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Sirilert S, Khamrin P, Kumthip K, Malasao R, Tongsong T, Maneekarn N. Hepatitis B virus genotypes associated with pregnant women in Northern Thailand. J Infect Public Health 2024; 17:406-411. [PMID: 38262076 DOI: 10.1016/j.jiph.2023.12.020] [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: 07/10/2023] [Revised: 12/17/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Mother-to-child transmission of hepatitis B virus (HBV) is the major route of transmission causing persistent infection. The prevalence of HBV infection and HBV genotypes found in different geographical areas varies from country to country. Therefore, this study was conducted to identify the HBV genotypes in HBV-infected pregnant women in Northern Thailand. METHODS Stored blood samples that were collected from 145 HBsAg-positive pregnant women who gave birth at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand from 2017 to 2020 were analyzed. The partial nucleotide sequence of the S gene of HBV was amplified by nested PCR and sequenced. All sequences were analyzed phylogenetically together with the reference strains to define the HBV genotypes. RESULTS A total of 31 blood samples from 145 HBsAg-positive pregnant women were positive for HBV by nested PCR. The detected HBV strains were identified as presumptive subgenotypes C1 (77.4%; 24/31), B9 (9.7%; 3/31), C2 (3.2%; 1/31), B2 (3.2%; 1/31), B4 (3.2%; 1/31), and presumptive B4/C2 recombinant subgenotype (3.2%; 1/31). CONCLUSIONS The findings revealed that presumptive subgenotype C1 was the most common subgenotype circulating in pregnant women in Northern Thailand and accounted for 77.4% of cases, followed by presumptive subgenotypes B9, C2, B2, and B4. Furthermore, this study reported, for the first time in Thailand, the HBV genotypes and presumptive subgenotypes, particularly subgenotype B9 circulating in pregnant women.
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Affiliation(s)
- Sirinart Sirilert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pattara Khamrin
- Department of Microbiology, Faculty of Medicine, and Emerging and Re-emerging Diarrheal Viruses Cluster, Chiang Mai University, Chiang Mai, Thailand
| | - Kattareeya Kumthip
- Department of Microbiology, Faculty of Medicine, and Emerging and Re-emerging Diarrheal Viruses Cluster, Chiang Mai University, Chiang Mai, Thailand
| | - Rungnapa Malasao
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Niwat Maneekarn
- Department of Microbiology, Faculty of Medicine, and Emerging and Re-emerging Diarrheal Viruses Cluster, Chiang Mai University, Chiang Mai, Thailand.
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Langat BK, Ochwedo KO, Borlang J, Osiowy C, Mutai A, Okoth F, Muge E, Andonov A, Maritim ES. Genetic diversity, haplotype analysis, and prevalence of Hepatitis B virus MHR mutations among isolates from Kenyan blood donors. PLoS One 2023; 18:e0291378. [PMID: 37963165 PMCID: PMC10645356 DOI: 10.1371/journal.pone.0291378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/28/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND The rapid spread of HBV has resulted in the emergence of new variants. These viral genotypes and variants, in addition to carcinogenic risk, can be key predictors of therapy response and outcomes. As a result, a better knowledge of these emerging HBV traits will aid in the development of a treatment for HBV infection. However, many Sub-Saharan African nations, including Kenya, have insufficient molecular data on HBV strains circulating locally. This study conducted a population-genetics analysis to evaluate the genetic diversity of HBV among Kenyan blood donors. In addition, within the same cohort, the incidence and features of immune-associated escape mutations and stop-codons in Hepatitis B surface antigen (HBsAg) were determined. METHODS In September 2015 to October 2016, 194 serum samples were obtained from HBsAg-positive blood donors residing in eleven different Kenyan counties: Kisumu, Machakos, Uasin Gishu, Nairobi, Nakuru, Embu, Garissa, Kisii, Mombasa, Nyeri, and Turkana. For the HBV surface (S) gene, HBV DNA was isolated, amplified, and sequenced. The sequences obtained were utilized to investigate the genetic and haplotype diversity within the S genes. RESULTS Among the blood donors, 74.74% were male, and the overall mean age was 25.36 years. HBV genotype A1 (88.14%) was the most common, followed by genotype D (10.82%), genotype C (0.52%), and HBV genotype E (0.52%). The phylogenetic analysis revealed twelve major clades, with cluster III comprising solely of 68 blood donor isolates (68/194-35.05%). A high haplotype diversity (Hd = 0.94) and low nucleotide diversity (π = 0.02) were observed. Kisumu county had high number of haplotypes (22), but low haplotype (gene) diversity (Hd = 0.90). Generally, a total of 90 haplotypes with some consisting of more than one sequence were observed. The gene exhibited negative values for Tajima's D (-2.04, p<0.05) and Fu's Fs (-88.84). Several mutations were found in 139 isolates, either within or outside the Major Hydrophilic Area (MHR). There were 29 mutations found, with 37.9% of them situated inside the "a" determinant. The most common mutations in this research were T143M and K122R. Escape mutations linked to diagnostic failure, vaccination and immunoglobulin treatment evasion were also discovered. Also, one stop-codon, W163STP, inside the MHR, was found in one sample from genotype A. CONCLUSION In Kenya, HBV/A1 is still the most common genotype. Despite limited genetic and nucleotide diversity, haplotype network analysis revealed haplotype variance among HBV genotypes from Kenyan blood donors. The virological properties of immune escape, which may be the source of viral replication endurance, were discovered in the viral strains studied and included immune-escape mutations and stop-codon. The discovery of HBsAg mutations in MHR in all isolates highlighted the need of monitoring MHR mutations in Kenya.
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Affiliation(s)
| | - Kevin Omondi Ochwedo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | | | - Carla Osiowy
- National Microbiology Laboratory, Winnipeg, Canada
| | - Alex Mutai
- Kenya National Blood Transfusion Services, Nairobi, Kenya
| | - Fredrick Okoth
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edward Muge
- Department of Medical Biochemistry, University of Nairobi, Nairobi, Kenya
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Duduyemi BM, Asante DB, Titiloye NA, Ohene-Nketia B, SA A. Molecular Analysis of HBV in Histologically Confirmed Hepatocellular Carcinoma in a Tertiary Hospital in Ghana. Niger Med J 2022; 63:147-154. [PMID: 38803700 PMCID: PMC11128152 DOI: 10.60787/nmj-63-2-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a leading cause of death in Africa. Viral hepatitis B is a leading cause of hepatocellular cancer in Ghana and most African countries except Egypt where hepatitis C virus is more prevalent. This study aims at reviewing the histopathological patterns of HCC and its association with hepatitis B virus in our environment. Methodology Demographics and histological diagnosis were retrieved from the surgical daybook and archival FFPE tissue samples with histopathologically confirmed HCC were used for this study. Sections (10μm) were taken from the tissues and digested to obtain DNA lysates. The DNA lysates were used in polymerase chain reaction (PCR) to determine the prevalence of HBV in the biopsies. Result Of the 24 confirmed cases of HCC seen in the 5-year period, there were 17 males and 7 females with M:F ratio of 2.4:1. The mean age of our patients was 39.92 ± 1.98 years with age range 13-85 years. 50% of the cases were moderately differentiated while 25% each were well and poorly differentiated. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Eight of the 11 cases were found in the male and 3 in females. Of the 11 (45.83%) samples that were positive for HBV DNA, 3 were above 40 years and 8 were 40 years and younger. Conclusion The overall prevalence of HBV DNA in our study was 45.83% and a greater proportion seen in ≤ 40 years. This suggests that most of our patients are infected with HBV early in life in our environment.
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Affiliation(s)
- Babatunde Moses Duduyemi
- Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Pathology, University of Sierra Leone Teaching Hospitals Complex & College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | - Du-Bois Asante
- Department of Biomedical Science, University of Cape Coast, Cape Coast, Ghana
| | - Nicholas Akinwale Titiloye
- Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Adams SA
- Department of Biomedical Science, University of Cape Coast, Cape Coast, Ghana
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Alshabi A, Fatima N, Marwan A, Oraibi KG, Qubaisi EA, Arif HO, Daghriri EM, Zelai NA, Ali Khan I. Epidemiology screening and genotyping analysis for Hepatitis B virus in Southwestern region of Saudi Arabia. J Infect Public Health 2021; 14:187-192. [PMID: 33486374 DOI: 10.1016/j.jiph.2020.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/13/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus (HBV) is a global human pathogen that can cause life-threatening liver disease including persistent hepatitis, cirrhosis of the liver and hepatocellular cancer. The aim of this present study was to investigate the infection of HBV epidemiology and also examine the HBsAg genotype distribution in the southwestern region of Jizan city in the Saudi Arabia. Since 2015-2018, epidemiological study has been conducted within the city premises of Jazan region. HBsAg genotyping with the molecular biology grade techniques was performed in 50 subjects. In this study, 1888 subjects in the Jazan city of the Southwestern region were diagnosed as positive for HBV. The mean age of the participants was found to be 44.5 ± 16.9 years. Over 68% of males and 31% of females participated in this epidemiological study. Approximately, 88% of Saudi nationalities were recruited with 12% involving non-Saudi subjects Genotyping analysis confirmed that 90% of subjects confirmed genotype-D and 10% confirmed genotypes A, H and E. Anova analysis could find no significant association between the genotype analysis and the clinical data (p > 0.05). The prevalence of HBV in the Jazan region was found to be high based on the clinical data from epidemiological studies conducted in the Southwestern region. Since 2015-2018, a total of 1888 samples have been found to be positive at Jazan premises. The HBsAg genotyping studies confirm in this study 90% of the genotyping-D was documented.
