obtenidas de pacientes y donantes de sangre. Sin embargo, por las discrepancias observadas en los patrones de RFLP fue necesario realizar análisis filogenéticos y un análisis in silico de secuencias del HBV.<br /><strong>Materiales y métodos.</strong> Se obtuvieron 56 muestras de suero. Tras la extracción de ADN, se amplificó un fragmento del ORF S del HBV mediante reacción en cadena de la polimerasa, cuyos productos se analizaron por RFLP con las enzimas <em>AlwI</em>, <em>BsrI</em>, <em>CfrI</em>, <em>HpaII</em> y <em>StyI</em>, y algunos se secuenciaron. Los patrones obtenidos se compararon con los reportados previamente. Se efectuó un análisis<em> in silico</em> de RFLP en consideración de las diferencias entre los patrones esperados y los observados.<br /><strong>Resultados.</strong> Se identificaron los genotipos A y F, subgenotipo F3, en las muestras. Este resultado coincide con lo descrito en estudios previos en los que se ha demostrado que el genotipo F, subgenotipo F3, es prevalente en la población de la región andina del país, en tanto que el genotipo A predomina en el occidente (departamento del Chocó). Con base en el análisis <em>in silico</em> de 229 secuencias virales obtenidas del GenBank y las 11 secuencias de este estudio, se caracterizó un nuevo patrón de RFLP específico para el genotipo F, subgenotipo F3, y se describieron algunas modificaciones en el patrón de RFLP del genotipo A, subgenotipo A1.<br /><strong>Conclusiones.</strong> Se caracterizó el patrón de genotipificación del genotipo F, subgenotipo F3, del HBV mediante RFLP, análisis in silico y secuenciación. Se requieren nuevos análisis in silico con un número mayor de secuencias para validar los patrones de RFLP de los genotipos y subgenotipos del VHB.</p>
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di Filippo Villa D, Cortes-Mancera F, Payares E, Montes N, de la Hoz F, Arbelaez MP, Correa G, Navas MC. Hepatitis D virus and hepatitis B virus infection in Amerindian communities of the Amazonas state, Colombia. Virol J 2015; 12:172. [PMID: 26497287 PMCID: PMC4619413 DOI: 10.1186/s12985-015-0402-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/12/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In Colombia, cases of Hepatitis D virus (HDV) infection have been officially described since 1985 mainly in Amerindian population from Sierra Nevada de Santa Marta (North Caribbean Coast), Uraba (North West), and Amazon (South East). The last official report of a clinical case of HDV infection in Colombia was registered in 2005. OBJECTIVES The aims of this study were to identify cases of HDV and/or Hepatitis B virus (HBV) infection in asymptomatic Amerindians from Amazonas state, South East Colombia, and to describe the circulating viral genotypes in this population. STUDY DESIGN The study population was recruited in 19 Amerindian communities in the Amazonas state. Individuals over 18 years old were screened by rapid test for Hepatitis B surface Antigen (HBsAg). Blood samples obtained from individuals positives for HBsAg in the rapid-test assay were analyzed for HBsAg, anti-HBc, anti-HDV IgM/IgG by ELISA. The detection of HBV DNA and HDV RNA was performed by PCR amplification. The viral genotype was determined by sequencing and phylogenetic analysis. RESULTS A total of 23/861 individuals were positive for HBsAg detection by rapid test. Serological and/or molecular markers of HDV infection were demonstrated in 43.5 % (10/23) of samples from Amerindians. The phylogenetic analysis demonstrated the exclusive circulation of HBV subgenotype F1b of and HDV 3 in this population. CONCLUSIONS A high frequency of HBV/HDV infection was found in Amerindian population from Amazonas State, Colombia (43.5 %, 10/23). Nine cases were identified in a population of 861 asymptomatic Amerindian individuals; one symptomatic case (with diagnosis of end-stage hepatic disease) was also identified in the study. The circulation of HDV 3 and HBV subgenotype F1b suggests a constant flow of these viral genotypes as a result of the interaction of the Amerindian populations from Amazon basin. Further studies are necessary to confirm whether HBV subgenotype F1b is the prevalent in the population from South East region in Colombia.
