Distribution and clinical significance of hepatitis B virus genotypes in Pakistan

Abstract

BackgroundHepatitis B virus (HBV) genotype and its role in disease progression and patients’ response to antiviral treatment, is not well studied in Pakistan. This comprehensive study was aimed to determine the distribution of HBV genotypes in Pakistan and their possible association with phases of HBV infection.MethodsA total of 840 HBsAg positive samples was collected and tested for HBV DNA quantity. Samples below 100 IU/ml were excluded from the study. A total of 715 samples representing all the six parts of the country were genotyped by type specific primer PCR method. Clinical data of only 384 patients was compared as the remaining 332 were either receiving antiviral treatment or their infection phase was not confirmed.ResultsGenotype D was found in 509 samples (71.2 %), genotype A in 55 samples (7.7 %) and mixed infection with genotypes A and D in 124 samples (17.3 %). Genotypes B, C and E were identified in less than 1 % of the total samples. Genotype A, D and their mixture (A + D) were compared for severity of HBV infection. Significant differences were not found in distribution of HBV genotypes among different disease stages.ConclusionHBV genotype D was the predominant infection in all study areas of Pakistan followed by mixed genotypes infection (A + D) whereas genotype A has 10 times lower prevalence than genotype D. Genotypes B, C, E and F altogether make only 1.5 % of the prevalence. Genotype do not appears to show the severity of liver disease.

Hebatitis B Virus Genotypes in Pakistan

“…A recently published smaller study [24] described that about 64 % of the studied HBV samples belong to genotype D while remaining 36 % had a mixture of genotypes A and D. The study however, confirmed sub genotype D1 with complete genome sequencing of 4 out of the total 22 samples. The prevalence and distribution of HBV genotypes is almost confirmed in a conclusive study with a large number of samples from all over the Pakistan [25]. With a total of 715 samples from all 6 geopolitical regions of Pakistan, this study reported that genotype D is the predominant genotype in all regions of Pakistan with an overall prevalence of about 71 %.…”

Pattern of prevalent Hepatitis B virus genotypes in Zaria, Nigeria

“…Recently, ten genotypes of HBV (A through J) have been identified on the basis of 8% or less difference in genome sequences, each with a distinctive geographical distribution. [9,10] In Sub-Saharan Africa, genotypes E is predominant in the region, followed by genotypes A and D. [11,12] Different HBV genotypes present different clinical outcome and response to interferon-based therapy. Typically, infections with HBV genotypes A and D tend to progress to chronic phase than genotypes B and C, while genotypes A and B have higher rates of spontaneous HBeAg seroconversion compared to C and D. [13] Genotype E, the most common HBV genotype in the West African region is associated with poor response to interferon-based therapy and is also moderately associated with pre-core and basal-core promoter mutations.…”

Comparative Study on Hepatitis C Occurrence in Health Staff (Doctors, Nurses and Other Helping Staff) in Four Different Hospitals of the Twin Cities Islamabad-Rawalpindi (Cmh, Mh, Qih and Pims)’

“…Because of diverse geography and different cast the prevalence of HCV could not remain constant throughout Pakistan [12]. There number are barriers to investigate the actual patient numbers of HCV due to which there is a constant and regular increase in HCV occurrence and Prevalence which is becoming threating [13,14].…”