Genotype and Subtype Analyses of Hepatitis B Virus (HBV) and Possible Co‐Infection of HBV and Hepatitis C Virus (HCV) or Hepatitis D Virus (HDV) in Blood Donors, Patients with Chronic Liver Disease and Patients on Hemodialysis in Surabaya, Indonesia

Abstract

Hepatitis B virus (HBV) infection is a worldwide health problem. The prevalence of HBV carriers varies from 0.1 to 2% in low prevalent areas to 10 to 20% in high prevalent areas. Indonesia is among the HBV high prevalent countries (16). The identification of the common determinant a and two pairs of allelic variations, d/y and w/r, has lead to the definition of the four major subtypes of hepatitis B surface antigen (HBsAg), adw, adr, ayw, and ayr (3,13,18,37). Another classification system, which is based on the sequence diversity of the HBV genome has been developed and, currently eight genotypes designated A to H have been identified (1,4,23,25,35). It has been reported that distribution of HBV subtypes and genotypes varies with different geographical areas (2,15,18,22,24,26). Also, clinical manifestations and therapeutic responses to antiviral therapy might differ with different HBV genotypes (11,12,39 Abstract: Four subtypes (adw, adr, ayw, and ayr) and eight genotypes (A to H) of the hepatitis B virus (HBV) have been identified. They appear to be associated with particular geographic distribution, ethnicity, and possibly clinical outcomes. In this study, hepatitis B surface antigen (HBsAg) subtyping and HBV genotyping were carried out on sera obtained from HBsAg-positive HBV carriers, including healthy blood donors; patients with acute hepatitis, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma; and patients on hemodialysis all located in Surabaya, Indonesia. We report here that all HBV isolates tested in Surabaya belonged to genotype B, with more than 90% of them being classified into subtype adw. Our results also revealed that prevalence of hepatitis C virus (HCV) co-infection among HBV carriers in Surabaya was approximately 10% for healthy blood donors and patients with chronic liver disease, and approximately 60% for patients on maintenance hemodialysis. Interestingly, HBsAg titers were lower in HBV carriers with HCV co-infection than in those without HCV co-infection. We also found that prevalence of hepatitis D virus (HDV) co-infection was <0.5% among HBV carriers in Surabaya.

High Rates of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus Infections and Uncommon HBV Genotype/Subtype and HCV Subtype Distributions among Transgender Individuals in Surabaya, Indonesia

“…However, several data resources exist regarding the prevalence of HBV and HIV among the general population in several parts of Indonesia (6,9,13,15,25).…”

“…Indonesia is a multiethnic country. We previously reported the distribution of the genotypes and subtypes of HBV across several geographical areas in Indonesia (9,13). In addition, we reported the prevalence of each HCV subtype, including HCV subtype 1c (HCV-1c), among various clinical populations in Indonesia.…”

Genotype and variations in core promoter and pre-core regions are related to progression of disease in HBV-infected patients from Northern Vietnam

“…In contrast to the findings of the above studies in Vietnamese, a study by Song et al reported that genotype A was very commonly observed in HBV-infected Vietnamese patients (98.7%), that the pre-core mutation (G1896A) was not found, and dual core promoter mutations (A1762T/G1764A) were very rare in HCC patients (8%) and were not found in LC patients, CH patients or asymptomatic carriers (ASC) (33). The results reported by Song et al were very surprising, since the results of many other studies in East Asia and some in Vietnam, with only the exception of studies in the Philippines, showed that genotypes B and C were the major HBV genotypes in this region and mutations in the core promoter and pre-core regions were frequently found (8)(9)(10)(12)(13)(14)(15)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(34)(35)(36)(37)(38).…”

Distribusi Genotipe dan Subtipe Virus Hepatitis B pada Penderita Hepatitis B Kronik di Pekanbaru

“…16 dilaporkan bahwa genotipe B sebagai satu-satunya genotipe pada penderita hepatitis B kronik dan penderita hemodialisis di Surabaya. Perbedaan hasil ini mungkin disebabkan adanya perbedaan asal subjek penelitian, subjek penelitian kali 16 berasal dari daerah yang didominasi genotipe B. Hal ini didukung oleh hasil penelitian yang dilaporkan dari kota Padang sebagai daerah yang memiliki kedekatan geografik dan etnik dengan kota Pekanbaru, bahwa genotipe C merupakan 65% genotipe VHB yang ditemukan pada penderita hepatitis B kronik. 15 Selain itu, pada penelitian tersebut juga diketahui bahwa subtipe adr adalah subtipe HBsAg yang paling banyak ditemukan, yaitu sebesar 67,6%, lebih kurang hampir sama dengan yang ditemukan pada penelitian ini, yaitu 60%.…”