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Affiliation(s)
- Diana di Filippo Villa
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia. .,Present Address: Facultad de Investigación Judicial, Forenses y Salud, Tecnologico de Antioquia, Medellín, Colombia.
| | - Fabian Cortes-Mancera
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia. .,Grupo de Investigación e Innovación Biomedica, Instituto Tecnológico Metropolitano, Medellin, Colombia.
| | - Edra Payares
- Laboratorio Departamental de Salud Publica de Amazonas, Leticia, Colombia.
| | - Neyla Montes
- Coordinacion de Salud Publica, Alcaldia de Puerto Nariño, Amazonas, Colombia.
| | - Fernando de la Hoz
- Instituto Nacional de Salud, Bogota, Colombia and Grupo de Epidemiología y Evaluación en Salud Pública, Universidad Nacional, Bogota, Colombia.
| | - Maria Patricia Arbelaez
- Grupo de Epidemiologia, Facultad de Salud Pública, Universidad de Antioquia, Medellin, Colombia.
| | - Gonzalo Correa
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia.
| | - Maria-Cristina Navas
- Grupo de Gastrohepatologia, Facultad de Medicina, Universidad de Antioquia, UdeA, Calle 70 No. 52-21, Medellin, Colombia.
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Botelho-Souza LF, Souza Vieira D, de Oliveira Dos Santos A, Cunha Pereira AV, Villalobos-Salcedo JM. Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil. Intervirology 2015; 58:166-71. [PMID: 26112316 DOI: 10.1159/000431040] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/24/2015] [Indexed: 01/11/2023] Open
Abstract
UNLABELLED The hepatitis delta virus (HDV) is a hepatotropic subvirus that is dependent on the hepatitis B virus (HBV) and supplies the viral envelope containing the surface antigen of hepatitis B. Viral genetic diversity is related to the geographical origin of the isolates, and there are at least eight genotypes that are referred to as HDV-1 through HDV-8. HDV-3 is responsible for epidemics of severe and fulminant hepatitis, which are common in northeastern South America. HDV-3 is prevalent in the Brazilian Amazon and is associated with the increased aggressiveness of HDV infections. Although isolated, the characteristics of the clinical presentation of HDV-1 in the Amazon region have not yet been clearly reported. OBJECTIVE This study aims to assess the genotypic and clinical characteristics of individuals with the HDV-1 genotype in the western Amazon region. METHODS The HDV was genotyped by nested PCR-RFLP and sequencing from serum samples of 56 patients with HBV/HDV infection. The genotypes were correlated with the clinical characteristics presented by patients with HBV/HDV infection. RESULTS A prevalence of 92.3% for the HDV-3 genotype (n = 48) and 7.6% (n = 4) for the HDV-1 genotype was observed. CONCLUSION To date, this is the most extensive clinical study of HDV-1 genotype infections in the nonindigenous population of Western Amazonia.
