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Sant’Anna TBF, Martins TLS, dos Santos Carneiro MA, Teles SA, Caetano KAA, de Araujo NM. First Detection of Hepatitis B Virus Subgenotype A5, and Characterization of Occult Infection and Hepatocellular Carcinoma-Related Mutations in Latin American and African Immigrants in Brazil. Int J Mol Sci 2024; 25:8602. [PMID: 39201291 PMCID: PMC11354843 DOI: 10.3390/ijms25168602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024] Open
Abstract
This study aims to characterize the molecular profile of the hepatitis B virus (HBV) among socially vulnerable immigrants residing in Brazil to investigate the introduction of uncommon HBV strains into the country. Serum samples from 102 immigrants with positive serology for the HBV core antibody (anti-HBc) were tested for the presence of HBV DNA by PCR assays. Among these, 24 were also positive for the HBV surface antigen (HBsAg). The full or partial genome was sequenced to determine genotype by phylogenetic analysis. Participants were from Haiti (79.4%), Guinea-Bissau (11.8%), Venezuela (7.8%), and Colombia (1%). Of the 21 HBV DNA-positive samples, subgenotypes A1 (52.4%), A5 (28.6%), E (9.5%), F2 (4.8%), and F3 (4.8%) were identified. Among the 78 HBsAg-negative participants, four were positive for HBV DNA, resulting in an occult HBV infection rate of 5.1%. Phylogenetic analysis suggested that most strains were likely introduced to Brazil by migration. Importantly, 80% of A5 sequences had the A1762T/G1764A double mutation, linked to an increased risk of hepatocellular carcinoma development. In conclusion, this study is the first report of HBV subgenotype A5 in Brazil, shedding new light on the diversity of HBV strains circulating in the country. Understanding the genetic diversity of HBV in immigrant communities can lead to better prevention and control strategies, benefiting both immigrants and wider society.
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Affiliation(s)
| | | | | | - Sheila Araujo Teles
- Faculty of Nursing, Federal University of Goiás, Goiania 74605-080, Brazil; (T.L.S.M.); (S.A.T.); (K.A.A.C.)
| | | | - Natalia Motta de Araujo
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, Brazil;
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Lago BV, Portilho MM, Mello VM, De Sousa PSF, Angelice GP, Marques BCL, da Silva Andrade LT, Marques VA, Lewis-Ximenez LL, Mello FCDA, Villar LM. Genetic variability of hepatitis B virus in acute and in different phases of chronic infection in Brazil. Sci Rep 2024; 14:10742. [PMID: 38730249 PMCID: PMC11087654 DOI: 10.1038/s41598-024-60900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
The selection pressure imposed by the host immune system impacts on hepatitis B virus (HBV) variability. This study evaluates HBV genetic diversity, nucleos(t)ide analogs resistance and HBsAg escape mutations in HBV patients under distinct selective pressures. One hundred and thirteen individuals in different phases of HBV infection were included: 13 HBeAg-positive chronic infection, 9 HBeAg-positive chronic hepatitis, 47 HBeAg-negative chronic infection (ENI), 29 HBeAg-negative chronic hepatitis (ENH) and 15 acute infected individuals. Samples were PCR amplified, sequenced and genetically analyzed for the overlapping POL/S genes. Most HBV carriers presented genotype A (84/113; 74.3%), subgenotype A1 (67/84; 79.7%), irrespective of group, followed by genotypes D (20/113; 17.7%), F (8/113; 7.1%) and E (1/113; 0.9%). Clinically relevant mutations in polymerase (tL180M/M204V) and in the Major Hydrophilic Region of HBsAg (sY100C, T118A/M, sM133T, sD144A and sG145R) were observed. Our findings, however, indicated that most polymorphic sites were located in the cytosolic loops (CYL1-2) and transmembrane domain 4 (TMD4) of HBsAg. Lower viral loads and higher HBV genetic diversity were observed in ENI and ENH groups (p < 0.001), suggesting that these groups are subjected to a higher selective pressure. Our results provide information on the molecular characteristics of HBV in a diverse clinical setting, and may guide future studies on the balance of HBV quasispecies at different stages of infection.
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Affiliation(s)
- Barbara Vieira Lago
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fiocruz, Rio de Janeiro, Brazil.
| | - Moyra Machado Portilho
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Vinicius Motta Mello
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.
| | - Paulo Sergio Fonseca De Sousa
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Giovana Paula Angelice
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Bianca Cristina Leires Marques
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Larissa Tropiano da Silva Andrade
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Vanessa Alves Marques
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Lia Laura Lewis-Ximenez
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Francisco Campello do Amaral Mello
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Livia Melo Villar
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fiocruz, Hélio and Peggy Pereira Pavillion, Ground Floor, Office B09, FIOCRUZ Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
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Reuter T, Gomes-Gouvea MS, Chuffi S, Duque UH, Perini W, Azevedo RS, Pinho JRR. Core Promoter and Pre-Core Variants of the Hepatitis B Virus (HBV) Are Frequent in Chronic Hepatitis B HBeAg-Negative Patients Infected by Genotypes A and D. Viruses 2023; 15:2339. [PMID: 38140580 PMCID: PMC10746983 DOI: 10.3390/v15122339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/24/2023] Open
Abstract
In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Espírito Santo State in the southeast region. In this study, we intend to characterize the basal core promoter (BCP) and pre-core region (PC) variants and their association with clinical/epidemiological disease patterns in patients infected with genotypes A and D. The study included 116 chronic hepatitis B patients from Espírito Santo State, Southeast Brazil, infected with genotypes A and D. Basal core promoter (BCP) and pre-core mutations were analyzed in these patients. The frequency of BCP and PC mutations was compared with age, HBeAg status, HBV genotype and subgenotype, HBV-DNA level, clinical classification, and transmission route. HBeAg-negative status was found in 101 (87.1%) patients: 87 (75.0%) were infected with genotype A (A1 = 85; A2 = 2) and 29 (25.0%) were infected with genotype D (D3 = 24; D4 = 3; D2 = 2). BCP + PC variants altogether were more frequent (48.1%) in genotype D than in genotype A strains (6.0%) (p < 0.001). When this evaluation was performed considering the cases that presented only the A1762T and/or G1764A (BCP) mutations, it was observed that the frequency was higher in genotype A (67.5%) compared to genotype D (7.4%) (p < 0.001). On the other hand, considering the samples with mutations only in positions G1896A and/or G1899A (PC), the frequency was higher in genotype D (75.8%) than in genotype A (6.9%) (p < 0.001). Interestingly, HBV DNA was lower than 2000 IU/mL especially when both BCP/PC mutations were present (p < 0.001) or when only PC mutations were detected (p = 0.047), reinforcing their role in viral replication.