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Affiliation(s)
- Alkhansa Alshabi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Nuzhath Fatima
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Amany Marwan
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Khadejh G Oraibi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Ebtihal A Qubaisi
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Hanan O Arif
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Elham M Daghriri
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Noran A Zelai
- Department of Medical Lab Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Alqahtani SA, Sanai FM, Alolayan A, Abaalkhail F, Alsuhaibani H, Hassanain M, Alhazzani W, Alsuhaibani A, Algarni A, Forner A, Finn RS, Al-hamoudi WK. Saudi Association for the Study of Liver diseases and Transplantation practice guidelines on the diagnosis and management of hepatocellular carcinoma. Saudi J Gastroenterol 2020; 26:S1-S40. [PMID: 33078723 PMCID: PMC7768980 DOI: 10.4103/sjg.sjg_477_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/10/2020] [Indexed: 01/27/2023] Open
Affiliation(s)
- Saleh A. Alqahtani
- Liver Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Faisal M. Sanai
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ashwaq Alolayan
- Adult Medical Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Faisal Abaalkhail
- Department of Medicine, Gastroenterology Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Hamad Alsuhaibani
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mazen Hassanain
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
| | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Abdullah Alsuhaibani
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdullah Algarni
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alejandro Forner
- Barcelona Clinic Liver Cancer Group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain
| | - Richard S Finn
- Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California,United States
| | - Waleed K. Al-hamoudi
- Liver Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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6
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Al-Qahtani AA, Pourkarim MR, Trovão NS, Vergote V, Li G, Thijssen M, Abdo AA, Sanai FM, Dela Cruz D, Bohol MFF, Al-Anazi MR, Al-Ahdal MN. Molecular epidemiology, phylogenetic analysis and genotype distribution of hepatitis B virus in Saudi Arabia: Predominance of genotype D1. INFECTION GENETICS AND EVOLUTION 2019; 77:104051. [PMID: 31634640 DOI: 10.1016/j.meegid.2019.104051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/28/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
Despite the implementation of various vaccination programs, hepatitis B virus (HBV) poses a considerable health problem in Saudi Arabia. Insight on HBV evolutionary history in the region is limited. We performed a comprehensive epidemiological and phylogenetic reconstruction based on a large cohort of HBV infected patients. Three hundred and nineteen HBV-infected patients with different clinical manifestations, including inactive and active chronic carriers and patients with cirrhosis and hepatocellular carcinoma (HCC), were enrolled in this study. The full-length large S gene was amplified and sequenced. Phylogenetic analysis was performed to determine the genotype and subgenotypes of the isolates. Phylogenetic tree analysis revealed that genotype D is the most dominant genotype among patients. Moreover, this analysis identified two strains with genotype E isolated from active carriers. Detailed phylogenetic analyses confirmed the presence of four HBV D subgenotypes, D1 (93%, n = 296), D2 (0.02%, n = 5), D3 (0.003%, n = 1), and D4 (0.003%, n = 1). In addition, six genotype D strains were not assigned to any existing HBV D subgenotype. The large S gene of eight strains showed signatures of genotype recombination between the genotypes D and A and between D and E. Several strains harbored medically important point mutations at the protein level. Along with the dominance of the HBV genotype D, isolation of the E genotype and several recombinant strains from patients with Saudi Arabian origin is an essential result for decisions involving therapeutic measures for patients. Development of vaccines and detection of diagnostic escape mutations at antigenic epitopes on the HBsAg will be valuable to public health authorities. Furthermore, the diversity at the nucleotide and amino acid levels and different proportions of dN/dS at the PreS1, PreS2, and HBsAg reveal the selective pressure trend from inactive status towards advanced liver diseases.
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Affiliation(s)
- Ahmed A Al-Qahtani
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Microbiology and Immunology, Alfaisal University, School of Medicine, Riyadh, Saudi Arabia.
| | - Mahmoud Reza Pourkarim
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Nídia Sequeira Trovão
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Valentijn Vergote
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Guangdi Li
- Department of Public Health, Central South University, Changsha 410078, Hunan, China
| | - Marijn Thijssen
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Division of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Ayman A Abdo
- Section of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faisal M Sanai
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Damian Dela Cruz
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Marie Fe F Bohol
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mashael R Al-Anazi
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohammed N Al-Ahdal
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Microbiology and Immunology, Alfaisal University, School of Medicine, Riyadh, Saudi Arabia
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7
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Al-Sadeq DW, Taleb SA, Zaied RE, Fahad SM, Smatti MK, Rizeq BR, Al Thani AA, Yassine HM, Nasrallah GK. Hepatitis B Virus Molecular Epidemiology, Host-Virus Interaction, Coinfection, and Laboratory Diagnosis in the MENA Region: An Update. Pathogens 2019; 8:pathogens8020063. [PMID: 31083509 PMCID: PMC6630671 DOI: 10.3390/pathogens8020063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus (HBV) is an enveloped partial double-stranded DNA virus that can cause acute and chronic hepatitis. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), 257 million people are living with HBV. Moreover, 20,900 acute hepatitis B cases were reported in 2016. Hepatitis B is highly prevalent in the African, Western Pacific, Eastern Mediterranean, South-East Asia, and European regions, respectively. Due to the high mutational rate of HBV and lack of reverse transcriptase proofreading activity, ten different genotypes with different geographical distributions have been identified. HBV pathogenesis and severity of infection depend on several host and viral factors, particularly, the genetic variability of both the host and virus. Although HBV infection is a global health concern, there is a lack of adequate studies and reports in the Middle East and North Africa (MENA) region. Here, we provide a review on HBV epidemiology, pathogenesis, host-pathogen interactions, coinfection with selected viruses, and laboratory diagnosis, focusing on studies conducted in the MENA region to determine the current situation of the HBV infection and outline the future study areas.
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Affiliation(s)
- Duaa W Al-Sadeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara A Taleb
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Roan E Zaied
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Sara M Fahad
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Maria K Smatti
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Balsam R Rizeq
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Department of Biological and Environmental Sciences, College of Arts & Sciences, Qatar University, Doha 2713, Qatar.
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Gheyath K Nasrallah
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
- Biomedical Science Department, College of Health Sciences, Qatar University, Doha 2713, Qatar.
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Nodeh MM, Mosavat A, Valizadeh N, Zadeh AM, Boskabadi A, Mashkani B, Sima H, Rafatpanah H. Genotype characteristic and phylogenetic analysis of hepatitis B virus in northeast-Iran. INFECTION GENETICS AND EVOLUTION 2018; 59:148-154. [PMID: 29425854 DOI: 10.1016/j.meegid.2018.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/27/2018] [Accepted: 02/04/2018] [Indexed: 01/05/2023]
Abstract
Viral hepatitis is considered as a worldwide health problem and hepatitis B virus (HBV) infection is one of the major health concerns which are annually responsible for more than one million deaths. HBV can be classified into at least eight genotypes, A-H and four major subtypes. Predominant HBV genotype in Mediterranean and Middle East countries is genotype D, but there is a few studies have been performed on the HBV genotype in Iran. The genotype characteristic and phylogenetic analyses were determined in chronic HBV patients in the northeast of Iran. First, seventy-eight patients with chronic HBV infection were enrolled. Demographic features were reviewed and sera samples were collected. HBV genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, and results were confirmed by sequencing. Finally, a phylogenetic tree was obtained using Geneious software. Sixty-two (79.48%) of patients were males (mean age: 36.82 years). Twelve out of 78 patients (15.4%) were hepatitis B envelope antigen (HBeAg)-reactive. There were no significant differences between the clinical and HBeAg-positive serological data and HBeAb positive individuals. RFLP DNA sequencing and phylogenetic analysis showed that genotype D was the only genotype which observed in Mashhad, northeast of Iran. This is the first report of HBV genotyping in Mashhad. The results revealed that genotype D was the only genotype detected in this area which was consistence with previous studies in the Middle East, Mediterranean countries, southwest and center of Iran.
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Affiliation(s)
- Mohammad Moeini Nodeh
- Hematology and Oncology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Narges Valizadeh
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Abbas Boskabadi
- Neonatology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Baratali Mashkani
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Sima
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Houshang Rafatpanah
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ansari MHK, Rasmi Y, Abbasi L. Hepatitis B virus Genotypes in West Azarbayjan Province, Northwest Iran. Open Access Maced J Med Sci 2017; 5:875-879. [PMID: 29362612 PMCID: PMC5771288 DOI: 10.3889/oamjms.2017.206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND: Infections caused by Hepatitis B are one of the world health’s most serious problems. According to assessments, nearly 500,000 to 1.2 million people die each year due to chronic hepatitis, cirrhosis of the liver and hepatocellular carcinoma. Hepatitis B is one of the diseases which can be transferred through blood and its products. Clinical importance of genotypes of hepatitis B virus and their relations with mutations are well known. AIM: Since epidemiological data resulting from determining genotypes and sub-genotypes of hepatitis B can help a lot in defining a vaccination plan, antiretroviral therapy, detection and prevention of diseases, genotypes of this virus in hepatitis B patients were evaluated in West Azarbaijan province. MATERIALS AND METHODS: In this cross-sectional study, serum samples of 100 hepatitis B patients (70 male/30 female) were taken randomly from Urmia University of Medical Sciences (UMSU) referrals, Urmia, Iran; and were tested positive for the presence of surface antigens of hepatitis B virus (HBsAg) using ELISA method. In the first method, after extracting the DNA of the virus, sequencing of S genes was carried out using Sanger method, and the sequences were aligned and edited using Bioedit software. In the next step, phylogenic analysis of the sequences was done in comparison with the reference sequences which were extracted from a gene bank, utilising Neighbour-joining assay method with CLUSTRAL W software. To ensure genotyping accuracy, the samples were tested once more, using Nested PCR method. RESULTS: The results were consistent with the sequence method and the dominant genotype in patients suffering hepatitis was type D. In other words, Iranian’s HBV genotypic types are homogeneous and in close coordination with each other. CONCLUSIONS: The results reveal that D genotype is the main genotype of HBV in West Azarbayjan province, northwest Iran. Presence of this genotype was in conformity conformed withto the low rate of acute liver diseases caused by hepatitis B chronic infection, cirrhosis of the liver and hepatocellular carcinoma.
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Affiliation(s)
| | - Yousef Rasmi
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.,Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Laya Abbasi
- Department of Microbiology, Azad Islamic University-Urmia Branch, Urmia, Iran
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Alshayea AI, Eid GE, El-Hazmi MM, Alhetheel AF. Prevalence and characterization of occult hepatitis B infection among blood donors in central Saudi Arabia. Saudi Med J 2017; 37:1114-9. [PMID: 27652363 DOI: 10.15537/smj.2016.10.14708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence of occult hepatitis B viral infections (OBIs) among blood donors considering the clinical and epidemiological importance of identifying OBIs. METHODS A cross-sectional study conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2011 and January 2012. Blood donors (n=8501) were screened for Hepatitis B virus surface antigen (HBsAg) and hepatitis B core antibodies (HBcAb). All HBsAg-negative and HBcAb-positive samples were tested further for hepatitis B surface antibodies (HBsAb), hepatitis B virus (HBV)-DNA, and HBV genotyping. RESULTS Of the 8501 serum samples tested, 56 (0.7%) were positive and 8445 (99.3%) were negative for HBsAg. Among the HBsAg-negative samples, 198 (2.3%) were positive for HBcAb and these patients were suspected to have OBIs. Among the HBcAb-positive samples, 119 (60.1%) were positive while 79 (39.9%) were negative for HBsAb. Analysis of HBV-DNA for the suspected OBIs showed that 17 out of 198 samples (8.6%) yielded positive results, and all of them were HBsAb-negative. The viral load was low (less than 20-186 IU/mL) in all OBIs. Hepatitis B virus genotyping showed that 15 out of 17 samples (88.2%) were genotype D, and the other 2 samples (11.8%) were genotype E. CONCLUSION The prevalence of OBIs among blood donors in Riyadh was 0.2%. Therefore, it is recommended that HBV molecular testing should be incorporated with serological assays for screening of blood donors.