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Shirvani-Dastgerdi E, Tacke F. Molecular interactions between hepatitis B virus and delta virus. World J Virol 2015; 4:36-41. [PMID: 25964870 PMCID: PMC4419120 DOI: 10.5501/wjv.v4.i2.36] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/12/2015] [Accepted: 03/09/2015] [Indexed: 02/05/2023] Open
Abstract
As a deficient virus due to the lack of envelope proteins, hepatitis D virus (HDV) causes chronic or fulminant “delta hepatitis” only in people with simultaneous hepatitis B virus (HBV) infection. HBV encodes three types of surface proteins known as small (S), medium (M) and large (L) envelope proteins. All three types of HBV surface antigens (HBsAgs) are present on HDV virions. The envelopment process of HDV occurs through interactions between the HDV ribonucleoprotein (RNP) complex and HBV HBsAgs. While HBsAg is the only protein required by HDV, the exact interaction sites between the S protein and pre-mature HDV are not well defined yet. In fact, these sites are distributed along the S protein with some hot spots for the envelopment process. Moreover, in most clinically studied samples, HDV infection is associated with a dramatically reduced HBV viral load, temporarily or permanently, while HBsAg resources are available for HDV packaging. Thus, beyond interacting with HBV envelope proteins, controlling mechanisms exist by which HDV inhibits HBV-DNA replication while allowing a selective transcription of HBV proteins. Here we discuss the molecular interaction sites between HBsAg and the HDV-RNP complex and address the proposed indirect mechanisms, which are employed by HBV and HDV to facilitate or inhibit each other’s viral replication. Understanding molecular interactions between HBV and HDV may help to design novel therapeutic strategies for delta hepatitis.
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Sadeghian H, Varasteh N, Esmaeelzadeh A, Nomani H, Alimardani M, Davoodnejad M, Meshkat M, Ahadi M, Sepahi S, Rostami S, Meshkat Z. Distribution of hepatitis delta virus genotypes in mashhad, northeast iran. Jundishapur J Microbiol 2015; 8:e14908. [PMID: 25793092 PMCID: PMC4353030 DOI: 10.5812/jjm.14908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/17/2013] [Accepted: 12/25/2013] [Indexed: 12/29/2022] Open
Abstract
Background: Hepatitis delta virus (HDV) is dependent on the hepatitis B virus for transmission and propagation. Based on isolated HDV sequences from different parts of the world, at least three major different genotypes with different geographic distributions are suggested. Studies have shown that genotype 1 is the predominant genotype of HDV in different parts of Iran; however, the genotype distribution of this virus has not been identified in Mashhad, northeast Iran. Objectives: This current study determines the frequency of HDV major genotypes in Mashhad, Iran. Patients and Methods: Twenty-five participants were enrolled in this study. All samples were positive for HBsAg (determined by Enzyme-linked immunosorbent assay (ELISA)) and anti-HDV. RNA extraction and cDNA synthesis was performed. Then, PCR was performed and HDV genotypes were determined by restriction fragment length polymorphism (RFLP). Results: Of 25 patients, 12 (48%) were positive for HDV RNA. Genotype analysis of HDV RNA revealed that the prevalence of HDV genotypes I and II was 83.3% (n = 10) and 16.7% (n = 2), respectively. Conclusions: This study showed that the most prevalent genotype of HDV in Mashhad was genotype I. It was of interest that in contrast to other provinces of Iran, HDV genotype 2 was observed in Mashhad. Similar studies with larger sample sizes could provide valuable information regarding the molecular epidemiology and geographical distribution. It may also help control and prevent the spread of hepatitis D virus infections. In addition, the genotyping of HDV may predict the severity of the disease.
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Affiliation(s)
- Hamid Sadeghian
- Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Naiemeh Varasteh
- School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, IR Iran
| | - Abbas Esmaeelzadeh
- Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hosein Nomani
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Maliheh Alimardani
- Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Mahdieh Davoodnejad
- Department of Human Genetic, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Mojtaba Meshkat
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mitra Ahadi
- Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Samaneh Sepahi
- Targeted Drug Delivery Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Sina Rostami
- Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, IR Iran
| | - Zahra Meshkat
- Department of Human Genetic, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding author: Zahra Meshkat, Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118012453, Fax: +98-5118002960, E-mail:
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Abstract
Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV), and infection with this virus aggravates acute and chronic liver disease. While HBV seroprevalence is very high across sub-Saharan Africa, much less is known about HDV in the region. In this study, almost 2,300 blood serum samples from Burkina Faso (n=1,131), Nigeria (n=974), Chad (n=50), and the Central African Republic (n = 118) were screened for HBV and HDV. Among 743 HBsAg-positive serum samples, 74 were positive for HDV antibodies and/or HDV RNA, with considerable differences in prevalence, ranging from <2% (pregnant women from Burkina Faso) to 50% (liver patients from Central African Republic). HDV seems to be much more common in chronic liver disease patients in the Central African Republic (CAR) than in similar cohorts in Nigeria. In a large nested mother-child cohort in Burkina Faso, the prevalence of HDV antibodies was 10 times higher in the children than in their mothers, despite similar HBsAg prevalences, excluding vertical transmission as an important route of infection. The genotyping of 16 full-length and 8 partial HDV strains revealed clade 1 (17/24) in three of the four countries, while clades 5 (5/24) and 6 (2/24) were, at least in this study, confined to Central Nigeria. On the amino acid level, almost all our clade 1 strains exhibited a serine at position 202 in the hepatitis D antigen, supporting the hypothesis of an ancient African HDV-1 subgroup. Further studies are required to understand the public health significance of the highly varied HDV prevalences in different cohorts and countries in sub-Saharan Africa.