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Affiliation(s)
- Tania Reuter
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Michele Soares Gomes-Gouvea
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Samira Chuffi
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
| | - Ulisses Horst Duque
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
| | - Waltesia Perini
- Internal Medicine Department, Health Science Center, University Hospital Cassiano Antônio de Moraes, Federal University of Espirito Santo, Vitória 29041-295, ES, Brazil; (U.H.D.); (W.P.)
| | - Raymundo Soares Azevedo
- Department of Pathology, School of Medicine, University of Sao Paulo, São Paulo 01246-903, SP, Brazil;
| | - João Renato Rebello Pinho
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, São Paulo 05403-907, SP, Brazil; (M.S.G.-G.); (S.C.); (J.R.R.P.)
- Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
- LIM-03, Central Laboratories Division, Clinics Hospital, School of Medicine, University of Sao Paulo, São Paulo 05403-000, SP, Brazil
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4
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do Lago BV, Bezerra CS, Moreira DA, Parente TE, Portilho MM, Pessôa R, Sanabani SS, Villar LM. Genetic diversity of hepatitis B virus quasispecies in different biological compartments reveals distinct genotypes. Sci Rep 2023; 13:17023. [PMID: 37813888 PMCID: PMC10562391 DOI: 10.1038/s41598-023-43655-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023] Open
Abstract
The selection pressure imposed by the host immune system impacts hepatitis B virus (HBV) quasispecies variability. This study evaluates HBV genetic diversity in different biological fluids. Twenty paired serum, oral fluid, and DBS samples from chronic HBV carriers were analyzed using both Sanger and next generation sequencing (NGS). The mean HBV viral load in serum was 5.19 ± 4.3 log IU/mL (median 5.29, IQR 3.01-7.93). Genotype distribution was: HBV/A1 55% (11/20), A2 15% (3/20), D3 10% (2/20), F2 15% (3/20), and F4 5% (1/20). Genotype agreement between serum and oral fluid was 100% (genetic distances 0.0-0.006), while that between serum and DBS was 80% (genetic distances 0.0-0.115). Two individuals presented discordant genotypes in serum and DBS. Minor population analysis revealed a mixed population. All samples displayed mutations in polymerase and/or surface genes. Major population analysis of the polymerase pointed to positions H122 and M129 as the most polymorphic (≥ 75% variability), followed by V163 (55%) and I253 (50%). Neither Sanger nor NGS detected any antiviral primary resistance mutations in the major populations. Minor population analysis, however, demonstrated the rtM204I resistance mutation in all individuals, ranging from 2.8 to 7.5% in serum, 2.5 to 6.3% in oral fluid, and 3.6 to 7.2% in DBS. This study demonstrated that different fluids can be used to assess HBV diversity, nonetheless, genotypic differences according to biological compartments can be observed.
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Affiliation(s)
- Bárbara Vieira do Lago
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Cristianne Sousa Bezerra
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Educação, Instituto Federal de Educação, Ciência e Tecnologia do Ceará, Fortaleza, Ceará, Brazil
| | - Daniel Andrade Moreira
- Laboratório de Genômica Aplicada e Bioinovações, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Thiago Estevam Parente
- Laboratório de Genômica Aplicada e Bioinovações, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Rodrigo Pessôa
- Postgraduate Program in Translational Medicine, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
| | - Sabri Saeed Sanabani
- Laboratory of Medical Investigation (LIM) 03, Clinics Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Livia Melo Villar
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
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5
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Hoogeveen RC, Dijkstra S, Bartsch LM, Drescher HK, Aneja J, Robidoux MP, Cheney JA, Timm J, Gehring A, de Sousa PSF, Ximenez L, Peliganga LB, Pitts A, Evans FB, Boonstra A, Kim AY, Lewis-Ximenez LL, Lauer GM. Hepatitis B virus-specific CD4 T cell responses differentiate functional cure from chronic surface antigen + infection. J Hepatol 2022; 77:1276-1286. [PMID: 35716846 DOI: 10.1016/j.jhep.2022.05.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/12/2022] [Accepted: 05/25/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND & AIMS With or without antiviral treatment, few individuals achieve sustained functional cure of chronic hepatitis B virus (HBV) infection. A better definition of what mediates functional cure is essential for improving immunotherapeutic strategies. We aimed to compare HBV-specific T cell responses in patients with different degrees of viral control. METHODS We obtained blood from 124 HBV-infected individuals, including those with acute self-limiting HBV infection, chronic infection, and chronic infection with functional cure. We screened for HBV-specific T cell specificities by ELISpot, assessed the function of HBV-specific T cells using intracellular cytokine staining, and characterized HBV-specific CD4 T cells using human leukocyte antigen (HLA) class II tetramer staining, all directly ex vivo. RESULTS ELISpot screening readily identified HBV-specific CD4 and CD8 T cell responses in acute resolving infection compared with more limited reactivity in chronic infection. Applying more sensitive assays revealed higher frequencies of functional HBV-specific CD4 T cells, but not CD8 T cells, in functional cure compared to chronic infection. Function independent analysis using HLA multimers also identified more HBV-specific CD4 T cell responses in functional cure compared to chronic infection, with the emergence of CD4 T cell memory both after acute and chronic infection. CONCLUSIONS Functional cure is associated with higher frequencies of functional HBV-specific CD4 memory T cell responses. Thus, immunotherapeutic approaches designed to induce HBV functional cure should also aim to improve CD4 T cell responses. LAY SUMMARY Immunotherapy is a form of treatment that relies on harnessing the power of an individual's immune system to target a specific disease or pathogen. Such approaches are being developed for patients with chronic HBV infection, in an attempt to mimic the immune response in patients who control HBV infection spontaneously, achieving a so-called functional cure. However, what exactly defines protective immune responses remains unclear. Herein, we show that functional cure is associated with robust responses by HBV-specific CD4 T cells (a type of immune cell).