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Affiliation(s)
- Areej I Alshayea
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Al-Humayed SM. Hepatitis B and C Viral Infections in Tihamet Aseer, South-Western Saudi Arabia: Are There Gender Differences? SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 5:110-115. [PMID: 30787767 PMCID: PMC6298365 DOI: 10.4103/1658-631x.204853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Hepatitis B virus (HBV) infection is endemic in Saudi Arabia. Many studies have shown varying results in gender differences in HBV and hepatitis C virus (HCV) infection. The objective of this study was to determine if gender differences exist in HBV and HCV infection and to elucidate any related risk factors in Tihamet Aseer, south-western Saudi Arabia. Materials and Methods The study was a cross-sectional study of a representative sample of males and females in Tihamet Aseer, south-western Saudi Arabia. A comprehensive questionnaire was completed by all participants. Blood samples were taken and sera were tested for hepatitis B surface antigen and HCV antibodies by fourth-generation enzyme immunoassays. Results The study included 1532 participants from the Tihamet Aseer area. An overall seroprevalence of 7.9% and 1.7% was found for HBV and HCV infections, respectively. In logistic regression analysis, no gender differences were found for HBV seroprevalence. Identified risk factors for HBV infection included a history of blood transfusion and lack of hepatitis B vaccination. On the other hand, females were more prone to become seropositive for HCV (adjusted odds ratio = 5.034, 95% confidence interval: 1.042-9.321). Other identified risk factors for HCV infection were illiteracy and a history of blood transfusion. Conclusion The prevalence and HBV and HCV infection is high compared to the national figures. Gender differences were only observed in HCV infection. It is recommended to have an active educational and media campaign. A "catch-up" vaccination program against HBV should be introduced for adults as a strategy to achieve the herd immunity effect in the affected area.
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Affiliation(s)
- Suliman M Al-Humayed
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Ziaee M, Javanmard D, Sharifzadeh G, Hasan Namaei M, Azarkar G. Genotyping and Mutation Pattern in the Overlapping MHR Region of HBV Isolates in Southern Khorasan, Eastern Iran. HEPATITIS MONTHLY 2016; 16:e37806. [PMID: 27882062 PMCID: PMC5111392 DOI: 10.5812/hepatmon.37806] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/04/2016] [Accepted: 07/18/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B virus, with 8 known distinct genotypes, is one of the most serious health problems which results to liver injuries. The surface gene of Hepatitis B virus completely overlaps with the polymerase gene. Mutations in the RT gene result in changes in the overlapping hepatitis B surface antigen. OBJECTIVES The present study aimed to evaluate the genotypes and prevalence of mutations in a segment of S and RT gene in HBV isolates in Southern Khorasan, Iran. METHODS This was a population-based study comprising 5,235 randomized samples for HBV screening. A nested-polymerase chain reaction (PCR) test was followed by direct sequencing, and the sequences blast with present sequences of NCBI database for genotyping. Alignment and phylogenic analysis was performed using MEGA-6 software, and mutation pattern of this segment was finally surveyed in Bioedit software. RESULTS The mean age was 39.07 ± 14.04 years, with 52.2% female and 47.8% male. All isolates belonged to HBV genotype D, sub-genotype D1. The most amino acid substitutions of surface protein were Q129H (34.42%) and A168V (8.2%), other escape mutants observed in this study were P127L/T, S117G, T125M, S143L, D144E and E164D. In the RT gene, Q149K was the most frequently identified amino acid substitution (9.83%), followed by L122F (8.19%), N118D/T (6.55%), L157M (4.91%), and H124Y (3.27%). CONCLUSIONS This finding represents an ongoing dominancy of HBV genotype D in Eastern Iran, corresponding to other parts of Iran. There were a lot of variations in the S gene leading to an escape mutation, some of which affected the corresponding area of the RT region.
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Affiliation(s)
- Masood Ziaee
- Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
| | - Davod Javanmard
- Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
- Corresponding Author: Davod Javanmard, Hepatitis Research Center, Birjand University of Medical Sciences, Ghafari Ave., Birjand, IR Iran. Tel/Fax: +98-5632433004, E-mail:
| | | | | | - Ghodsiyeh Azarkar
- Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
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Al Humayed SM. Seroprevalence of HBsAg among adolescents and adults in the Muhayil Aseer region of KSA: 25 years after the introduction of national vaccination. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2015.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Al-Qudari AY, Amer HM, Abdo AA, Hussain Z, Al-Hamoudi W, Alswat K, Almajhdi FN. Surface gene variants of hepatitis B Virus in Saudi Patients. Saudi J Gastroenterol 2016; 22:133-8. [PMID: 26997220 PMCID: PMC4817297 DOI: 10.4103/1319-3767.167186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS Hepatitis B virus (HBV) continues to be one of the most important viral pathogens in humans. Surface (S) protein is the major HBV antigen that mediates virus attachment and entry and determines the virus subtype. Mutations in S gene, particularly in the "a" determinant, can influence virus detection by ELISA and may generate escape mutants. Since no records have documented the S gene mutations in HBV strains circulating in Saudi Arabia, the current study was designed to study sequence variation of S gene in strains circulating in Saudi Arabia and its correlation with clinical and risk factors. PATIENTS AND METHODS A total of 123 HBV-infected patients were recruited for this study. Clinical and biochemical parameters, serological markers, and viral load were determined in all patients. The entire S gene sequence of samples with viral load exceeding 2000 IU/mL was retrieved and exploited in sequence and phylogenetic analysis. RESULTS A total of 48 mutations (21 unique) were recorded in viral strains in Saudi Arabia, among which 24 (11 unique) changed their respective amino acids. Two amino acid changes were recorded in "a" determinant, including F130L and S135F with no evidence of the vaccine escape mutant G145R in any of the samples. No specific relationship was recognized between the mutation/amino acid change record of HBsAg in strains in Saudi Arabia and clinical or laboratory data. Phylogenetic analysis categorized HBV viral strains in Saudi Arabia as members of subgenotypes D1 and D3. CONCLUSION The present report is the first that describes mutation analysis of HBsAg in strains in Saudi Arabia on both nucleotide and amino acid levels. Different substitutions, particularly in major hydrophilic region, may have a potential influence on disease diagnosis, vaccination strategy, and antiviral chemotherapy.
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Affiliation(s)
- Ahmed Y. Al-Qudari
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Haitham M. Amer
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia,Department of Virology, Cairo University, Giza, Egypt
| | - Ayman A. Abdo
- Department of Medicine, King Saud University Liver Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zahid Hussain
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Waleed Al-Hamoudi
- Department of Medicine, King Saud University Liver Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alswat
- Department of Medicine, King Saud University Liver Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad N. Almajhdi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Fahad N. Almajhdi, Department of Botany and Microbiology, College of Science, King Saud University, PO Box 2455, Riyadh - 11451, Saudi Arabia. E-mail:
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15
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A molecular epidemiological study of the hepatitis B virus in Thailand after 22 years of universal immunization. J Med Virol 2015; 88:664-73. [DOI: 10.1002/jmv.24368] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 12/18/2022]
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16
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Hepatitis B virus genotyping in chronic hepatitis B patients in southwestern Saudi Arabia. Braz J Infect Dis 2015; 19:525-8. [PMID: 25997779 PMCID: PMC9427501 DOI: 10.1016/j.bjid.2015.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/21/2015] [Accepted: 03/29/2015] [Indexed: 02/07/2023] Open
Abstract
The distribution of hepatitis B virus genotypes in Saudi Arabia is largely unknown. To the best of our knowledge there are no data available about HBV genotypes in southwestern region of the country. This study aimed to determine the epidemiologic distribution of hepatitis B virus genotypes in chronic hepatitis B patients in southwestern region, and to verify possible correlations between these genotypes and the clinical symptoms. A total of 160 patients with chronic hepatitis B infection were enrolled in this study. Sera were tested for liver function tests, hepatitis B virus markers and DNA load by standard procedures. HBV genotyping was performed by 2-tube nested PCR for determination of six genotypes (A–F). Genotype D was the most common, found in 135 (84.4%) patients, followed by A (18; 11.3%) and E (7; 4.3%). The rate of HBeAg positivity in genotype D patients was significantly lower compared with that in genotype A and E patients (p = 0.01). There was no significant association between HBV genotypes and age, gender, liver function tests, or HBV DNA load. Genotypes D and E were predominant in chronic hepatitis B patients in southwestern Saudi Arabia. Awareness of hepatitis B virus serologic and genotypic patterns might help in the formulation of management plans, predicting clinical outcomes and updating prevention strategies.
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Ansari N, Makvandi M, Samarbaf-Zadeh AR. Hepatitis B virus Genotyping Among Patients With Cirrhosis. Jundishapur J Microbiol 2015; 8:e14571. [PMID: 25964845 PMCID: PMC4417903 DOI: 10.5812/jjm.14571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 01/22/2014] [Accepted: 03/15/2014] [Indexed: 12/11/2022] Open
Abstract
Background: Hepatitis B virus (HBV) infection is a worldwide public health problem. Nine HBV genotypes (A-I) have been already discovered. HBV genotypes are important both in the clinical manifestation of disease and treatment response. Moreover, HBV DNA without HBs (Hepatitis B surface)-antigenemia was detected in some patients with chronic hepatitis (occult hepatitis). There is little information about HBV genotypes and its relation to occult infection despite the importance of this infection in Khuzestan Province. Objectives: This study aimed to determine both occult hepatitis B infection and HBV genotypes among cirrhotic patients. Patients and Methods: Thirty-eight patients with liver cirrhosis, including 11 (28.9%) HBsAg-positive patients and 27 (71.1%) patients with cryptogenic cirrhosis participated in this study. The mean age of the patients at the time of cirrhosis diagnosis was 54.85 years (range 26-75 years). All patients were anti-HCV and anti-HIV negative. For all the samples, the serological Enzyme-Linked Immunosorbent Assay (ELISA) was performed for HBV markers including HBsAg, HBcAb, HBeAg, HBeAb tests. The common primer of S region of HBV was used for Nested PCR. The PCR products of the positive individuals were sequenced for genotyping and subtyping of HBV. Results: Eleven (40.7%) out of 27 HBV cryptogenic cirrhosis and all 11 HBsAg-positive patients were positive for HBV DNA. The seroprevalences of Hepatitis B virus HBe antigen, anti-HBe and anti-HBc antibodies among the cryptogenic cirrhosis patients were 5 (18.5%), 1 (3.7%), and 5 (20.83), and among HBsAg-positive patients were 6 (54.5%), 5 (45.5%), and 7 (63.6%), respectively. Conclusions: In our study, only HBV genotype D was found among all the positive HBsAg and occult HBV infection. Moreover, high prevalence (40.7%) of occult HBV infection was determined among patients suffered from cryptogenic cirrhosis.
