Hepatitis B virus: molecular genotypes and HBeAg serological status among HBV-infected patients in the southeast of Brazil

Abstract

BackgroundKnowledge of HBV genotype is very important for clinical treatment. Studies have suggested possible pathogenic and therapeutic differences among HBV genotypes. The aim of this study was to determine HBV subtypes and genotypes in HBV-infected patients in our region (southeast Brazil) and to correlate results with clinical and histopathological data.MethodsOne hundred and thirty-nine HBsAg-positive patients were included in the study. All patients were anti-HCV and anti-HIV negative (64% male; mean age 42 ± 14.5 years; range 7-80 years; 84% Caucasian) and were followed up at the University Hospital. A method for genotyping and subtyping HBV by partial HBsAg gene sequencing with primers common to all known genotypes was used. The viral load was measured by Amplicor Monitor assay (Roche).ResultsHBV genotype A was the most prevalent (55%), while genotypes C, D and F were found in 3%, 38% and 4% of HBV-infected patients, respectively. Among the patients infected by genotype A, 18.3% (14/76) were African descendents and, among the patients infected by genotype D, 11.3% (6/53) were also African descendents. In the four patients infected with genotype C, 2 were Asian descendents and 2 were Caucasians. All (7) genotype F infected patients were Caucasians. Seventy percent of our HBsAg-positive patients were HBeAg negative (62% genotypes A; 26.2% D; 7.1% C and 4.7%F). The viral load of HBV-DNA was about 5 times higher in HBeAg-positive than in HBeAg-negative patients. About 40% of these patients had alanine aminotransferase of up to 1.5 times the normal level. The mean stage of fibrosis in genotype A patients (2.8) was significantly higher than the mean stage of fibrosis in genotype D patients (2.0) (P = 0.0179).ConclusionThe genotypes encountered in our HBV-infected patients were apparently a consequence of the types of immigration that occurred in our region, where European and African descendents predominate. The HBeAg-negative status predominated, possibly due to the length of time of infection. The viral load in HBeAg-positive patients was higher than in HBeAg-negative individuals. The fibrosis grade in genotype A-infected patients was more advanced than genotype D-infected patients.

Hepatitis B virus genotypes in Southeast Brazil and its relationship with histological features

“…In accordance with previous reports (Moraes et al 1996, Araujo et al 2004, Ribeiro et al 2006, Mello et al 2007, Tonetto et al 2009), this study showed that HBV genotype A was the most prevalent in RJ, followed by genotypes D and F. The predominance of genotype A may be the result of the influx of African population during the slavery colonial period and the influence from European immigration that occurred during the 20th century. An interesting finding was that HBV genotype F infection, derived from the Amerindian population and the most prevalent in Central and South America, was rare in Brazil, suggesting that indigenous population had less influence in the introduction of HBV in our country (Parana & Almeida 2005, Viana et al 2005, Mello et al 2007.…”

“…Data are conflicting, with some groups reporting severe liver disease in patients with genotype A (Lindh et al 1996, Mayerat et al 1999, Kumar et al 2005, Tonetto et al 2009) compared with genotype D, while other groups found no significant differences between genotypes A or D, concerning the severity of liver disease, observed in liver specimens (Sanchez-Tapias et al 2002, Halfon et al 2006, Madan et al 2009). The present study is the first to describe less intense histological liver disease in genotype D patients.…”

“…There was a significant association between ALT levels and HBV genotypes with lower ALT levels observed in genotype D patients compared with genotypes A and F. Most cross-sectional studies (Thakur et al 2002, Chu et al 2003, Gandhe et al 2003, Kumar et al 2005, Halfon et al 2006, Ribeiro et al 2006, Madan et al 2009, Tonetto et al 2009), that have focused on patients with non-B and non-C genotypes, monitored ALT on only one occasion, thus the findings of these studies could not be compared with our results that evaluated ALT levels during a six month period. We acknowledge that patients with chronic HBV may have fluctuating serum ALT and HBV-DNA levels so in the present study we incorporated three determinations of ALT and liver biopsy was a standardized protocol done within the first month after the measurement of HBV-DNA viral load.…”

Hepatitis B Virus (HBV) Serological Patterns in Benue State, Nigeria

“…Hence, 3.8% of chronic HBeAg subjects in this study may be expected to have high chances of developing persistent liver disease leading to cirrhosis and even primary liver cancer if not treated [27] while 8.7% of those acute if not well managed could also become chronic.…”

HBV Surface Ag mutations in chronic carriers are rare in Baloochstan provinces of Iran: a community with a low rate of HBV-related cirrhosis and HCC

“…Prospective, case-control and crosssectional studies predominantly but not entirely indicate that the severity and outcome of chronic hepatitis B are more serious in patients infected with genotype C and D compared with B and A respectively (16). Clinical differences between genotype A and D infections have been reported from Europe, where these genotypes are frequent and differences between genotypes A and D prevailing in Western countries, India and the United States, are increasingly coming to the fore (16)(17)(18)(19)(20)(21)(22)(23). In this study, we analyzed the relationship between the HBV surface genetic and protein variations, liver function (assessed by alanine aminotransferase [ALT] levels), and anti-HBe status in a group of patients who were residents of north-eastern part of Iran.…”