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Affiliation(s)
- Ruben C Hoogeveen
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Suzan Dijkstra
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Lea M Bartsch
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Hannah K Drescher
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Jasneet Aneja
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Maxwell P Robidoux
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - James A Cheney
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Joerg Timm
- Institute of Virology, Heinrich Heine University, University Hospital, Düsseldorf, Germany
| | - Adam Gehring
- Toronto Centre for Liver Disease, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | | | - Lya Ximenez
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luis Baiao Peliganga
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; Faculdade de Medicina da Universidade Agostinho Neto, Luanda, Angola; Ministério da Saúde de Angola, Luanda, Angola
| | - Anita Pitts
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Fiona B Evans
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - André Boonstra
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Arthur Y Kim
- Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | | | - Georg M Lauer
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
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6
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Roca TP, Villar LM, Nogueira Lima FS, Vasconcelos MPA, Borzacov LMP, Silva EDCE, do Lago BV, da Silva MTL, Botelho Souza LF, Salcedo JMV, dos Santos ADO, Vieira DS. Genomic Variability of Hepatitis B Virus Circulating in Brazilian Western Amazon. Viruses 2022; 14:v14102100. [PMID: 36298655 PMCID: PMC9611064 DOI: 10.3390/v14102100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022] Open
Abstract
The emergence of clinically relevant mutations in the hepatitis B virus (HBV) genome has been a matter of great debate because of the possibility of escape from the host’s immune system, the potential to cause more severe progression of liver diseases and the emergence of treatment-resistant variants. Here we characterized the circulating variants of HBV in Rondônia State, in the north of Brazil. Serum samples of 62 chronic HBV carriers were subjected to PCR assays and clinical data were collected. Mutations and genotypes were characterized through direct sequencing. The findings show the presence of subgenotypes A1 (54.83%, 34/62), D3 (16.13%, 10/62), F2 (16.13%, 10/62), A2 (4.84%, 3/62), D2 (3.23%, 2/62), D1 (1.61%, 1/62), D4 (1.61%, 1/62) and F4 (1.61%, 1/62). Deletions in the pre-S2 region were found in 13.79% (8/58) of the samples, mutations in the S gene in 59.68% (37/62) and RT mutations in 48.39% (30/62). We found a variable genotypic distribution in different locations and important mutations related to immune escape and drug resistance in Western Amazonia, which contributed to genetic surveillance and provided important information to help control the disease.
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Affiliation(s)
- Tárcio Peixoto Roca
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, Brazil
- Laboratory of Molecular Virology, Oswaldo Cruz Foundation of Rondônia—FIOCRUZ/RO, Porto Velho 76812-245, Brazil
- Correspondence: (T.P.R.); (L.M.V.)
| | - Livia Melo Villar
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, Brazil
- Correspondence: (T.P.R.); (L.M.V.)
| | - Felipe Souza Nogueira Lima
- Laboratory of Molecular Virology, Oswaldo Cruz Foundation of Rondônia—FIOCRUZ/RO, Porto Velho 76812-245, Brazil
| | | | | | | | - Bárbara Vieira do Lago
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, Brazil
| | - Mayara Torquato Lima da Silva
- Laboratory of Biotechnology and Structural Bioengineering, Biophysics Institute Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | | | - Juan Miguel Villalobos Salcedo
- Laboratory of Molecular Virology, Oswaldo Cruz Foundation of Rondônia—FIOCRUZ/RO, Porto Velho 76812-245, Brazil
- Tropical Medicine Research Center of Rondônia—CEPEM/RO, Porto Velho 76812-329, Brazil
| | | | - Deusilene Souza Vieira
- Laboratory of Molecular Virology, Oswaldo Cruz Foundation of Rondônia—FIOCRUZ/RO, Porto Velho 76812-245, Brazil
- Tropical Medicine Research Center of Rondônia—CEPEM/RO, Porto Velho 76812-329, Brazil
- Postgraduate Program in Experimental Biology, Federal University of Rondônia—PGBIOEXP/UNIR, Porto Velho 76801-059, Brazil
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7
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Santos Alves FAGD, Nogueira Lima FDS, Ribeiro JR, Roca TP, Santos ADOD, Botelho Souza LF, Villalobos-Salcedo JM, Vieira DS. Genetic diversity of HBV in indigenous populations on the border between Brazil and Bolivia. Braz J Infect Dis 2022; 26:102700. [PMID: 36088957 PMCID: PMC9513627 DOI: 10.1016/j.bjid.2022.102700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 02/07/2023] Open
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8
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The unexpected high prevalence of HBV subgenotype D4 in patients with chronic hepatitis B in Galicia, a northwestern Spanish region, reflects strong links with Latin America. J Clin Virol 2022; 153:105195. [PMID: 35661583 DOI: 10.1016/j.jcv.2022.105195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/09/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) comprises 9 genotypes and multiple subgenotypes that depict differences in geographic distribution, clinical outcome and response to antiviral therapy. However, the molecular epidemiology of HBV geno/subgenotypes is globally scarce. In Spain, HBV genotype D seems to be more prevalent in the northwestern regions compared to the rest of the country for unclear reasons. METHODS HBV genotyping was performed using geno2pheno on a S gene fragment amplified from plasma collected from all chronic hepatitis B individuals attended at one reference hospital in Santiago de Compostela, the Galicia's capital town. Phylogenetic and phylogeographic analyses using a fragment of 345 bp were performed in all viremic specimens. To avoid misleading allocation as consequence of short fragment analysis, several bioinformatic controls were used. RESULTS A total of 320 individuals with persistent serum HBsAg+ and detectable HBV-DNA were seen between 2000 and 2016 (male 68.4%; median age, 52 years-old; native Spaniards 83.8%). HBV genotype distribution was as follows: A 15.3%; B 1.6%; C 2.5%; D 71.6%; E 3.1%; F 2.2%; G 3.1%; and H 0.6%. HBV genotype D was mostly represented by D4 and D2 subgenotypes (33.4% and 15% of total, respectively). Compared to chronic hepatitis B patients with genotypes B, C, E and G, HBV-D4 carriers tended to be older (54.2% had >50 years-old) and HBeAg-negative (85%). Moreover, 43% were female, 4.7% had cirrhosis, 10.2% hepatitis C and 6.4% HIV coinfection. Phylogenetic analyses could be performed on 82 HBV-D4 specimens; and 79 were confirmed as HBV-D4 using PhyML. Phylogeography using FasTree suggested at least two distinct introductions of HBV-D4 in Galicia, one from the Caribbean and South America, and another from India. CONCLUSIONS HBV subgenotype D4 is the most prevalent HBV variant in chronic hepatitis B patients living in the northwest of Spain, representing 33.4% (107/320) of all chronic hepatitis B infections. This rate of HBV-D4 is among the highest reported worldwide. Epidemiological and phylogenetic analyses suggest a strong association with historical migrant exchanges with Latin America, and especially with the Caribbean basin.