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Affiliation(s)
- Nastaran Ansari
- Department of Virology, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Nastaran Ansari, Department of Virology, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-218112677819, E-mail:
| | - Manochehr Makvandi
- Department of Virology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Reza Samarbaf-Zadeh
- Department of Virology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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18
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Sopipong W, Tangkijvanich P, Payungporn S, Posuwan N, Poovorawan Y. The KIF1B (rs17401966) single nucleotide polymorphism is not associated with the development of HBV-related hepatocellular carcinoma in Thai patients. Asian Pac J Cancer Prev 2015; 14:2865-9. [PMID: 23803045 DOI: 10.7314/apjcp.2013.14.5.2865] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Hepatitis B virus (HBV) infection can become chronic and if left untreated can progress to hepatocellular carcinoma (HCC).Thailand is endemic for HBV and HCC is one of the top five cancers, causing deaths among Thai HBV-infected males. A single nucleotide polymorphism (SNP) at the KIF1B gene locus, rs17401966, has been shown to be strongly associated with the development of HBV-related HCC. However, there are no Thai data on genotypic distribution and allele frequencies of rs17401966. Thai HBV patients seropositive for HBsAg (n=398) were therefore divided into two groups: a case group (chronic HBV with HCC; n=202) and a control group (HBV carriers without HCC; n=196). rs17401966 was amplified by polymerase chain reaction (PCR) and analyzed by direct nucleotide sequencing. The genotypic distribution of rs174019660 for homozygous major genotype (AA), heterozygous minor genotype (AG) and homozygous minor genotype (GG) in the case group was 49.5% (n=100), 40.1% (n=81) and 10.4% (n=21), respectively, and in controls was 49.5% (n=97), 42.3% (n=83) and 8.2% (n=16). Binary logistic regression showed that rs17401966 was not statistically associated with the risk of HCC development in Thai chronic HBV patients (p-value=0.998, OR=1.00 and 95% CI=0.68-1.48). In conclusion, the KIF1B gene SNP (rs174019660) investigated in this study showed no significant association with HBV-related HCC in Thai patients infected with HBV, indicating that there must be other mechanisms or pathways involved in the development of HCC.
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Affiliation(s)
- Watanyoo Sopipong
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Alsohaibani F, Alturaif N, Abdulshakour A, Alghamdi S, Alshaibani A, Alashgar H, Alkahtani K, Kagevi I. Tenofovir in the treatment of naïve and refractory chronic Hepatitis B: A single center experience in Saudi Arabia. Saudi J Gastroenterol 2015; 21:295-9. [PMID: 26458856 PMCID: PMC4632254 DOI: 10.4103/1319-3767.164189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS Tenofovir disoproxil fumarate (TDF) is a nucleotide analog used in the treatment of chronic hepatitis B (CHB) infection. This study evaluated the efficacy of TDF in achieving undetectable HBV DNA after 48 weeks of treatment in a Saudi cohort of CHB patients. PATIENTS AND METHODS This retrospective study included patients treated at a tertiary care center in Saudi Arabia from January 2009 to December 2012. Of the 68 eligible patients, 51 were treatment naïve and 17 were treatment-refractory. Twenty-three patients tested positive for HBeAg. The remaining 45 patients were HBeAg-negative. RESULTS The mean HBV DNA viral load decreased from 95 million IU/mL at baseline to 263 IU/mL after 48 weeks of treatment (P < 0.001). Overall, 62% of patients achieved a complete virological response (CVR) and 37% a partial virological response (PVR). Respective CVR and PVR rates according to subgroup were: HBeAg-positive (21.7% and 78.3%) and HBeAg-negative (84.4% and 15.6%). At 48 weeks, HBV DNA was undetectable in 66.7% of treatment-naÏve and 53% of treatment-refractory patients (P = 0.3). Seroconversion occurred in 13 (57%) of HBeAg-positive patients. Two (3%) of the HBeAg-negative patients lost HBsAg at follow up. Mean alanine aminotransferase decreased significantly from 134 U/L before treatment to 37 U/L at 48 weeks (P < 0.001). Significant adverse events were not encountered during the study period. CONCLUSION Forty-eight weeks of treatment with TDF reduced HBV DNA to undetectable levels in more than half of our patients regardless of whether they were treatment-naïve or refractory. HBeAg-negative (vs positive) patients experienced a better response rate.
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Affiliation(s)
- Fahad Alsohaibani
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia,Address for correspondence: Dr. Fahad Alsohaibani, Department of Medicine, King Faisal Specialist Hospital and Research Centre, MBC 46 P.O Box 3354, Riyadh 11211, Saudi Arabia. E-mail:
| | - Noura Alturaif
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Abdulshakour
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Saad Alghamdi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Alfadel Alshaibani
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hamad Alashgar
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Khalid Alkahtani
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ingvar Kagevi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Bokharaei-Salim F, Keyvani H, Monavari SH, Esghaei M, Fakhim S, Ataei Pirkooh A, Behnava B. Distribution of hepatitis B virus genotypes in azerbaijani patients with chronic hepatitis B infection. HEPATITIS MONTHLY 2014; 14:e25105. [PMID: 25685166 PMCID: PMC4310019 DOI: 10.5812/hepatmon.25105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 11/18/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) has been classified into ten genotypes (A-J) based on genome sequence divergence, which is very important for etiological and clinical investigations. HBV genotypes have distinct geographical distributions worldwide. OBJECTIVES The aim of this study was to investigate the distribution of HBV genotypes among Azerbaijani patients with chronic hepatitis B, came from the Republic of Azerbaijan country to Iran to receive medical care. PATIENTS AND METHODS One hundred and three patients with chronic HBV infection, referred to hospitals related to Iran University of Medical Sciences and Tehran Hepatitis Center from August 2011 to July 2014, were enrolled in this cross sectional study. About 3-milliliter of peripheral blood was taken from each patient. After viral DNA extraction, HBV genotypes were tested using the INNO-LiPA™ HBV kit (Innogenetics, Ghent, Belgium). HBV genotyping was confirmed using sequencing of hepatitis B surface antigen (HBsAg) and polymerase (pol) regions of HBV. RESULTS The mean age of patients was 35.9 ± 11.7 years (19-66). Of 103 patients, 72 (69.9%) were male. In the present study, the predominant HBV genotype was D (93.2%) followed by genotype A (5.8%) and concurrent infection with A and D genotypes (0.97%). CONCLUSIONS The main and frequent HBV genotype among Azerbaijani patients with chronic hepatitis B virus infection was genotype D followed by genotype A.
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Affiliation(s)
- Farah Bokharaei-Salim
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Farah Bokharaei Salim, Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188602205, E-mail:
| | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
| | | | - Maryam Esghaei
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
| | - Shahin Fakhim
- Department of Civil Engineering, Faculty of Engineering, Payame Noor University, Karaj, IR Iran
| | | | - Bita Behnava
- Middle East Liver Diseases Center, Tehran, IR Iran
- Iran Hepatitis Network, Tehran, IR Iran
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Pellicelli AM, Vignally P, Messina V, Izzi A, Mazzoni E, Barlattani A, Bacca D, Romano M, Mecenate F, Stroffolini T, Furlan C, Picardi A, Gentilucci UV, Gulminetti R, Bonaventura ME, Villani R, D’Ambrosio C, Paffetti A, Mastropietro C, Marignani M, Fondacaro L, Cerasari G, Andreoli A, Barbarini G. Long term nucleotide and nucleoside analogs treatment in chronic hepatitis B HBeAg negative genotype D patients and risk for hepatocellular carcinoma. Ann Hepatol 2014. [DOI: 10.1016/s1665-2681(19)30844-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Alqahtani JM, Abu-Eshy SA, Mahfouz AA, El-Mekki AA, Asaad AM. Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: the need for national guidelines for health students. BMC Public Health 2014; 14:577. [PMID: 24912684 PMCID: PMC4059075 DOI: 10.1186/1471-2458-14-577] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/28/2014] [Indexed: 12/11/2022] Open
Abstract
Background The objectives of the study were to study the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among health college students (HS) and health care workers (HCWs) in the Najran Region of south-western Saudi Arabia and to study the students’ knowledge of occupational exposure to blood-borne viral infections. Methods A cross-sectional study of a representative sample of 300 HS and 300 HCWs was conducted. Results An overall seroprevalence of HBV of 1.7% and 8.7% was found among HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of HCWs lack anti-HBs and are susceptible to HBV infection. An overall seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs, respectively. The present study indicates poor knowledge among HS and moderate knowledge among HCWs regarding occupationally transmitted blood-borne diseases, safe injection practices, and standard precautions to prevent occupationally transmitted blood-borne infections. Conclusion It is mandatory to develop a structured program to raise awareness among HS, and current health colleges’ curricula should be upgraded to address these issues early. The HS should be considered new recruits to health services in terms of their initial screening for blood-borne infections and vaccination against HBV. The development of a novel continuing medical education and pre-employment awareness program for HCWs is recommended to address the following: blood-borne diseases transmitted occupationally, standard precautions to prevent occupationally transmitted blood borne infections, and safe injection practices.
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Affiliation(s)
| | | | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, P,O, Box 641, Saudi Arabia.
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Bajrai LH, Kumosani T, El-Kafrawy S, El-Daly M, Hindawi S, Ashshi A, Azhar EI. Distribution of HBV genotypes from two blood transfusion centers in western Saudi Arabia. Future Virol 2014. [DOI: 10.2217/fvl.14.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To determine the distribution of HBV genotypes among HBsAg-positive blood donors in Makkah and Jeddah. Materials & methods: A total of 158 volunteered HBsAg-positive male blood donors donated blood samples at two transfusion centers in western Saudi Arabia. RFLP digestion was performed on 83 PCR products of the S gene. A subset of 77 positive samples were sequenced and aligned with reference Genbank sequences. Results: RFLP showed the following genotype distribution: 71 (85.6%) D; two (2.4%) E; one (1.2%) A; one (1.2%) B; one (1.2%) C; five (6.0%) untypable; one (1.2%) mixed genotypes D+A; and one (1.2%) mixed genotype D+C. Seventy-seven samples were genotyped by sequencing as follows: 73 (94.8%) D, three (3.9%) E; and one (1.3%) A. The study showed that there is concordance in the results of RFLP and sequencing in 67 samples and discrepancy in ten samples: genotypes B, genotype C, one of genotype E and dual genotypes by RFLP could only been detected as genotype D by sequencing. Sequencing showed the RFLP untypable samples as genotypes D and E. Conclusion: HBV type D is the most prevalent genotype in western Saudi Arabia. RFLP is a reliable tool for predicting genotype D in Saudi population.
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Affiliation(s)
- Leena H Bajrai
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Taha Kumosani
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Experimental Biochemistry Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherif El-Kafrawy
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mai El-Daly
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salwa Hindawi
- Blood Transfusion Services, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Ashshi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Haghshenas MR, Arabi M, Mousavi T. Hepatitis B genotypes in iran. Mater Sociomed 2014; 26:129-33. [PMID: 24944540 PMCID: PMC4035145 DOI: 10.5455/msm.2014.26.129-133] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/04/2014] [Indexed: 12/18/2022] Open
Abstract
Hepatitis B virus (HBV) infection is a public health problem as a cause of liver diseases including hepatocellular carcinoma and cirrhosis. It is estimated that 350 million people live with chronic infection and about one million people die every year from complication of this chronic disease in the world. So far, ten HBV genotypes (A-J) has been identified which show a geographical distribution. Throughout the world, carrier variability rate for hepatitis B infection is estimated to be 0.1% to 20%, with regions classified as having low endemicity (<2%), intermediate endemicity (2-7%) and high endemicity (>8%). The prevalence of hepatitis B infection is estimated at 2 to 7 percent In Iran. After HBV vaccination program the prevalence of hepatitis B infection has been reported less than 2%, so Iran can be considered one of the countries with low HBV infection endemicity. In Iran several studies were shown that the only genotype of HBV(100%)was found genotype D as the prominent type in some provinces, but some studies reported genotype B(5%)as well as genotype D(95%).The distribution of HBV genotypes may guide us in determining disease burden, prognosis and antiviral responses. So, it is important to know the epidemiologically of HBV genotyping as well.
