Hepatitis B virus subtypes and hepatitis C virus genotypes in patients with chronic liver disease or on maintenance hemodialysis in Indonesia

Abstract

Hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) RNA were surveyed in patients in Yogyakarta, Indonesia, and their subtypes and genotypes were determined by serological methods and polymerase chain reaction with type-specific primers, respectively. Of 149 patients with chronic liver disease including 24 with chronic hepatitis, 86 with liver cirrhosis, and 39 with primary hepatocellular carcinoma, HBsAg was detected in 40 (27%) and HCV RNA in 48 (32%); one patient was positive both for HBsAg and HCV RNA. Thus, the cause of chronic liver disease was not identified in 62 (42%) patients. Of 58 patients on maintenance hemodialysis, four (7%) were positive for HBsAg and 44 (76%) for HCV RNA. Subtype adw was found in 34 (74%) of 46 HBsAg samples and adr in five (11%); compound subtypes, such as adyw and adyr were detected in the remaining seven (15%). Among HCV RNA samples from 48 patients with chronic liver disease, 23 (48%) were of genotype II, 17 (35%) of genotype III and one (2%) of genotype V, in a distribution strikingly different from that of 44 samples from patients on maintenance hemodialysis, 39 (89%) of which were of genotype I and only one (2%) of genotype II. Genotypes were not classifiable in seven (15%) patients with liver disease and four (9%) patients on hemodialysis despite high HCV RNA titers in them all. These results indicate that different HCV genotypes prevail in patients with distinct diseases, as well as unclassifiable HCV genotypes in Indonesia.

Survey of major genotypes and subtypes of hepatitis C virus using RFLP of sequences amplified from the 5' non-coding region

“…Our own sequence analysis of a subset of the Thailand blood donor samples in the core and NS-5 regions has revealed the existence of several new subtypes of type 3 (L. M. Jarvis and others, unpublished information) distinct from the six described from Nepal (Tokita et al, 1994). However, this more detailed analysis has confirmed that type 3a followed by 3b are the commonest subtypes in Thailand.…”

“…Few 5'NCR sequences are available for type 3 subtypes other than type 3a (Tokita et al, 1994). All 16 type 3a 5'NCR sequences have a C to U substitution at position -164 and a G to A substitution at position -121 (Simmonds et al, 1994b;Tokita et al, 1994) destroying ScrFI restriction sites.…”

“…All 16 type 3a 5'NCR sequences have a C to U substitution at position -164 and a G to A substitution at position -121 (Simmonds et al, 1994b;Tokita et al, 1994) destroying ScrFI restriction sites. These substitutions are also present in single examples of types 3c, 3d and 3e but are not found in the two sequences from types 3b (Tokita et al, 1994) (K. Chayama and others: GenBank accession number Dl1443), and in 3f (Tokita et al, 1994), producing ScrFI electropherotypes G and A respectively (Fig. 2iii).…”

“…The existence of numerous subtypes of type 1 Simmonds et al, 1993b), 3 (Tokita et al, 1994 and 4 (Bukh et al, 1994), and the description of new major genotypes in South-East Asia Apichartpiyakul et al, 1994;Hadiwandowo et al, 1994) hints at a complexity in genotype distribution not generally found in Western countries, and which potentially affects the accuracy of any survey based upon typing assays. For example, recent reports describe the detection of HCV variants in Thailand and Indonesia that differ from those classified as genotypes 1 to 6 (Tokita et al, 1994;Hadiwandowo et al, 1994). We therefore have to be cautious in the interpretation of the results from Thailand, Macau, Singapore and possibly Taiwan reported here, as it is possible that a proportion of individuals may be infected with novel variants of HCV that produce RFLP patterns resembling other genotypes.…”

Liver cirrhosis and hepatocellular carcinoma in hepatic vena cava disease, a liver disease caused by obstruction of inferior vena cava

“…In developing countries, the cause of 25-55% of LC and 42-46% of cases of HCC is unknown [45][46][47][48][49][50]. High incidence of HVD in Nepal and reports of 2,677 cases of IVCO from four hospitals in China during the period 1981-2003 [51] suggested that HVD is still an important cause of HVOO in developing countries.…”