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Botelho-Souza LF, dos Santos ADO, Borzacov LM, Honda ER, Villalobos-Salcedo JM, Vieira DS. Development of a reverse transcription quantitative real-time PCR-based system for rapid detection and quantitation of hepatitis delta virus in the western Amazon region of Brazil. J Virol Methods 2013; 197:19-24. [PMID: 24316446 DOI: 10.1016/j.jviromet.2013.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 11/19/2013] [Accepted: 11/25/2013] [Indexed: 12/31/2022]
Abstract
The hepatitis delta virus (HDV) is a pathogen that causes a severe and rapidly progressive disease of hepatocytes. The measurement of viral load in the peripheral blood of patients with HDV infections is important for diagnosis, treatment monitoring, and support for follow-up studies of viral replication during the course of the disease. This study reports the development of an assay capable of detecting and quantifying the abundance of HDV particles in serum samples, based on reverse-transcription quantitative PCR (RT-qPCR). Two standards for calibration were produced for determining the viral load of HDV: a cDNA cloned into a linear plasmid and a transcribed RNA. For validating this assay, 140 clinical samples of sera were used, comprising 100 samples from patients who tested positive for anti-HDV and hepatitis B virus surface antigen (HBsAg) by ELISA; 30 samples from blood donors; 5 samples monoinfected with hepatitis B virus (HBV); and 5 samples monoinfected with hepatitis C virus (HCV). The HDV RT-qPCR assay performed better when calibrated using the standard based on HDV cDNA cloned into a linear plasmid, yielding an efficiency of 99.8% and a specificity of 100% in the in vitro assays. This study represents the first HDV RT-qPCR assay developed with clinical samples from Brazil and offers great potential for new clinical efficacy studies of antiviral therapeutics for use in patients with hepatitis delta in the western Amazon region.
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Affiliation(s)
- Luan Felipo Botelho-Souza
- Fundação Oswaldo Cruz Rondônia (FIOCRUZ-RO), Laboratório Plataforma Técnica, Brazil; Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM), Brazil; Universidade Federal de Rondonia (UNIR), Núcleo de Saúde, Departamento de Medicina, Programa de Pós-graduação em Biologia Experimental (PGBIOEXP), Brazil.