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Affiliation(s)
- Mohammad Reza Haghshenas
- Molecular Cell-Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences,Sari, Iran
| | - Mohsen Arabi
- Molecular Cell-Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences,Sari, Iran
| | - Tahoora Mousavi
- Molecular Cell-Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences,Sari, Iran
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25
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Abaalkhail F, Elsiesy H, AlOmair A, Alghamdi MY, Alalwan A, AlMasri N, Al-Hamoudi W. SASLT practice guidelines for the management of hepatitis B virus. Saudi J Gastroenterol 2014; 20:5-25. [PMID: 24496154 PMCID: PMC3952421 DOI: 10.4103/1319-3767.126311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Faisal Abaalkhail
- Department of Liver and Small Bowel Transplantation, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hussien Elsiesy
- Adult Transplant Hepatology, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmed AlOmair
- Department of Medicine, Gastroenterology Unit, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Y. Alghamdi
- Department of Gastroenterology, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Abduljaleel Alalwan
- Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nasser AlMasri
- Department of Gastroenterology, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Waleed Al-Hamoudi
- Adult Transplant Hepatology, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Gastroenterology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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26
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Khan A, Al Balwi MA, Tanaka Y, Hajeer A, Sanai FM, Al Abdulkarim I, Al Ayyar L, Badri M, Saudi D, Tamimi W, Mizokami M, Al Knawy B. Novel point mutations and mutational complexes in the enhancer II, core promoter and precore regions of hepatitis B virus genotype D1 associated with hepatocellular carcinoma in Saudi Arabia. Int J Cancer 2013; 133:2864-2871. [PMID: 23740667 DOI: 10.1002/ijc.28307] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 05/14/2013] [Indexed: 10/10/2023]
Abstract
In this study, a cohort of 182 patients [55 hepatocellular carcinoma (HCC) and 127 non-HCC] infected with hepatitis B virus (HBV) in Saudi Arabia was investigated to study the relationship between sequence variation in the enhancer II (EnhII), basal core promoter (BCP) and precore regions of HBV genotype D (HBV/D) and the risk of HCC. HBV genotypes were determined by sequencing analysis and/or enzyme-linked immunosorbent assay. Variations in the EnhII, BCP and precore regions were compared between 107 non-HCC and 45 HCC patients infected with HBV/D, followed by age-matched analysis of 40 cases versus equal number of controls. Age and male gender were significantly associated with HCC (p = 0.0001 and p = 0.03, respectively). Serological markers such as aspartate aminotransferase, albumin and anti-HBe were significantly associated with HCC (p = 0.0001 for all), whereas HBeAg positivity was associated with non-HCC (p = 0.0001). The most prevalent HBV genotype was HBV/D (94%), followed by HBV/E (4%), HBV/A (1.6%) and HBV/C (0.5%). For HBV/D1, genomic mutations associated with HCC were T1673/G1679, G1727, C1741, C1761, A1757/T1764/G1766, T1773, T1773/G1775 and C1909. Age- and gender-adjusted stepwise logistic regression analysis indicated that mutations G1727 [odds ratio (OR) = 18.3; 95% confidence interval (CI) = 2.8-118.4; p = 0.002], A1757/T1764/G1766 (OR = 4.7; 95% CI = 1.3-17.2; p = 0.01) and T1773 (OR = 14.06; 95% CI = 2.3-84.8; p = 0.004) are independent predictors of HCC development. These results implicate novel individual and combination patterns of mutations in the X/precore region of HBV/D1 as predictors of HCC. Risk stratification based on these mutation complexes would be useful in determining high-risk patients and improving diagnostic and treatment strategies for HBV/D1.
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Affiliation(s)
- Anis Khan
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Virology and Liver Unit, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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27
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Emergence of hepatitis B virus genotype f in aligarh region of north India. Adv Virol 2013; 2013:846849. [PMID: 24381592 PMCID: PMC3870090 DOI: 10.1155/2013/846849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 12/18/2022] Open
Abstract
Introduction. HBV genotypes and subtypes are useful clinical and epidemiological markers. In this study prevalent HBV genotypes were assessed in relation to serological profile and clinical status. Material & Methods. 107 cases of HBV were genotyped. Detailed clinical history was elicited from them. HBsAg, HBeAg, anti-HBs, anti-HBe, and anti-HBc-IgM were assessed. HBV genotyping was performed using Kirschberg's type specific primers (TSP-PCR), heminested PCR, and Naito's monoplex PCR. Nucleotide sequencing was performed. Results. A total of 97 (91%) were genotyped following the methods of Kirschberg et al./Naito et al. Genotype D was by far the most prevalent genotype 91 (85.04%) in this region. A surprising finding was the detection of genotype F in 5 (4.67%) of our patients. Genotype A strangely was observed only in one case. In 85.7% genotype D was associated with moderate to severe liver disease, 43.9% HBeAg, and 18.7% anti-HBc-IgM positivity. Majority of genotype F (80%) was seen in mild to moderate liver disease. It was strongly associated with HBeAg 60% and 20% anti-HBc-IgM positivity. Conclusion. Emergence of genotype F in India merits further study regarding its clinical implications and treatment modalities. Knowledge about HBV genotypes can direct a clinician towards more informed management of HBV patients.
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Pourkarim MR, Sharifi Z, Soleimani A, Amini-Bavil-Olyaee S, Elsadek Fakhr A, Sijmons S, Vercauteren J, Karimi G, Lemey P, Maes P, Alavian SM, Van Ranst M. Evolutionary analysis of HBV “S” antigen genetic diversity in Iranian blood donors: A nationwide study. J Med Virol 2013; 86:144-55. [DOI: 10.1002/jmv.23798] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 12/15/2022]
Affiliation(s)
- Mahmoud Reza Pourkarim
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - Zohre Sharifi
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - Ali Soleimani
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - Samad Amini-Bavil-Olyaee
- Department of Molecular Microbiology and Immunology; Keck School of Medicine; University of Southern California; Harlyne J. Norris Cancer Research Tower; Los Angeles CA 90033
| | - Ahmed Elsadek Fakhr
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
| | - Steven Sijmons
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
| | - Jurgen Vercauteren
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
| | - Gharib Karimi
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - Philippe Lemey
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
| | - Piet Maes
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
| | - Seyed Moayed Alavian
- Department of Molecular Microbiology and Immunology; Keck School of Medicine; University of Southern California; Harlyne J. Norris Cancer Research Tower; Los Angeles CA 90033
- Middle East Liver Disease Clinics; Tehran Iran
| | - Marc Van Ranst
- Department of Microbiology and Immunology; Laboratory of Clinical and Epidemiological Virology; Rega Institute for Medical Research; KU Leuven Leuven Belgium
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29
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Gasim GI. Hepatitis B virus in the Arab world: where do we stand? Arab J Gastroenterol 2013; 14:35-43. [PMID: 23820498 DOI: 10.1016/j.ajg.2013.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 03/28/2013] [Accepted: 04/21/2013] [Indexed: 12/12/2022]
Abstract
The epidemiology of viral hepatitis is of great importance for planning and managing health provision for all the countries in the Arab world. However, data on viral hepatitis are not readily available in a large percentage of Arab countries. Hepatitis B virus (HBV) is considered to be one of the most important causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma. A systematic electronic search of published literature was conducted to extract data on epidemiology and risk factors for the analysis of HBV infection among the countries in the Arab world. The prevalence of chronic HBV infection was found to be decreasing in some Arab countries although it was still unacceptably high. This was particularly evident in the Arabian Gulf region, in Lebanon, Egypt and Libya. The age-specific prevalence varied from country to country with decline in prevalence being noted among children in the Gulf States and among Libyan women. These declines in prevalence are most likely to be related to the Expanded Immunization Programme. The alarmingly high prevalence of chronically infected patients in some areas and the widespread differences in HBV prevalence between Arab nations may be explained by the variation in risk factors involved. This situation calls for targeted approaches to tackle HBV-related mortality and morbidity. Precise HBV infection prevalence data are needed at the national and the sub-national level to estimate the disease burden, guide health intervention programmes and evaluate vaccine efficiency.
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Wong GLH, Chan HLY, Yiu KKL, Lai JWY, Chan VKK, Cheung KKC, Wong EWN, Wong VWS. Meta-analysis: The association of hepatitis B virus genotypes and hepatocellular carcinoma. Aliment Pharmacol Ther 2013; 37:517-26. [PMID: 23305043 DOI: 10.1111/apt.12207] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 11/29/2012] [Accepted: 12/19/2012] [Indexed: 01/30/2023]
Abstract
BACKGROUND A meta-analysis on the risk of hepatocellular carcinoma (HCC) among hepatitis B virus (HBV) genotypes is warranted as the current data are conflicting. AIM To investigate the relative risk of HCC among the four major HBV genotypes (A-D). METHODS A meta-analysis was performed based on literature search from electronic databases and bibliography between 1950 and 2012. All abstracts with keywords 'hepatitis B', 'hepatocellular carcinoma' and 'genotype' were screened. Studies were included if they reported HBV genotype as an exposure and HCC as an outcome. RESULTS Nine hundred and eighty-eight abstracts were found through literature search, among them 43 studies were eligible for this meta-analysis. A total of 14,545 patients with an average age of 43 years were included; 71% were male patients and 17% had cirrhosis. In 33 studies, HCC was found in 1541/6060 (25%) genotype C vs. 550/4417 (12%) genotype B HBV-infected patients [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.52-2.76, P < 0.001]. No difference in the risk of HCC was found among genotype A (71/517, 14%) vs. genotype D (170/1506, 11%) HBV-infected patients in 14 studies (OR = 0.94, 95% CI = 0.67-1.32). In 10 studies, the risk of HCC was also found higher among genotype C (498/1659, 30%) than genotype A&D (103/1403, 7%) HBV-infected patients (OR = 2.34, 95% CI = 1.63-3.34, P < 0.001). Subgenotype Ce and Cs HBV-infected patients had similar risk on HCC (OR = 1.13, 95% CI = 0.76-1.67, P = 0.54). On funnel plot analysis, there was no significant publication bias in all comparisons. CONCLUSION Genotype C hepatitis B virus is associated with a higher risk of hepatocellular carcinoma than other major hepatitis B virus genotypes.
