HBV epidemiology and genetic diversity in an area of high prevalence of hepatitis B in southern Brazil

Paoli, Juliana de; Wortmann, André Castagna; Klein, Mirelli Gabardo; Pereira, Vagner Reinaldo Zingalli Bueno; Cirolini, Adriana Maria; Godoy, Bibiane Armiliato de; Fagundes, Nelson J. R.; Wolf, Jonas Michel; Lunge, Vagner Ricardo; Simon, Daniel

doi:10.1016/j.bjid.2018.06.006

Cited by 19 publications

(20 citation statements)

References 37 publications

(90 reference statements)

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“…Phylogenetic analysis revealed that HBV/D2 and D3 isolates were genetically related to sequences from East Europe and Italy, respectively. HBV/D3 is highly prevalent in Italy [31,38] and have been described in populations of Italian ancestry in Brazil [20,36,39,40,41] and Argentina [42]. In our study, all Brazilian D3 clustered together, suggesting closer ancestral relationships (intragroup divergence of 0.005 ± 0.001, versus 0.007 ± 0.001 when compared to international sequences).…”

Section: Discussionsupporting

confidence: 62%

Genetic Diversity of the Hepatitis B Virus Subgenotypes in Brazil

Lago

Espírito-Santo

Costa

et al. 2019

Viruses

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Hepatitis B virus (HBV) subgenotypes may be related to clinical outcomes and response to antiviral therapy. Most Brazilian studies on HBV subgenotypes are restricted to some regions and to specific population groups. Here, we provide an insight about genetic diversity of HBV subgenotypes in 321 serum samples from all five geographical regions, providing a representative overview of their circulation among chronic carriers. Overall, HBV/A1 was the most prevalent subgenotype, being found as the major one in all regions except in South Brazil. Among HBV/D samples, subgenotype D3 was the most prevalent, found in 51.5%, followed by D2 (27.3%) and D4 (21.2%). D2 and D3 were the most prevalent subgenotypes in South region, with high similarity with European strains. D4 was found in North and Northeast region and clustered with strains from Cape Verde and India. For HBV/F, the most frequent subgenotype was F2 (84.1%), followed by F4 (10.1%) and F1 (5.8%), closely related with strains from Venezuela, Argentina and Chile, respectively. Phylogeographic analyses were performed using an HBV full-length genome obtained from samples infected with genotypes rarely found in Brazil (B, C, and E). According to Bayesian inference, HBV/B2 and HBV/C2 were probably introduced in Brazil through China, and HBV/E from Guinea, all of them mostly linked to recent events of human migration. In conclusion, this study provided a comprehensive overview of the current circulation of HBV subgenotypes in Brazil. Our findings might contribute to a better understand of the dynamics of viral variants, to establish a permanent molecular surveillance on the introduction and dispersion patterns of new strains and, thus, to support public policies to control HBV dissemination in Brazil.

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Section: Discussionsupporting

confidence: 62%

Genetic Diversity of the Hepatitis B Virus Subgenotypes in Brazil

Lago

Espírito-Santo

Costa

et al. 2019

Viruses

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“…It is also important to mention that the mean age for developing HCC in Africa and other developing regions is younger than what is seen in developed regions such as North America and Western Europe. Therefore, productive years are lost to HCC as a result of HBV infection in SSA [9,15,16].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and meta-analysis

et al. 2020

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Chronic hepatitis B (HBV) remains a significant public health problem in Ghana and past reviews conducted could not calculate a nationwide prevalence of the disease due to lack of primary research for some regions of the country. We therefore conducted this study to summarize and update the available information on HBV infection burden (prevalence) in Ghana from 2015-2019.We systematically searched PubMed, Embase, ScienceDirect, and Google Scholar to retrieve primary studies published in peer-reviewed journals from November 2015 to September 2019, assessing the prevalence of HBV among the Ghanaian populace. The review included 21 studies across all ten old regions of Ghana with a total sample population of 29 061. The HBV prevalence was estimated for subpopulations as follows: 8.36% in the adult population, 14.30% in the adolescent population, and 0.55% in children under five years (pre-school). Among adults, HBV infection prevalence was the highest in the special occupation group (14.40%) and the lowest prevalence rate of 7.17% was recorded among blood donors. Prevalence was lower in the north than in the southern part of the country. The Ashanti region had the most studies at 6/21 (29%), while no study was identified for the Upper West region. Across the country, the highest HBV infection prevalence rates were recorded in the age group of 20-40 years. The burden of hepatitis B is enormous and remains an important public health issue in Ghana. Addressing the issue will require an integrated public health strategy and rethinking of the implementation gaps in the current HBV infection control program. This will help propel the country towards eliminating the disease by 2030.

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“…Transmission of HBV and HCV is mainly related to blood contamination due to injecting drug use, formerly due to contaminated blood transfusion. Sexual intercourse is still somewhat controversial in HCV transmission, with conflicting data in the literature, while in HBV transmission its role has already been proven 6,[22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

“…A geographical analysis of Map 1, which reveals the pattern of HBV endemic regions in the country, indicates the northern and southern borders as the most affected areas. The involvement of border areas could be explained by the fact that they are less developed and have difficulties in consolidating control measures, such as vaccination and prenatal care 6,23,25 . In the northern border, Acre, Amazonas, Rondônia and Mato Grosso states have high birth rates; thus, the virus can be transmitted from mother to child, which has been frequently described in endemic areas such as East Asia and Sub-Saharan Africa 25 .…”

Section: Discussionmentioning

confidence: 99%

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Ecological study of viral hepatitis in Brazil: A geographical and temporal analysis

et al. 2019

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Introduction: Viral hepatitis is a group of diseases that present high hepatotropism and are related to liver dysfunctions, having either an acute or a chronic course. Their worldwide epidemiology is diverse, with several endemic places, such as South America. The objective of this study was to analyze the epidemiology of viral hepatitis in Brazil, in order to better understand its pattern of distribution and evolution. Method: A temporal aggregation study was conducted using the Viral Hepatitis Database of the Brazilian Ministry of Health. The serological markers used were HBsAg and anti-HCV for hepatitis B and C, respectively. Mortality data were collected from the Mortality Information System for deaths attributed to viral hepatitis. The period analyzed was from 2007 to 2016/17. Results: The incidence was 7.88 (95% CI, 7.30-8.45) for hepatitis B and 11.9 (95% CI, 11.15-12.65) for hepatitis C. Mortality attributed to viral hepatitis was 1.61 (95% CI, 1.35-1.87) deaths per 100,000 people. An analysis of municipal distribution data showed several endemic areas. The Brazilian regions most affected by hepatitis B virus were the northern and southern borders, Santa Catarina coast and Espírito Santo state, while hepatitis C virus was mostly present in metropolitan areas such as Porto Alegre and São Paulo. Conclusions: Viral hepatitis has a diverse geographic distribution in the Brazilian territory, with highly endemic areas. The distribution differs between hepatitis B and hepatitis C viruses.

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HBV epidemiology and genetic diversity in an area of high prevalence of hepatitis B in southern Brazil

Abstract: These results demonstrate a pivotal role of intrafamilial transmission for HBV spreading in this population. Furthermore, there is a high prevalence of HBV genotype D in this region.

Cited by 19 publications

References 37 publications

Genetic Diversity of the Hepatitis B Virus Subgenotypes in Brazil

Genetic Diversity of the Hepatitis B Virus Subgenotypes in Brazil

Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and meta-analysis

Ecological study of viral hepatitis in Brazil: A geographical and temporal analysis

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