| | - Alcione de Oliveira dos Santos
- Fundação Oswaldo Cruz Rondônia (FIOCRUZ-RO), Laboratório Plataforma Técnica, Brazil; Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM), Brazil; Universidade Federal de Rondonia (UNIR), Núcleo de Saúde, Departamento de Medicina, Programa de Pós-graduação em Biologia Experimental (PGBIOEXP), Brazil
| | | | | | - Juan Miguel Villalobos-Salcedo
- Fundação Oswaldo Cruz Rondônia (FIOCRUZ-RO), Laboratório Plataforma Técnica, Brazil; Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM), Brazil; Universidade Federal de Rondonia (UNIR), Núcleo de Saúde, Departamento de Medicina, Programa de Pós-graduação em Biologia Experimental (PGBIOEXP), Brazil
| | - Deusilene Souza Vieira
- Fundação Oswaldo Cruz Rondônia (FIOCRUZ-RO), Laboratório Plataforma Técnica, Brazil; Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM), Brazil; Universidade Federal de Rondonia (UNIR), Núcleo de Saúde, Departamento de Medicina, Programa de Pós-graduação em Biologia Experimental (PGBIOEXP), Brazil
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Sy BT, Ratsch BA, Toan NL, Song LH, Wollboldt C, Bryniok A, Nguyen HM, Luong HV, Velavan TP, Wedemeyer H, Kremsner PG, Bock CT. High prevalence and significance of hepatitis D virus infection among treatment-naïve HBsAg-positive patients in Northern Vietnam. PLoS One 2013; 8:e78094. [PMID: 24205106 PMCID: PMC3799775 DOI: 10.1371/journal.pone.0078094] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/07/2013] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis D virus (HDV) infection is considered to cause more severe hepatitis than hepatitis B virus (HBV) monoinfection. With more than 9.5 million HBV-infected people, Vietnam will face an enormous health burden. The prevalence of HDV in Vietnamese HBsAg-positive patients is speculative. Therefore, we assessed the prevalence of HDV in Vietnamese patients, determined the HDV-genotype distribution and compared the findings with the clinical outcome. Methods 266 sera of well-characterized HBsAg-positive patients in Northern Vietnam were analysed for the presence of HDV using newly developed HDV-specific RT-PCRs. Sequencing and phylogenetic analysis were performed for HDV-genotyping. Results The HDV-genome prevalence observed in the Vietnamese HBsAg-positive patients was high with 15.4% while patients with acute hepatitis showed 43.3%. Phylogenetic analysis demonstrated a predominance of HDV-genotype 1 clustering in an Asian clade while HDV-genotype 2 could be also detected. The serum aminotransferase levels (AST, ALT) as well as total and direct bilirubin were significantly elevated in HDV-positive individuals (p<0.05). HDV loads were mainly low (<300 to 4.108 HDV-copies/ml). Of note, higher HDV loads were mainly found in HBV-genotype mix samples in contrast to single HBV-infections. In HBV/HDV-coinfections, HBV loads were significantly higher in HBV-genotype C in comparison to HBV-genotype A samples (p<0.05). Conclusion HDV prevalence is high in Vietnamese individuals, especially in patients with acute hepatitis B. HDV replication activity showed a HBV-genotype dependency and could be associated with elevated liver parameters. Besides serological assays molecular tests are recommended for diagnosis of HDV. Finally, the high prevalence of HBV and HDV prompts the urgent need for HBV-vaccination coverage.
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Affiliation(s)
- Bui Tien Sy
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
- Department of Pathophysiology, Vietnam Military Medical University, Ha Noi, Ha Dong, Viet Nam
| | - Boris A. Ratsch
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, Ha Noi, Ha Dong, Viet Nam
| | - Le Huu Song
- 108 Institute of Clinical Medical and Pharmaceutical Sciences Tran Hung Dao Hospital, Ha Noi, Viet Nam
| | | | - Agnes Bryniok
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Hung Minh Nguyen
- Center of Research and Development, Duy Tan University, da Nang, Viet Nam
| | - Hoang Van Luong
- Department of Pathophysiology, Vietnam Military Medical University, Ha Noi, Ha Dong, Viet Nam
| | | | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Peter G. Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - C.-Thomas Bock
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
- Department of Molecular Pathology, University of Tübingen, Tübingen, Germany
- * E-mail:
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Alvarado-Mora MV, Pinho JRR. Epidemiological update of hepatitis B, C and delta in Latin America. Antivir Ther 2013; 18:429-33. [PMID: 23792375 DOI: 10.3851/imp2595] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2012] [Indexed: 12/12/2022]