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Affiliation(s)
- G L-H Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, China
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31
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Alghamdi A, Aref N, El-Hazmi M, Al-Hamoudi W, Alswat K, Helmy A, Sanai FM, Abdo AA. Correlation between hepatitis B surface antigen titers and HBV DNA levels. Saudi J Gastroenterol 2013; 19:252-7. [PMID: 24195978 PMCID: PMC3958972 DOI: 10.4103/1319-3767.121035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/AIM To assess the correlation between serum HBsAg titers and hepatitis B virus (HBV) DNA levels in patients with hepatitis B envelop antigen-negative (HBeAg -ve) HBV genotype-D (HBV/D) infection. PATIENTS AND METHODS A total of 106 treatment- naïve, HBeAg -ve HBV/D patients were included; 78 in the inactive carrier (IC) state and 28 in the active hepatitis (AH) stage. HBV DNA load and HBsAg titers were tested using TaqMan real-time polymerase chain reaction (PCR) and automated chemiluminescent microparticle immunoassay, respectively. RESULTS The median (range) log10 HBsAg titer was significantly lower in the IC group compared with AH group, 3.09 (-1 to -4.4) versus 3.68 (-0.77 to 5.09) IU/mL, respectively; P < 0.001. The suggested cutoff value of HBsAg titer to differentiate between the two groups was 3.79 log10 IU/mL. In addition, there was a significant positive correlation between HBsAg and HBV DNA levels in the whole cohort, AH, and IC groups (r = 0.6, P < 0.0001; r = 0.591, P = 0.001; and r = 0.243, P = 0.032, respectively). CONCLUSION Serum HBsAg titers may correlate with HBV DNA in treatment-naïve HBeAg -ve HBV/D patients, and supports the use of HBsAg levels in clinical practice as a predictor of serum HBV DNA levels.
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Affiliation(s)
- Amal Alghamdi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nagwa Aref
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Malak El-Hazmi
- Department of Pathology, College of Medicine, Riyadh 11461, Saudi Arabia
| | - Waleed Al-Hamoudi
- Department of Medicine, College of Medicine, Riyadh 11461, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh 11461, Saudi Arabia
| | - Khalid Alswat
- Department of Medicine, College of Medicine, Riyadh 11461, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh 11461, Saudi Arabia
| | - Ahmed Helmy
- Liver Disease Research Center, King Saud University, Riyadh 11461, Saudi Arabia,Department of Tropical Medicine and Gastroenterology, Assiut University Hospitals, Assiut 71511, Egypt
| | - Faisal M. Sanai
- Liver Disease Research Center, King Saud University, Riyadh 11461, Saudi Arabia,Department of Hepatobiliary Sciences and Liver Transplantation, King Abdul Aziz Medical City, Riyadh 11426, Saudi Arabia
| | - Ayman A. Abdo
- Department of Medicine, College of Medicine, Riyadh 11461, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh 11461, Saudi Arabia,Address for correspondence: Dr. Ayman Abdo, Division of Gastroenterology, Department of Medicine, King Saud University, P. O. Box-2925 (59), Riyadh - 11461, Saudi Arabia. E-mail:
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32
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Al-Qahtani A, Al-Anazi M, Viswan NA, Khalaf N, Abdo AA, Sanai FM, Al-Ashgar H, Al-Ahdal M. Role of single nucleotide polymorphisms of KIF1B gene in HBV-associated viral hepatitis. PLoS One 2012; 7:e45128. [PMID: 23028799 PMCID: PMC3445584 DOI: 10.1371/journal.pone.0045128] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 08/13/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/AIM Kinesin family member 1B (KIF1B) gene resides in the chromosomal region 1p36.22 and has been reported to have frequent deletions in a variety of human cancers. A recent genome wide association study (GWAS) study conducted on a Chinese population has reported the involvement of a KIF1B genetic variant in Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). This study aims to investigate the significance of KIF1B genetic variations in HBV-associated hepatitis in patients of Saudi Arabian ethnicity. METHODS TaqMan genotyping assay was used to investigate the association of three SNPs (rs17401966, rs12734551, and rs3748578) in 584 normal healthy controls and 660 HBV-infected patients. The patients were categorized into inactive carriers (Case I), active carriers (Case II), Cirrhosis (Case III) and Cirrhosis-HCC (Case IV) sub-groups. RESULTS Since SNPs rs12734551 and rs3748578 are in strong linkage disequilibrium (LD) with rs17401966, only results for the latter SNP are reported. Therefore, the allele frequency of rs17401966 among HBV-infected patients and healthy controls were comparable and therefore, no significant association was observed (P=0.2811, Odds Ratio (OR) 0.897). A similar analysis was performed among the different sub-groups in order to determine whether KIF1B SNPs were associated with the advancement of the disease. No significant differences were observed in any of the comparisons performed. CONCLUSION Polymorphisms at KIF1B gene locus investigated in this study showed no significant association with HBV infection or with HBV-associated diseases such as liver cirrhosis or HCC.
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Affiliation(s)
- Ahmed Al-Qahtani
- Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
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Saadah OI, Sindi HH, Bin-Talib Y, Al-Harthi S, Al-Mughales J. Entecavir treatment of children 2-16 years of age with chronic hepatitis B infection. Arab J Gastroenterol 2012; 13:41-4. [PMID: 22980589 DOI: 10.1016/j.ajg.2012.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 01/25/2012] [Accepted: 04/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND STUDY AIMS Childhood acquired chronic hepatitis B is associated with a significant lifetime risk of developing cirrhosis or hepatocellular carcinoma. Our objective in this study was to report retrospectively the response to treatment with Entecavir in 8 children with chronic hepatitis B followed at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS This study is an observational hospital based chart review of children and adolescents with chronic hepatitis B treated with entecavir at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia in the period between June 2007 and July 2011. RESULTS Half of the studied group was males, and the median age at the time of treatment was 4.8 years (range, 2.6-15). All subjects displayed infection with HBV genotype D and all were HBeAg positive. Half of the patients had been previously treated with lamivudine, while the remaining half was treatment naïve patients. The mean ALT±SD was 84.9±34.7IU/L (range, 46-133) and the mean HBV DNA was 5.01×10(8)±5.7×10(8) IU/mL (range, 5.5×10(7)-1.3×10(9)). Patients were treated with a daily oral dose of 0.5mg entecavir, and the mean duration of treatment was 23.8±11.9 months, (range 14.9-44.7 months). HBV DNA suppression of more than 2 log(10) was achieved in all patients. HBV DNA was undetected in 37.5%, with ALT normalization in 87.5% and lastly HBeAg seroconversion and loss occurred in 37.5%. No adverse side effects were observed during the treatment with entecavir. CONCLUSION We conclude from this limited data that 37.5% of children treated with entecavir achieved HBeAg loss and seroconversion with no side effects observed during treatment period, however long term safety and efficacy in children should be demonstrated through a multicenter study, enrolling large number of patients.
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Affiliation(s)
- Omar I Saadah
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Mohebbi SR, Amini-Bavil-Olyaee S, Zali N, Damavand B, Azimzadeh P, Derakhshan F, Sabahi F, Zali MR. Characterization of hepatitis B virus genome variability in Iranian patients with chronic infection, a nationwide study. J Med Virol 2012; 84:414-23. [PMID: 22246826 DOI: 10.1002/jmv.23200] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hepatitis B virus (HBV) isolates from Iranian patients around the country were characterized. Eighty-one complete genomes from HBV isolates were sequenced and analyzed. The studied population was grouped into three categories including inactive carriers, patients with chronic hepatitis, and patients with liver cirrhosis. Molecular and phylogenetic analyses revealed that Iranian patients were infected with HBV genotype D and subgenotype D1. The most common subtype was ayw2, followed by ayw3 and ayw4. Several deletions and insertions that had no correlation with disease outcome were observed in the HBV genomes. The most frequent mutation in the major hydrophilic region (MHR) of HBV surface antigen (HBsAg) was sP120S. Almost half of the patients studied carried precore (PC) mutant variants and one-third of the studied population was infected with variants carrying basal core promoter (BCP) mutations. PC and BCP mutations were observed in older patients, especially in those with chronic liver disease. Sixty-seven patients (82.7%) were HBeAg negative, and the prevalence of precore mutant isolates (G1896A) was higher in this group than in HBeAg-positive patients. Lamivudine drug resistance mutations were detected after 1 year of treatment in about 30% of lamivudine-treated patients. In conclusion, these results demonstrate that HBV subgenotype D1 is the only subgenotype circulating in Iran, and there is no evidence of any exotic genotype in the region. The HBV PC (G1896A) mutation may play an important role in the clinical outcome of the disease by increasing the risk of progressive liver disease among Iranian patients infected with HBV.
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Affiliation(s)
- Seyed Reza Mohebbi
- Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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35
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Abdo AA, Hassanain M, AlJumah A, Al Olayan A, Sanai FM, Alsuhaibani HA, Abdulkareem H, Abdallah K, AlMuaikeel M, Al Saghier M, Babatin M, Kabbani M, Bazarbashi S, Metrakos P, Bruix J. Saudi guidelines for the diagnosis and management of hepatocellular carcinoma: technical review and practice guidelines. Ann Saudi Med 2012; 32:174-99. [PMID: 22366832 PMCID: PMC6086640 DOI: 10.5144/0256-4947.2012.174] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Recognizing the significant prevalence of hepatocellular carcinoma (HCC) in Saudi Arabia, and the difficulties often faced in early and accurate diagnoses, evidence-based management, and the need for appropriate referral of HCC patients, the Saudi Association for the Study of Liver diseases and Transplantation (SASLT) formed a multi-disciplinary task force to evaluate and update the previously published guidelines by the Saudi Gastroenterology Association. These guidelines were later reviewed, adopted and endorsed by the Saudi Oncology Society (SOS) as its official HCC guidelines as well. The committee assigned to revise the Saudi HCC guidelines was composed of hepatologists, oncologists, liver surgeons, transplant surgeons, and interventional radiologists. Two members of the task force served as guidelines editors. A wide based search on all published reports on all aspects of the epidemiology, natural history, risk factors, diagnosis, and management of HCC was performed. All available literature was critically examined and available evidence was then classified according to its strength. The whole document and the recommendations were then discussed in detail by members and consensus was obtained. All recommendations in these guidelines were based on the best available evidence, but were tailored to the patients treated in Saudi Arabia. We hope that these guidelines will improve HCC patient care and enhance the multidisciplinary care needed for these patients.
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Affiliation(s)
- Ayman A Abdo
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Abstract
Some 400 million people worldwide are currently infected with the hepatitis B virus (HBV), and the infection is common in the Middle East. Another 170 million people around the globe presently live with chronic hepatitis C virus (HCV) infection. Both HBV and HCV represent a worldwide epidemic. Despite significant decline in the prevalence of HBV and HCV infection in Saudi Arabia, these viral diseases cause significant morbidity and mortality, and impose a great burden on the country's healthcare system. On the other hand, Saudi epidemiology studies have shown that the hepatitis A virus seroprevalence in the country has reduced considerably over the past two decades. The progress in mapping the epidemiological pattern of viral hepatitis in Saudi Arabia has not only aided our understanding of the disease, but has also exposed the small but relevant gaps in our identification of the intricate details concerning the disease's clinical expression. In this review, we aim to document the timeline of viral hepatitis epidemiology in Saudi Arabia, while summarizing the relevant published literature on the subject.