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9
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Demarchi LHF, Bandeira LM, Taira DL, Zardin MCSU, Ibanhes ML, Esposito AOP, de Arruda LDC, Gonçalves CCM, Weis-Torres SMDS, Cesar GA, da Cunha RV, Tanaka TSO, Puga MAM, de Rezende GR, Lopes RB, Uehara SNDO, Pinho JRR, Carrilho FJ, Gomes-Gouvêa MS, Motta-Castro ARC. Hepatitis B Virus Infection among Japanese Immigrants and Descendants: The Need to Strengthen Preventive and Control Measures. Viruses 2022; 14:v14051085. [PMID: 35632826 PMCID: PMC9145874 DOI: 10.3390/v14051085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/01/2023] Open
Abstract
This cross-sectional study aimed to investigate the prevalence and risk factors of Hepatitis B virus infection among Japanese immigrants and their descendants from São Paulo (SP), and to verify the occurrence of occult hepatitis B and coinfection with HCV, Delta, and HTLV. All samples (n = 2.127) were tested for HBV serological markers by electrochemiluminescence. HBsAg and/or total anti-HBc positive samples were tested for HBV DNA by real-time PCR, and genotyped by sequencing using the Sanger methodology. The prevalence rate of HBV exposure was 13.4% (CI 95%: 11.9–14.9%), and 22 (1.1%) were HBsAg positive. A high rate of susceptibility to HBV infection was found (67.4%; CI 95%: 65.4–69.4%). In contrast, only 19.2% (CI 95%: 17.6–20.9%) presented a serological profile analogous to that elicited by Hepatitis B vaccination. HBV isolates (n = 8) were classified as genotypes HBV/B1 (62.5%), HBV/C2 (12.5%), HBV/F1b (12.5%), and HBV/A1 (12.5%). Hepatitis B vaccination strategies and educational measures to control this infection should be considered.
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Affiliation(s)
- Luiz Henrique Ferraz Demarchi
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
| | - Larissa Melo Bandeira
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
| | - Deborah Ledesma Taira
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Marina Castilhos Souza Umaki Zardin
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Mary Luizia Ibanhes
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Ana Olivia Pascoto Esposito
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | | | | | - Sabrina Moreira dos Santos Weis-Torres
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Gabriela Alves Cesar
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | | | - Tayana Serpa Ortiz Tanaka
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Marco Antonio Moreira Puga
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Grazielli Rocha de Rezende
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Roberta Barbosa Lopes
- Secretaria Nacional de Vigilância em Saúde SVS, Ministério da Saúde, Brasília, Distrito Federal 70740-610, Brazil;
| | - Silvia Naomi de Oliveira Uehara
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - João Renato Rebello Pinho
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Flair Jose Carrilho
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Michele Soares Gomes-Gouvêa
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Ana Rita Coimbra Motta-Castro
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz, Campo Grande 79081-746, Brazil
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
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10
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Villar LM, Fraga KA, Mendonça ACDF, Miguel JC, Silva EFD, Barbosa JR, Sousa PSFD, Lewis-Ximenez LL, Mello FCDA. Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio de Janeiro, Brazil. Braz J Infect Dis 2022; 26:102371. [PMID: 35661641 PMCID: PMC9387460 DOI: 10.1016/j.bjid.2022.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/03/2022] [Accepted: 05/18/2022] [Indexed: 10/28/2022] Open
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11
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Bezerra CS, Portilho MM, Barbosa JR, de Azevedo CP, Mendonça ACDF, da Cruz JNM, Frota CC, do Lago BV, Villar LM. Dried blood spot sampling for hepatitis B virus quantification, sequencing and mutation detection. Sci Rep 2022; 12:1651. [PMID: 35102169 PMCID: PMC8803841 DOI: 10.1038/s41598-022-05264-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/10/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) diagnosis is performed on serum samples, but the access to this diagnosis is difficult in low-income regions. The use of dried blood spot (DBS) samples does not require special structure for collection, storage or transport. This study evaluates the use of DBS for detection, quantification and sequencing of HBV DNA using in-house techniques. Two study groups were included: 92 HBsAg + individuals and 49 negative controls. Serum and DBS samples were submitted to quantitative and qualitative in-house PCR for S/pol genes, sequencing and phylogenetic analyses. Total of 84 serum samples were successfully amplified. Of them, 63 paired DBS were also positive in qualitative PCR. Qualitative PCR in DBS presented a sensitivity of 75% and specificity of 100% (Kappa = 0.689). Quantitative PCR in DBS presented a detection limit of 852.5 copies/mL (250 IU/mL), sensitivity of 77.63% and specificity of 100% (Kappa = 0.731). A total of 63 serum samples and 36 DBS samples were submitted to sequencing, revealing the circulation of genotypes A (65.08%), D (4.8%), E (3.2%) and F (27%) with 100% of correspondence between serum and DBS. All sequenced samples displayed polymorphisms in HBsAg gene. An HIV-coinfected patient presented the rtM204V/I-rtL180M double resistance mutation in serum and DBS. In conclusion, DBS is an alternative to detect, quantify and characterize HBV DNA, being a possibility of increasing diagnosis in low-income settings, closing gaps in HBV control.
