BackgroundChronic Hepatitis B infection is a major health problem in Republic of Congo therefore molecular analysis of HBV strains is important to detect the patients at high risk of disease progression.MethodsSerum samples were obtained from 111 chronic HBV patients in Pointe Noire. HBsAg, HBeAg and HBeAb were detected. A fragment of the preS1 region of HBV was amplified and sequenced to determine genotypes, subgenotypes and to identify mutations.ResultsOf the 111 samples analyzed, 35 patients were asymptomatic carriers (ASC), 24 with a chronic active hepatitis (CAH), 33 with liver cirrhosis (LC) and 19 have a hepatocellular carcinoma (HCC). The mean age were 45 ± 13 year, 88 (79.3 %) were male and 23 (20.7 %) female. The prevalence of HBeAg was 15.3 % and 73 % of subjects were anti-HBe positive. The mean serum level of alanine aminotransferase transaminase (ALT) and aspartate transaminase (AST) was 25.1 ± 9 IU/L and 28.6 ± 10 IU/L respectively. Eighty two samples out of 111 (73.9 %) were genotyped by the analyzing of the S region of HBV, 58 (70.7 %) cases belonged to HBV genotype E and 24 (29.3 %) were genotype A with three subgenotypes; A3 (66.7 %), A4 (20.8 %) and A6 (12.5 %). Prevalence of genotype A was relatively high in CAH (33.3 %) and HCC (31.6 %) patients in comparison with other groups. The most prevalent amino acids substitutions were R38K found in 14 (17.1 %) sequences, following by H44L in 11 (13.4 %), K13E in 8 (9.8 %), N29K in 8 (9.8 %), A35E in 8 (9.8 %), V80I in 7 (8.5 %) and in 6 (7.3 %) sequences for S90T. Different substitutions located in the hepatocyte binding site were higher among patients with LC and HCC (p < 0.05).ConclusionsThis study have shown that HBV genotype E and A were the most frequent strains circulating in Republic of Congo patients. HBV pres1 substitutions found in this study were associated with severe clinical forms of liver diseases. This data have shown the importance of implementing an effective program to fight HBV infection.
The resurgence of infectious diseases on the African continent plays a major role in the increase in cancer occurrence. Whereas in developed countries the causes of occurrence of cancers are related mainly to non-infectious factors; cancers of infectious origin become a dramatic particularity in Africa. The proportion of virus-induced cancers may reach up to 75% of cancer cases in certain countries. Oncogenic viruses such as human papilloma virus (HPV), hepatitis viruses B and C, human herpes virus 8 and Epstein Barr virus in association with human immunodeficiency virus are the main viral etiologies of cancers in Africa, representing around 30% of cancers causes. Optimistically, 30% of cancers could be prevented in Africa. However, health burden prevails on the continent due to the weakness of health policy especially regarding preventive medicine, but also the limited technical facilities, poor manpower and insufficient political commitment. We felt urgent to review the state of the art of the question, and necessary to analyze and publicize the current epidemiological advances in oncogenic viruses and virus-induced cancers in Africa. Prevention implies understanding, which is compulsory to reverse the current trends and to potentially instate a control of virus-induced cancers.
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