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Affiliation(s)
- Ayman A. Abdo
- Department of Medicine, Gastroenterology Unit, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Ayman A. Abdo, Gastroenterology Unit, Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box 2925 (59), Riyadh - 11461, Saudi Arabia. E-mail:
| | - Faisal M. Sanai
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia,Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Faleh Z. Al-Faleh
- Department of Medicine, Gastroenterology Unit, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
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Abstract
Experts from seven countries convened as a Specialist Panel for the Middle East to share information on practical issues relating to the epidemiology, diagnosis and management of chronic hepatitis B (CHB) infection. The Middle East is regarded as a region of high-to-intermediate epidemicity; however, infant vaccination programmes have successfully lowered the prevalence of hepatitis B infection in most countries to that of low-to-intermediate endemicity. Vaccine issues still to be addressed included improving coverage in some rural/poor communities, instituting hepatitis B vaccine at birth and providing vaccines for high-risk population groups. Hepatitis B infection in the Middle East primarily occurs as a result of perinatal infection, horizontal transmission between family members and transmission from injections. Blood transfusion services have broadly efficient screening programmes, but immunocompromised and haemodialysis patients are at risk. The cost of screening, monitoring and treating CHB influences practice in a number of Middle East countries, and there is a need for information on the most cost-effective options.
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Al-Ashgar HI, Khan MQ, Aljumah A, Sanai FM, Abdo AA, Dafalla MM, Fagih MA, Bzeizi KI. Efficacy of peginterferon α-2a and predictors of response in HBeAg-negative, genotype D-naive patients. Hepatol Int 2011; 6:718-26. [PMID: 23936583 PMCID: PMC3734594 DOI: 10.1007/s12072-011-9319-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Accepted: 11/10/2011] [Indexed: 01/05/2023]
Abstract
BACKGROUND Peginterferon (PEG-IFN) α-2a has been shown to induce a sustained virologic response (SVR) in 20-30% of "hepatitis B e antigen (HBeAg)"-negative patients. AIM To determine the safety and efficacy of PEG-IFN α-2a in HBeAg-negative, genotype D-naive patients and to analyze the predictors of response. METHODS This prospective, multicenter, open-label, nonrandomized trial was conducted at four hospitals. A total of 35 consecutive HBeAg-negative naive genotype D patients received PEG-IFN α-2a for 48 weeks. RESULTS Based on a cutoff of hepatitis B virus (HBV) DNA <400 copies ml(-1), an early virologic response (EVR) at week 12, end of treatment virologic response (ETVR) at week 48, and SVR at week 72 were achieved by 3 (9%), 9 (26%), and 8 patients (23%), respectively. The EVR rate improved to 43%, ETVR to 49%, and SVR to 57%, when a HBV DNA cutoff level of <20,000 copies ml(-1) was used. Pretreatment HBsAg level was not a predictor for SVR on univariate analysis, but correlated with decline in HBV DNA levels at weeks 48 and 72. On multivariate logistic regression analysis, low body weight, high alanine aminotransferase (ALT), low HBV DNA, and low triglyceride levels were identified as baseline predictors of SVR. CONCLUSION HBeAg-negative genotype D-naive patients treated with PEG-IFN α-2a achieved SVR in 23 (HBV <400 copies ml(-1)) and 57% (HBV <20,000 copies ml(-1)) of patients, a better response than previously reported that might be related to the absence of drug resistance in these naive patients. Pretreatment predictors of SVR were low body weight, high ALT, low HBV DNA, and low triglycerides.
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Affiliation(s)
- Hamad I Al-Ashgar
- Section of Gastroenterology, Department of Medicine (MBC-46), King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh, 11211 Saudi Arabia
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39
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Bahri O, Ezzikouri S, Alaya-Bouafif NB, Iguer F, Feydi AEE, Mestiri H, Benazzouz M, Khalfallah T, Afifi R, Elkihal L, Berkane S, Marchio A, Debzi N, Dejean A, Pineau P, Triki H, Benjelloun S. First multicenter study for risk factors for hepatocellular carcinoma development in North Africa. World J Hepatol 2011; 3:24-30. [PMID: 21307984 PMCID: PMC3035699 DOI: 10.4254/wjh.v3.i1.24] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 12/08/2010] [Accepted: 12/15/2010] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the role of the major risk factors for hepatocellular carcinoma (HCC) development in the western part of North Africa. METHODS A multicenter case control study was conducted in Tunisia, Morocco and Algeria in collaboration with Pasteur Institutes in these countries. A total of 164 patients with HCC and 250 control subjects without hepatic diseases were included. Prevalences of HBsAg, anti-hepatitis C virus (HCV) and diabetes were assessed. HCV and HBV genotyping were performed for anti-HCV and HBsAg positive patients. RESULTS The mean age of patients was 62 ± 10 years old for a 1.5 M:F sex ratio. Sixty percent of HCC patients were positive for anti-HCV and 17.9% for HBsAg. Diabetes was detected in 18% of cases. Odd ratio (OR) and 95% confidence intervals (CI) were 32.0 (15.8 - 65.0), 7.2 (3.2 - 16.1) and 8.0 (3.1 - 20.0) for anti-HCV, HBsAg and diabetes respectively. Multivariate analysis indicated that the three studied factors were independent. 1b HCV genotype and D HBV genotype were predominant in HCC patients. HCV was the only risk factor significantly associated with an excess of cirrhosis (90% vs 68% for all other risk factors collectively, P = 0.00168). Excessive alcohol consumption was reliably established for 19 (17.6%) cases among the 108 HCC patients for whom data is available. CONCLUSION HCV and HBV infections and diabetes are the main determinants of HCC development in North Africa. An active surveillance and secondary prevention programs for patients with chronic hepatitis and nutrition-associated metabolic liver diseases are the most important steps to reduce the risk of HCC in the region.
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Affiliation(s)
- Olfa Bahri
- Olfa Bahri, Hinda Triki, Laboratory of Clinical Virology, Institut Pasteur of Tunis, Tunis, BP 1002, Tunisia
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40
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Sanai FM, Sobki S, Bzeizi KI, Shaikh SA, Alswat K, Al-Hamoudi W, Almadi M, Al Saif F, Abdo AA. Assessment of alpha-fetoprotein in the diagnosis of hepatocellular carcinoma in Middle Eastern patients. Dig Dis Sci 2010; 55:3568-75. [PMID: 20397051 DOI: 10.1007/s10620-010-1201-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Accepted: 03/15/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alpha-fetoprotein (AFP) levels for the diagnosis of hepatocellular carcinoma (HCC) may vary by geographical region and racial background. No data exists for this test in the Middle Eastern population. In addition, there is limited data on the impact of virological status on AFP levels. METHODS In a multicenter, case-control study involving 206 cases, 199 cirrhotic and 197 chronic hepatitis controls, we assessed the utility of AFP in the diagnosis of HCC (sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and positive likelihood ratios (LR). PPV and NPV were evaluated for three additional HCC prevalence rates (5, 10, and 20%). RESULTS The best discriminating AFP value was 11.7 ng/ml. The sensitivity ranged from 32 to 79.5% at different AFP levels with the specificity increasing sequentially from 47.7 to 98.5%. Sensitivity of AFP at the best cut-off level for hepatitis C virus (HCV), hepatitis B virus (HBV) and non-viral etiology for HCC was 73.7, 65.6, and 59.5%, respectively. Specificity at this level for HCV, HBV, and non-viral etiology was 36.6, 30.1, and 29.4%, respectively. AFP cut-off levels of 102, 200, and 400 ng/ml showed similar sensitivity (39.8, 35.9, and 32%, respectively) and specificity (96, 98.5, and 98.5% respectively). Positive LR for AFP at >11.7, >20, >102, >200, >400 ng/ml were 2.8, 3.3, 9.9, 23.8, and 21.2, respectively. CONCLUSIONS In cirrhotic patients, AFP has a poor screening and diagnostic value for HCC. Underlying viral etiology fails to influence the diagnostic accuracy of this test. An AFP level greater than 100 ng/ml has a high degree of specificity and may be used as a confirmatory test.
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Affiliation(s)
- Faisal M Sanai
- Department of Gastroenterology, Riyadh Military Hospital A41, PO Box 7897, Riyadh 11159, Saudi Arabia.
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41
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Cao GW. Clinical relevance and public health significance of hepatitis B virus genomic variations. World J Gastroenterol 2010. [PMID: 19998495 DOI: 10.3748/wjg.15.5761.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
Ten hepatitis B virus (HBV) genotypes (A-J) and 34 HBV subgenotypes have been identified so far. HBV genotypes and subgenotypes have distinct geographical distributions, and have been shown to differ with regard to clinical outcome, prognosis, and response to interferon treatment. Infection with subgenotype A2 is frequently associated with high viral load, resulting in acute infection via horizontal transmission. Genotypes A and B are more sensitive to interferon treatment than genotypes D and C, respectively. Genotype B is more frequent in acute hepatitis than genotype C, whereas genotype C (C2) is more frequently associated with an increased risk of hepatocellular carcinoma (HCC), mostly cirrhotic, as compared with genotype B (B2). Genotype mixture is associated with high viral load and worse outcome of HBV infection. HBV mutations in the S genes, especially amino acids substitution at position 145 (G145R), are associated with immune escape, whereas mutations in the PreS or S genes which impair HBsAg secretion could present a risk to blood safety. HBV variants harboring mutations in the viral polymerase gene that confer resistance to nucleoside analogs may be selected during antiviral therapy. Different genotypes have distinct mutation patterns in the PreS and EnhII/BCP/Precore regions. PreS deletions, C1653T, T1753V, and A1762T/G1764A are associated with an increased risk of HCC. HCC-associated HBV mutants may not transmit via mother-to-child transmission, and are likely generated during HBV-induced pathogenesis. Examination of HBV mutations alone or in combination and host genetic susceptibility will be helpful in classifying the HBV-infected subjects who will develop HCC and need active anti-viral treatments.
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42
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High prevalence of HBV genotype D in Syria and the clinical characteristics of hepatitis B e antigen-negative chronic hepatitis B. Epidemiol Infect 2010; 138:40-4. [PMID: 19538827 DOI: 10.1017/s0950268809990288] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Hepatitis B virus (HBV) genotype D and hepatitis B e antigen (HBeAg) negative chronic hepatitis are the most prevalent in Mediterranean countries. No data have ever been published on their prevalence in Syria, a country of intermediate endemicity for HBV. The aims of the current study were to determine the HBV genotype distribution in Syria, the prevalence of HBeAg-positive and HBeAg-negative chronic hepatitis and to analyse the clinical characteristics of each group. A total of 220 patients were included. Ninety-seven percent of the patients were of genotype D, and 72% were HBeAg negative. The HBeAg-negative patients were older, had a lower viral load, had more cirrhosis and the mode of contamination was known less than for HBeAg-positive patients. These findings have major implications in understanding the natural history of the infection and are of great relevance in the choice of therapy.