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12
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Reuter TQ, Gomes-Gouvea M, Chuffi S, Duque UH, Carvalho JA, Perini W, Queiroz MM, Segal IM, Azevedo RS, Pinho JRR. Hepatitis B virus genotypes and subgenotypes and the natural history and epidemiology of hepatitis B. Ann Hepatol 2022; 27 Suppl 1:100574. [PMID: 34743021 DOI: 10.1016/j.aohep.2021.100574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Espírito Santo state is considered a region with a higher frequency of hepatitis B virus infection. This study characterized demographic, epidemiological, laboratory, virological and clinical aspects of 587 chronic HBV carriers followed up at the University of Espírito Santo Hospital. MATERIALS AND METHODS Demographic, epidemiological, laboratory and clinical data were extracted from medical records during the entire follow-up period. Classification of the evolutionary phases of chronic hepatitis B was defined as immunotolerant; inactive carrier; chronic active hepatitis HBeAg (+) and HBeAg (-). Characterization of HBV genotypes/subgenotypes was performed by sequencing of overlapping surface antigens and HBV DNA polymerase genes. Phylogenetic relationships were determined using BEAST 1.8.3 software. RESULTS and Conclusions: Genotypes found were A (132/65.3%) [A1 = 129 (63.9%) and A2 = 3 (1.5%)], D (66/32.7%) [D3 = 56 (27.7%), D4 = 8 (4.0%) and D2 = 2 (1.0%)] and F (4/2.0%) - all F2a. Subgenotypes A1 or D3 were not associated with age, sex, HIV/HCV co-infection, viral load, antiviral usage, HBeAg status or clinical stages of chronic hepatitis B. Mother -to-child-transmission (MTCT) was associated with the subgenotype A1 and intrafamilial transmission with subgenotype D3. Subgenotype A1 was more frequent than D3 among individuals born outside ES compared to those born in ES. CONCLUSIONS The most predominant clinical phases were HBeAg (-), inactive carrier and chronic active hepatitis HBeAg (-). Subgenotypes A1 and D3 were most frequent and were associated were MTCT and intrafamilial transmission of HBV, respectively.
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Affiliation(s)
- Tania Queiroz Reuter
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil; Infectology Service, Department of Internal Medicine, Cassiano Antônio de Moraes University Hospital, Federal University of Espírito Santo, Vitória, Brazil
| | - Michele Gomes-Gouvea
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Samira Chuffi
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Ulisses Horst Duque
- Infectology Service, Department of Internal Medicine, Cassiano Antônio de Moraes University Hospital, Federal University of Espírito Santo, Vitória, Brazil
| | - José Americo Carvalho
- Infectology Service, Department of Internal Medicine, Cassiano Antônio de Moraes University Hospital, Federal University of Espírito Santo, Vitória, Brazil
| | - Waltesia Perini
- Infectology Service, Department of Internal Medicine, Cassiano Antônio de Moraes University Hospital, Federal University of Espírito Santo, Vitória, Brazil
| | | | - Ingrid Marques Segal
- Infectology Service, Department of Internal Medicine, Cassiano Antônio de Moraes University Hospital, Federal University of Espírito Santo, Vitória, Brazil
| | | | - João Renato Rebello Pinho
- LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil; LIM-03, Central Laboratories Division, Clinics Hospital, São Paulo School of Medicine, University of São Paulo, SãoPaulo, Brazil.
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13
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MacDonald-Ottevanger MS, Boyd A, Prins M, van der Helm JJ, Zijlmans CWR, Hindori-Mohangoo AD, Harkisoen S, Hermelijn SM, Brinkman K, Codrington J, Roosblad J, Kort SAR, Dams ETM, van de Laar TJW, Vreden SGS. Differences in prevalence of hepatitis B virus infection and genotypes between ethnic populations in Suriname, South America. Virology 2021; 564:53-61. [PMID: 34656809 DOI: 10.1016/j.virol.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.
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Affiliation(s)
- M S MacDonald-Ottevanger
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname; Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - A Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Stichting HIV Monitoring, Amsterdam, the Netherlands
| | - M Prins
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - J J van der Helm
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - C W R Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - A D Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - S Harkisoen
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname
| | - S M Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Suriname
| | - K Brinkman
- Department of Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - J Codrington
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | - J Roosblad
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | | | - E Th M Dams
- Department of Internal Medicine, Diakonessenhuis, Paramaribo, Suriname
| | - T J W van de Laar
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Sanquin Research, Department of Donor Medicine Research, Amsterdam, the Netherlands
| | - S G S Vreden
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname; Foundation for Scientific Research Suriname, Paramaribo, Suriname
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14
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Ribeiro CRDA, Beghini DG, Lemos AS, Martinelli KG, de Mello VDM, de Almeida NAA, Lewis-Ximenez LL, de Paula VS. Cytokines profile in patients with acute and chronic hepatitis B infection. Microbiol Immunol 2021; 66:31-39. [PMID: 34647645 DOI: 10.1111/1348-0421.12947] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/13/2021] [Accepted: 10/03/2021] [Indexed: 12/13/2022]
Abstract
Hepatitis B virus (HBV) is one of the leading causes of acute and chronic hepatitis and represents a serious public health threat. Cytokines are important chemical mediators that regulate the differentiation, proliferation, and function of immune cells, with accumulating evidence indicating that the inadequate immune responses are responsible for the elimination or persistence of HBV. This study aimed to determine the cytokine profiles (IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, and IL-17A) during HBV infection and investigate their association with genotypes. A total of 66 plasma samples, 19 from patients with acute and 47 with chronic hepatitis B infection, were subjected to biochemical tests, nested-PCR, and real-time PCR, with cytokines evaluated using a commercial BD Cytometric Bead Array Human Th1/Th2/Th17 Cytokine Kit. Healthy controls (10 individuals) were selected from blood donors with no history of liver diseases. No correlation was found between genotypes, viral load, and cytokines analyzed. All cytokines showed higher levels of production among infected individuals when compared with the control group. A positive correlation classified as moderate to strong was found between cytokines IFN-γ, TNF, IL-10, IL-6, IL-4, and IL-2 through the Spearman correlation coefficient. TNF (P = 0.009), IL-10 (P < 0.001), and IL-6 (P < 0.001) levels were higher in acute individuals compared with chronic and control groups. Theses cytokines could be involved in the elimination of virus and protection against chronicity.
