High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico

Abstract

Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05) than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8%) and genotype A (4%). In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.

High prevalence of HBV infection, detection of subgenotypes F1b, A2, and D4, and differential risk factors among Mexican risk populations with low socioeconomic status

“…On the other hand, Mexican patients with asymptomatic chronic B infection and occult B hepatitis infection may frequently course with low viremia and fluctuations of HBV markers . Thus, a different diagnostic strategy than testing only with HBsAg is required to avoid omitting HBV infection in the health care setting.…”

“…On the other hand, Mexican patients with asymptomatic chronic B infection and occult B hepatitis infection may frequently course with low viremia and fluctuations of HBV markers. 13,[21][22][23][24] Thus, a different diagnostic strategy than testing only with HBsAg is required to avoid omitting HBV infection in the health care setting. Given the social, virological, clinical-diagnostic features mentioned above, the magnitude of HBV infection in different risk groups may be underestimated.…”

Risk factors associated with horizontal transmission of hepatitis B viral infection from parents to children in Mexico

“…The study period was from January 2015 to December 2016. Twentyfour cases diagnosed with HBV infection by serological and molecular tests from a previous cohort of 215 children were included [17]. Briefly, the status of infection of these 24 patients was occult HBV infection (HBV-DNA positive/HBsAg negative) in 87.5%, (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both markers.…”

“…In pregnant women, HBsAg prevalence ranges from 0.93% to 2.52% suggesting that young children could be exposed to HBV [11]. In recent studies, an HBsAg prevalence of 3.1% among Mexican children was reported [16], and a high prevalence of occult HBV infection (87.5%) was detected [17].…”

“…Among Mexican adults, horizontal transmission by percutaneous exposure, high-risk sexual practices, and parenteral transfusions is common, whereas injection drug use may be an emerging route [9][10][11][12]. Recently, a high frequency of HBV risk factors in parents of HBVinfected children was reported [17]. However, the association of the risk factors in Mexican children who are positive for HBV-DNA and their parent´s risk factors as well as the plausible route of transmission of HBV infection in children have not been thoroughly evaluated.…”