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43
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Poustchi H, Sepanlou SG, Esmaili S, Mehrabi N, Ansarymoghadam A. Hepatocellular carcinoma in the world and the middle East. Middle East J Dig Dis 2010; 2:31-41. [PMID: 25197510 PMCID: PMC4154905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2009] [Accepted: 12/26/2009] [Indexed: 11/18/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a major worldwide public health concern. Despite recent advances, there has been little success in improving the survival of HCC patients. Due to advances in diagnostic modalities and the increasing incidence of chronic viral hepatitis and nonalcoholic fatty liver disease (NAFLD), both of which are well known risk factors of HCC, the prevalence of HCC is increasing in developed countries and it is expected that this trend will continue in the future. In Middle Eastern countries the prevalence of this cancer is lower compared to sub-Saharan Africa and some Far East countries; however it is documented that the prevalence of this cancer in some parts of the Middle East is also increasing. In the current review, the prevalence and burden of this disease worldwide, particularly in Middle Eastern countries, and risk factors for HCC are discussed.
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Affiliation(s)
- H Poustchi
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - SG Sepanlou
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S Esmaili
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - N Mehrabi
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ansarymoghadam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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44
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Taghavi SA, Tabibi M, Eshraghian A, Keyvani H, Eshraghian H. Prevalence and clinical significance of hepatitis B Basal core promoter and precore gene mutations in southern Iranian patients. HEPATITIS MONTHLY 2010; 10:294-7. [PMID: 22312396 PMCID: PMC3271323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2010] [Revised: 05/01/2010] [Accepted: 05/07/2010] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND AIMS To investigate the prevalence and pattern of PC and BCP mutations and their clinical significance in patients with genotype D chronic hepatitis B infection in the Fars province of southern Iran. MATERIALS AND METHODS From January 2007 to March 2008, we evaluated 44 patients with chronic hepatitis B infection who were referred to our hepatology clinics affiliated with the Shiraz University of Medical Science. All Patients were HBeAg Negative and HBeAb positive. Basal core promoter and precore mutations in these patients were evaluated with clinical phenotype and laboratory tests. RESULTS The mean age of the patients was 37.21 ± 10.54 years. Twenty-seven patients (61.4%) had no mutations, whereas 17 patients (38.6%) had mutations in the precore or basal core promoter regions or both. The mean serum ALT level in mutation-free patients was 59.74 ± 55.86 IUL, whereas patients with PC and BCP mutations had a mean serum ALT level of 71.35 ± 59.49 IUL. The mean serum AST level in patients with mutations was higher than for patients without mutations (59.53 ± 41.35 IUL vs. 40.65 ± 25.21 IUL, respectively). There was no statistically significant difference between the mutation and mutation-free groups in terms of age, sex, and liver enzyme levels (P > 0.05). Fourteen of the 44 patients (31.8%) had mutations in the precore region (G 1896A). 17 patients (38.6%) had mutations in basal core promoter region. CONCLUSION This study revealed a high prevalence of precore and basal core promoter mutations in southern Iran. Although no statistically significant difference was noted in liver enzymes, patients with mutations had higher liver enzymes in comparison with mutation-free patients.
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Affiliation(s)
- Seyed Alireza Taghavi
- Gastroenterohepatology Research Center, Shiraz University of Medical Science, Shiraz, IR Iran,Internal medicine department, Shiraz University of medical science, Shiraz, IR Iran
| | - Manouchehr Tabibi
- Internal medicine department, Shiraz University of medical science, Shiraz, IR Iran
| | - Ahad Eshraghian
- Gastroenterohepatology Research Center, Shiraz University of Medical Science, Shiraz, IR Iran,Internal medicine department, Shiraz University of medical science, Shiraz, IR Iran,Corresponding author at: Dr. Ahad Eshraghian, MD, Internal medicine department, Nemazee Hospital, Shiraz, Fars province, P.O. Box: 71345- 1744, Shiraz, IR Iran. Tel.: +98-7116474316, Fax: +98-7116276212, E-mail:
| | - Hossein Keyvani
- Microbiology department, Iran University of medical science, Tehran, IR Iran
| | - Hamed Eshraghian
- Gastroenterohepatology Research Center, Shiraz University of Medical Science, Shiraz, IR Iran
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45
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Zaky S, Farghaly AM, Rashed HA, Hassan H, Faouzy E, Makhlouf N, Hussein MRA. Clinicopathologic features and genotyping of patients with chronic HBV infection in the Upper Egypt. Cell Immunol 2010; 265:97-104. [DOI: 10.1016/j.cellimm.2010.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 07/17/2010] [Accepted: 07/24/2010] [Indexed: 02/06/2023]
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46
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Abstract
Ten hepatitis B virus (HBV) genotypes (A-J) and 34 HBV subgenotypes have been identified so far. HBV genotypes and subgenotypes have distinct geographical distributions, and have been shown to differ with regard to clinical outcome, prognosis, and response to interferon treatment. Infection with subgenotype A2 is frequently associated with high viral load, resulting in acute infection via horizontal transmission. Genotypes A and B are more sensitive to interferon treatment than genotypes D and C, respectively. Genotype B is more frequent in acute hepatitis than genotype C, whereas genotype C (C2) is more frequently associated with an increased risk of hepatocellular carcinoma (HCC), mostly cirrhotic, as compared with genotype B (B2). Genotype mixture is associated with high viral load and worse outcome of HBV infection. HBV mutations in the S genes, especially amino acids substitution at position 145 (G145R), are associated with immune escape, whereas mutations in the PreS or S genes which impair HBsAg secretion could present a risk to blood safety. HBV variants harboring mutations in the viral polymerase gene that confer resistance to nucleoside analogs may be selected during antiviral therapy. Different genotypes have distinct mutation patterns in the PreS and EnhII/BCP/Precore regions. PreS deletions, C1653T, T1753V, and A1762T/G1764A are associated with an increased risk of HCC. HCC-associated HBV mutants may not transmit via mother-to-child transmission, and are likely generated during HBV-induced pathogenesis. Examination of HBV mutations alone or in combination and host genetic susceptibility will be helpful in classifying the HBV-infected subjects who will develop HCC and need active anti-viral treatments.
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47
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Hepatitis B virus genotype in Iranian patients with hepatocellular carcinoma. Int J Infect Dis 2009; 13:685-9. [PMID: 19138545 DOI: 10.1016/j.ijid.2008.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2008] [Accepted: 10/17/2008] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Chronic hepatitis B virus (HBV) infection is a major risk factor for the development of hepatocellular carcinoma (HCC). HBV appears to be the most common cause of HCC in Iran. To date, no study has been carried out on the HBV genotype in Iranian HCC patients. This study was undertaken to determine the HBV genotype in Iranian patients with HCC. METHODS Paraffin-embedded tissue samples from 40 patients (31 males and nine females) with HBV-associated HCC were collected from different pathology centers during 2000-2007. Genotyping of HBV was performed by nested PCR-mediated amplification of the target sequence. PCR products were sequenced, and the genotype of each HBV sequence was determined by comparison with sequences of known genotypes in the GenBank. A phylogenetic tree was constructed. RESULTS Phylogenetic analysis revealed that all of the HBV isolates were clustered in genotype D. CONCLUSIONS Our results concur with other reports from Iran, all showing that genotype D is the only detectable genotype in the different clinical forms of HBV infection in this country.
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48
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Panessa C, Hill WD, Giles E, Yu A, Harvard S, Butt G, Andonov A, Krajden M, Osiowy C. Genotype D amongst injection drug users with acute hepatitis B virus infection in British Columbia. J Viral Hepat 2009; 16:64-73. [PMID: 19192159 DOI: 10.1111/j.1365-2893.2008.01045.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The eight genotypes of hepatitis B virus (HBV) exhibit distinct geographical distributions. This study identified HBV genotypes and transmission modes associated with acute infection in British Columbia (BC), Canada, from 2001 to 2005. Seventy cases of acute HBV in BC were identified from laboratory reports using a standardized case definition. Interviews for risk factors and hepatitis history were conducted for each case. HBV genotypes were determined by BLAST comparison analysis of the surface (S) or preS gene sequence. To illustrate the distribution of genotypes identified amongst acute cases in BC, an annotated map was produced showing the global occurrence of HBV genotypes. The majority of acute HBV cases occurred in Caucasian, Canadian-born males, with 30% of cases reporting injection drug use (IDU) and 21% reporting incarceration. The most common genotype observed was genotype D (62.9%), followed by genotypes A (18.6%), C (11.4%), B (4.3%), and E (1.4%). A significant association was observed between Genotype D and IDU (P = 0.0025) and previous incarceration (P = 0.0067). Phylogenetic analysis of the S gene sequence demonstrated identical or high genetic relatedness amongst genotype D viral strains (86% sub-genotype D3), thus verifying transmission clustering amongst BC injection drug users. The association between acute HBV genotype and reported transmission modes has not been previously described in North America. Tracking of genotypes can help identify disease transmission patterns and target at-risk populations for preventive immunization.
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Affiliation(s)
- C Panessa
- BC Centre for Disease Control, Vancouver, BC, Canada
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49
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Masaadeh HA, Hayajneh WA, Alqudah EA. Hepatitis B virus genotypes and lamivudine resistance mutations in Jordan. World J Gastroenterol 2008; 14:7231-4. [PMID: 19084939 PMCID: PMC2776882 DOI: 10.3748/wjg.14.7231] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate and identify prevalent hepatitis B virus (HBV) genotypes and to explore lamivudine-resistant mutations among treated and untreated patients in Jordan.
METHODS: A total of 107 cases with chronic hepatitis B were recruited from different medical centers in Jordan. Serological tests were preformed for all cases using a microparticle enzyme immunoassay. HBV Genotyping was performed for 70 cases using Line probe genotyping assay. The YMDD mutations were explored for 20 cases (4 were lamivudine naive) using the INNO-LiPA HBV DR assay.
RESULTS: Genotype D was the only detected genotype. A total of 6 YMDD mutations were detected in 5 treated patients (31%) while one mutation was detected in the naive patients. Seventeen percent of cases were positive for HBeAg and had statistically significant higher levels of serum aminotransferases.
CONCLUSION: HBV genotype D appears to be the only circulating type in Jordanian patients. The YMDD mutations were detected in 31% of lamivudine-treated cases with similar patterns to those found in the literature. We also found a relatively low prevalence of HBeAg expression among examined cases (17%). Awareness of these serologic, genotypic and resistance patterns might help in the formulation of management plans and for predicting clinical outcomes. Further larger scale studies are needed to confirm our results and to examine possible associations among clinical, serologic, and genetic patterns of HBV infections in Jordan.
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50
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Mohebbi S, Amini-Bavil-Olyaee S, Zali N, Noorinayer B, Derakhshan F, Chiani M, Rostami Nejad M, Antikchi M, Sabahi F, Zali M. Molecular epidemiology of hepatitis B virus in Iran. Clin Microbiol Infect 2008; 14:858-66. [DOI: 10.1111/j.1469-0691.2008.02053.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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