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Affiliation(s)
| | - Daniela Gois Beghini
- Laboratory of Innovations in Therapies, Teaching and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Andreza Salvio Lemos
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Lia Laura Lewis-Ximenez
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vanessa Salete de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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15
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Cruz JNMD, Villar LM, Mello FCDA, Lampe E, Hyppolito EB, Lima JMDC, Hyppolito SB, Pires Neto RDJ, Nicolete LDDF, Coelho ICB. Hepatitis B virus genotypes prevalence in patients from hepatology services in Ceará, Brazil. Rev Soc Bras Med Trop 2021; 54:e08072020. [PMID: 34495262 PMCID: PMC8437444 DOI: 10.1590/0037-8682-0807-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Hepatitis B virus (HBV) infection is a public health problem; therefore, we aimed to report HBV genotypes in Ceará, Brazil. METHODS A total of 103 HBsAg-positive samples were subjected to HBV genotyping and subgenotyping. RESULTS The following genetic compositions of samples were found: F-54% (F2-83.33%), A-40% (A1-65%), D-6%, C2-1%, E-1%, and G-1%. CONCLUSIONS Some genotypes are only prevalent in certain parts of the world; however, the State of Ceará is a hub for migration and has one of the most important liver transplantation centers in Brazil, which can explain the prevalence of the F genotype.
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Affiliation(s)
- José Napoleão Monte Da Cruz
- Universidade Federal do Ceará, Departamento de Patologia, Programa de Pós-Graduação em Patologia, Fortaleza, CE, Brasil
| | - Lívia Melo Villar
- Fundação Oswaldo Cruz, Laboratório de Hepatites Virais, Rio de Janeiro, RJ, Brasil
| | | | - Elisabeth Lampe
- Fundação Oswaldo Cruz, Laboratório de Hepatites Virais, Rio de Janeiro, RJ, Brasil
| | | | | | - Silvia Bomfim Hyppolito
- Universidade Federal do Ceará, Maternidade Escola Assis Chateaubriant, Fortaleza, CE, Brasil
| | - Roberto Da Justa Pires Neto
- Hospital São José, Fortaleza, CE, Brasil.,Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil
| | | | - Ivo Castelo Branco Coelho
- Universidade Federal do Ceará, Departamento de Patologia, Programa de Pós-Graduação em Patologia, Fortaleza, CE, Brasil
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16
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Wolf JM, Pereira VRZB, Simon D, Lunge VR. Temporal and geographic spreading of hepatitis B virus genotype A (HBV-A) in Brazil and the Americas. J Viral Hepat 2021; 28:1130-1140. [PMID: 33932242 DOI: 10.1111/jvh.13527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/17/2021] [Indexed: 12/27/2022]
Abstract
Hepatitis B virus genotype A (HBV-A) is disseminated in different countries around the world. It presents a high genetic diversity and is classified into seven subgenotypes (A1-A7). HBV-A1 and HBV-A2 are the most frequent and spread in almost all American countries. This study aimed to evaluate the molecular epidemiology of these two subgenotypes, with a special focus on the temporal and geographic spreading in the Americas and Brazil. Bayesian coalescent analyses with HBV-A1 and HBV-A2 whole-genome sequences were performed to study viral phylodynamic and phylogeography. HBV-A1 evolutionary history demonstrated that it was initially disseminated from Africa to other continents probably after the 1400s and mainly in the 17th-18th centuries. The whole viral population grew between the 1700s-1900s and then reached a stationary phase. In Brazil, HBV-A1 common ancestors dated back to the 1600s with successive introductions between the 17th-18th centuries. In contrast, HBV-A2 spread from Europe to other continents after the 1800s, with an increase in the viral population over decades. It was introduced in the 20th century in America and between the 1950s-1970s in Brazil, presenting a high increase in the viral population from the 1970s to the 1980s. The circulation continents for HBV-A1 are Africa and America, while for HBV-A2 are Europe and America. HBV-A is one of the predominant genotypes in America (including Brazil) because of the early introduction by human migration processes of the subgenotypes A1 and A2 between the 16th and 20th centuries and the continuous spreading inside the continent over time.
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Affiliation(s)
- Jonas Michel Wolf
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil, ULBRA, Canoas, Brazil.,Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Brazil
| | | | - Daniel Simon
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil, ULBRA, Canoas, Brazil.,Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Brazil
| | - Vagner Ricardo Lunge
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil, ULBRA, Canoas, Brazil.,Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Brazil
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17
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Portilho MM, Bezerra CS, Mendonça ACDF, Marques VA, Nabuco LC, Villela-Nogueira CA, Ivantes CAP, Lewis-Ximenez LL, do Lago BV, Villar LM. Applicability of oral fluid samples for tracking hepatitis B virus mutations, genotyping, and phylogenetic analysis. Arch Virol 2021; 166:2435-2442. [PMID: 34146173 DOI: 10.1007/s00705-021-05122-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the usefulness of saliva samples for hepatitis B virus (HBV) genotyping and mutation analysis. The aim of this study was to evaluate the usefulness of oral fluid samples to determine HBV genotype distribution, S/polymerase mutations, and HBV subpopulation diversity among chronically HBV-infected individuals. Serum and oral fluid samples were obtained from 18 individuals for PCR and nucleotide sequencing of the HBV surface antigen gene. Biochemical analysis of liver enzymes (ALT, AST, GGT) and HBV, HCV, and HIV serological tests were also performed. All serum samples were HBsAg (+), anti-HBc (+), and anti-HBs (-); 55.6% were HBeAg (+)/anti-HBe (-), and 11.1% were anti-HIV (+). The mean HBV DNA viral load was 6.1 ± 2.3 log IU/mL. The HBV genotype distribution was as follows: A, 72.2%; D, 11.1%; E, 5.6%; F, 11.1%. A concordance of 100% in genotype classification and 99.8% in sequence similarity between paired oral fluid and serum samples was observed. HBsAg mutations were detected in all samples, but no resistance mutations were found in the polymerase gene. This study demonstrates that oral fluid samples can be used reliably for tracking HBV mutations, genotyping, and phylogenetic analysis. This could be important for molecular epidemiology studies with hard-to-reach populations.