Abstract
Viral hepatitis B, C and delta still remain a serious problem in Latin America. Data from the 1980s indicated that HBV and HDV infection are the main causes of chronic hepatitis. However, the spread of HBV infection could be controlled through the implementation of immunization programmes. Different countries from Mexico to Argentina display marked differences in terms of HBV genotype distribution. HBV genotype F has been identified as the most frequent in most Latin America countries, except for Mexico and Brazil, where genotypes H and A are the most frequent, respectively. In Latin America, the overall prevalence of HCV antibody is estimated to be 1.5%. Latin American countries have been very proactive in screening their blood supplies, thus minimizing risk of HCV transmission through transfusion. The number of diagnosed and treated patients is still low, thereby increasing the burden of complications such as liver cirrhosis or hepatocellular carcinoma. The most prevalent HCV genotype is 1, which is the genotype with the greatest worldwide spread, but it is a different genotype from other regions like Africa and Asia. HDV is present worldwide but its distribution pattern is not uniform. HDV was recently detected in novel geographic regions, reinforcing that it is a very serious health threat in under-developed countries. The main prevalence areas are the Mediterranean basin, the Middle East, central and northern Asia, western and central Africa, the Amazonian basin (Brazil, Peru, Venezuela and Colombia) and the Pacific islands. Novel strategies to increase HBV immunization in the Latin American population are needed to warrant thorough coverage in the rural areas.
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Affiliation(s)
- Mónica V Alvarado-Mora
- Laboratory of Tropical Gastroenterology and Hepatology 'João Alves de Queiroz and Castorina Bittencourt Alves', Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
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Alvarado-Mora MV, Locarnini S, Rizzetto M, Pinho JRR. An update on HDV: virology, pathogenesis and treatment. Antivir Ther 2013; 18:541-8. [PMID: 23792471 DOI: 10.3851/imp2598] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2012] [Indexed: 02/06/2023]
Abstract
Hepatitis delta is an inflammatory liver disease caused by infection with HDV. HDV is a single-stranded circular RNA pathogen with a diameter of 36 nm. HDV is classified in the genus Deltavirus and is still awaiting a final taxonomic classification up to the family level. HDV shares similarities with satellite RNA and viroids including a small circular single-stranded RNA with secondary structure that replicates through the 'double rolling circle' mechanism. The HDV RNA genome is capable of self-cleavage through a ribozyme and encodes only one structural protein, the hepatitis delta antigen (HDAg), from the antigenomic RNA. There are two forms of HDAg, a shorter (S; 22 kDa) and a longer (L; 24 kDa) form, the latter generated from an RNA editing mechanism. The S form is essential for viral genomic replication. The L form participates in the assembly and formation of HDV. For complete replication and transmission, HDV requires the hepatitis B surface antigen (HBsAg). Thus, HDV infection only occurs in HBsAg-positive individuals, either as acute coinfection in treatment-naive HBV-infected persons, or as superinfection in patients with pre-existing chronic hepatitis B (CHB). HDV is found throughout the world, but its prevalence, incidence, clinical features and epidemiological characteristics vary by geographic region. There are eight genotypes (1 to 8) distributed over different geographic areas: HDV-1 is distributed worldwide, whereas HDV-2 to 8 are seen more regionally. Levels of HDV viraemia change over the course of HDV infection, being significantly higher in patients with early chronic hepatitis than in cirrhosis. Chronic HDV infection leads to more severe liver disease than chronic HBV monoinfection with an accelerated course of fibrosis progression, an increased risk of hepatocellular carcinoma and early decompensation in the setting of established cirrhosis. Current treatments include pegylated interferon-α and liver transplantation; the latter of which can be curative. Further studies are needed to develop better treatment strategies for this challenging disease.
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Affiliation(s)
- Mónica V Alvarado-Mora
- Laboratory of Tropical Gastroenterology and Hepatology 'João Alves de Queiroz and Castorina Bittencourt Alves', Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
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