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Affiliation(s)
- Moyra Machado Portilho
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.,Gonçalo Moniz Research Institute, FIOCRUZ, Salvador, BA, Brazil
| | - Cristianne Sousa Bezerra
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.,Federal Institute of Education, Science and Technology, Fortaleza, CE, Brazil
| | - Ana Carolina da Fonseca Mendonça
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Vanessa Alves Marques
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Leticia Cancella Nabuco
- Clementino Fraga Filho Hospital, University of Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
| | | | | | - Lia Laura Lewis-Ximenez
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil
| | - Bárbara Vieira do Lago
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.,Immunobiological Technology Institute (Bio-Manguinhos), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Livia Melo Villar
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Helio and Peggy, Ground Floor, Room B09, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 210360-040, Brazil.
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Delfino CM, Giorgio M, García G, Puch SS, Outon E, Mathet VL. Drug-resistant and immune-escape hepatitis B virus mutants, occult hepatitis B infection and coinfections in public hospital patients from Argentina. Virus Genes 2021; 57:327-337. [PMID: 34091827 DOI: 10.1007/s11262-021-01850-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/24/2021] [Indexed: 01/02/2023]
Abstract
Argentina exhibits low serological prevalence for Hepatitis B virus (HBV); however, occult hepatitis B infection (OBI) has been reported in blood donors, Amerindians and individuals coinfected with hepatitis C virus (HCV), and/or human immunodeficiency virus (HIV). The aim of this study was to analyze the genetic diversity of HBV and to evaluate serological marker associations and coinfections with HCV and HIV in patients attending and treated in a public hospital in the province of Buenos Aires, Argentina. A total of 189 HBV reactive samples (HBsAg and/or anti-HBc) were analyzed for HBV DNA characterization. All reactive samples were tested for anti-HCV and HIV-antigen/antibody using CMIA assays. Thirty-six samples exhibited detectable HBV DNA, 7 of which were OBI. HBV sequences were classified as subgenotypes A1, A2, B2, D3, F1b, F3 and F4. Mutations related to the ability to escape the host's immune response, resistance to antiviral therapy and progression to disease were found in patients, partly due to the variable sensitivity of HBsAg, the reverse transcriptase, the basal core promoter and the preCore. HCV and HIV prevalence was 10% and most of the genotypes found in the sequences were genotype 1 and B/F recombinant subtype, respectively. Of the total samples analyzed, 7 exhibited coinfections. This study shows the frequency of OBI, subgenotype distribution, HBV mutations and coinfections, which may have important clinical implications in public hospital patients. Planned prevention, detection and treatment adherence are needed to reduce transmission and morbidity in vulnerable populations.
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Affiliation(s)
- Cecilia María Delfino
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) - Universidad de Buenos Aires (UBA), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), Paraguay 2155 P11 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina.
| | - Marianela Giorgio
- Laboratorio de Virología, Hospital Interzonal General de Agudos "Dr. Pedro Fiorito", Avellaneda, Buenos Aires, Argentina
| | - Gabriela García
- Laboratorio de Virología, Hospital Interzonal General de Agudos "Dr. Pedro Fiorito", Avellaneda, Buenos Aires, Argentina
| | - Silvia Sánchez Puch
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) - Universidad de Buenos Aires (UBA), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), Paraguay 2155 P11 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina
| | - Estela Outon
- Laboratorio de Virología, Hospital Interzonal General de Agudos "Dr. Pedro Fiorito", Avellaneda, Buenos Aires, Argentina
| | - Verónica Lidia Mathet
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) - Universidad de Buenos Aires (UBA), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), Paraguay 2155 P11 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina
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19
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Hepatitis B virus genotypes in Brazil: Introduction and dissemination. INFECTION GENETICS AND EVOLUTION 2021; 93:104936. [PMID: 34023512 DOI: 10.1016/j.meegid.2021.104936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022]
Abstract
Hepatitis B is a viral infectious disease highly spread worldwide with a long evolutionary history associated with human migrations through the continents and countries. Hepatitis B virus (HBV) was disseminated probably from Africa and diverged into ten genotypes (HBV-A to HBV-J) distributed around the world. In Brazil, almost all HBV genotypes were already reported, with a predominance of three ones: A (52.1%), D (36.8%), and F (7.7%). This review aimed to evaluate the introduction and dissemination of the main HBV genotypes and subgenotypes in Brazil over the last centuries to explain the current epidemic scenario. The highest frequency of HBV-A is a consequence of the introduction and spreading of HBV-A1 in the 16th to 19th centuries due to the African slave trade, but the more recent introduction of HBV-A2 from Europe also contributed to the current situation. HBV-D is the second most frequent genotype because it was consecutively introduced by migrations from Europe (mainly subgenotype D3, but also D2) and the Middle East (D1) in the 19th to 20th centuries. On contrary, HBV-F (F1a, F1b, F2a, F2b, F3, and F4) was disseminated by the Amerindians in all South American countries, including Brazil, by migrations inside the continent for more than three centuries ago. Other HBV genotypes are rare and eventually frequent in some human groups because of the dissemination by very specific epidemiological routes. In conclusion, the current scenario of the HBV epidemics is a consequence of the introduction and dissemination of some subgenotypes from the three main genotypes A, D, and F over the last five centuries.
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Ribeiro CRDA, Martinelli KG, de Mello VDM, Baptista BDS, Dias NST, Paiva IA, Lewis-Ximenez LL, Pinto LMDO, de Paula VS. Cytokine, Genotype, and Viral Load Profile in the Acute and Chronic Hepatitis B. Viral Immunol 2020; 33:620-627. [PMID: 33090087 DOI: 10.1089/vim.2020.0176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Several hepatitis B virus (HBV) factors, including viral load, genotype, genome mutations, and cytokine production, have been reported to be associated with different risks of progression of liver disease. The aim of this study was to verify if there is an association among the levels of cytokines (interleukin [IL]-35, IL-6, IL-17A, interferon [IFN]-γ) in the plasma, viral load, and the different genotypes of HBV in patients with acute or chronic hepatitis B. Methods: 49 serum samples, 20 from acute and 29 from chronic cases, were submitted to a real-time and nested-polymerase chain reaction to quantify, detect, and genotype HBV DNA. The cytokines IL-35, IL-6, IL-17A, and IFN-γ were detected by an enzyme-linked immunosorbent assay (ELISA). The median viral load was 3.15 log10 IU DNA/mL and 2.90 log10 IU DNA/mL for acute and chronic patients, respectively. Genotype A, D, E, and F were identified in chronic carriers of HBV infection, while only genotype A and F were identified in individuals with acute infection. IFN-γ (p = 0.024) and IL-17A (p = 0.046) levels were significantly increased in chronic patients and IL-6 and IL-35 were higher in patients with acute infection, however, without statistical difference. IL-17A and IFN-γ can be modulating proinflammatory effects and inducing hepatocellular damage, in chronic patients, and IL-6 and IL-35 may be involved in viral elimination and protection against chronicity during the acute phase of infection. These results can contribute to understanding of the complex regulatory mechanisms of the host antiviral response related to cytokine production during acute and chronic HBV infection.
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Affiliation(s)
| | | | | | - Bruna da Silva Baptista
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Natália Spitz Toledo Dias
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Iury Amancio Paiva
- Laboratory of Viral Immunology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Lia Laura Lewis-Ximenez
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Vanessa Salete de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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21
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Lima LA, Lago BVD, Weis-Torres SMDS, Martins RMB, Cesar GA, Bandeira LM, Rezende GR, Lindenberg ADSC, Gomes SA, Motta-Castro ARC. Hepatitis B: changes in epidemiological features of Afro-descendant communities in Central Brazil. Sci Rep 2020; 10:6708. [PMID: 32317697 PMCID: PMC7174315 DOI: 10.1038/s41598-020-63094-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/18/2020] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B virus (HBV) infection is still a concern in vulnerable populations. In a study performed by our team in 1999–2003 in two Afro-Brazilian communities, Furnas dos Dionísios (FD) and São Benedito (SB), high prevalence rates of HBV exposure (42.7% and 16.0%, respectively), high susceptibility to HBV (55.3% and 63.0%) and low HBV vaccination like profile rates (2.0% and 21.0%) were observed. In 2015–2016, we reassessed HBV epidemiological and molecular features in these two communities to verify the impact of health actions adopted in the last years. The prevalence rate of HBV exposure among the enrolled 331 subjects was 35.3% in FD and 21.8% in SB. HBV chronic infection (5.8% in FD, 4.9% in SB) remained high. The rate of HBV vaccination like profile increased from 10.7% to 43.5% (2.0% to 45.9% in FD, 21.0% to 39.5% in SB) while susceptible subjects declined from 58.9% to 26.3% (55.3% to 18.8% in FD, 63.0% to 38.7% in SB). Among 18 HBsAg positive samples, 13 were successfully sequenced (pre-S/S region). Phylogenetic analyses showed that all isolates belong to HBV subgenotype A1, clustering within the Asian-American clade. Despite the maintenance of high prevalence rate of HBV exposure over these 13 years of surveillance, significant improvements were observed, reinforcing the importance of facilitated HBV vaccination to difficult-to-access population to close gaps in prevention.
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Affiliation(s)
- Livia Alves Lima
- Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bárbara Vieira do Lago
- Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, RJ, Brazil. .,Institute of Technology in Immunobiology, Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
| | | | | | | | | | | | | | | | - Ana Rita Coimbra Motta-Castro
- Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil. .,Oswaldo Cruz Foundation, FIOCRUZ Mato Grosso do Sul, Ministry of Health, Campo Grande, MS, Brazil.
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22
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Epidemiology of hepatitis B and C virus infection in Central West Argentina. Arch Virol 2020; 165:913-922. [PMID: 32078045 DOI: 10.1007/s00705-020-04540-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/30/2019] [Indexed: 02/07/2023]
Abstract
Little information is available regarding the prevalence of viral hepatitis in Central West Argentina. This study aims to give new information regarding HBV and HCV prevalence, genotypes, and risk factors in Central West Argentina and the suitability of dried blood spot (DBS) sampling for HBV and HCV screening. METHODS A total of 622 individuals were included; the mean age was 36.6 ± 14.3 years and 55.4% were females. HBV and HCV markers were detected using serological and molecular analysis, and risk factors were evaluated using statistical analysis. RESULTS Using serum samples, the HBsAg prevalence was 1.8%, the rate of HBV exposure (anti-HBc positivity) was 5.3%, and the rate of HBV immunity was 34.9%. HBV DNA was found in four out of 11 HBsAg+ samples, and the viruses in three of these samples were classified as genotypes A1, A2 and F2a. Multivariate analysis showed that anti-HBs positivity was associated with the level of schooling and history of HBV vaccination. The anti-HCV prevalence was 2.6%, and HCV RNA was found in 11 samples, seven of which contained viruses of genotypes 1a (n = 2), 1b (n = 3) and 2 (n = 2). The sensitivity of the DBS assay for HBsAg, anti-HBc, and anti-HCV was 100%, 66.6%, and 75%, respectively, and the specificity was above 98% for all markers when compared to serum. CONCLUSION A low rate of HBV immunity was observed, demonstrating the importance of HBV vaccination. High HCV prevalence was found, and HCV 1b was closely related to other Argentinian isolates. Finally, the performance of DBS testing in this population needs more optimization to increase its sensitivity and specificity.
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