Hepatitis Delta virus genotype 8 infection in Northeast Brazil: Inheritance from African slaves?

Abstract

Hepatitis Delta virus (HDV) is endemic worldwide, but its prevalence varies in different geographical areas. While in the Brazilian Amazon, HDV is known to be endemic and to represent a significant public health problem, few studies have assessed its prevalence in other regions in the country. This study evaluated the seroprevalence of HDV among HBsAg chronic carriers from Maranhão state, a region located in the Northeast of Brazil. Among 133 patients, 5 had anti-HD, of whom 3 had HDV RNA. HDV genotypes were characterized by Bayesian phylogenetic analysis of nucleotide sequences from the HDAg coding region. HDV-3 was identified in one patient who lives in Maranhão, but was born in Amazonas state (Western Amazon basin). Phylogenetic analysis shows that this HDV-3 sequence grouped with other HDV-3 sequences isolated in this state, which suggests that the patient probably contracted HDV infection there. Surprisingly, the other two patients were infected with HDV-8, an African genotype. These patients were born and have always lived in Urbano Santos, a rural county of Maranhão state, moreover they had never been to Africa and denied any contact with people from that continent. This is the first description of the HDV-8 in non-native African populations. This genotype may have been introduced to Brazil through the slaves brought to the country from the West Africa regions during the 16-18th centuries. Our results indicate that the need of clinical and epidemiological studies to investigate the presence of this infection in other areas in Brazil.

Genetic diversity of hepatitis D virus genotype‐1 in Europe allows classification into subtypes

“…HDV infections with different genotypes exhibit different clinical course and outcomes: HDV‐1 strains show a broad spectrum of virulent and pathogenic phenotypes, HDV‐2 and HDV‐4 cause milder forms of liver disease, HDV‐3 isolates are associated with outbreaks of fulminant hepatitis in South America. The pathogenic properties of HDV 5‐8 isolates are not well understood …”

Characterization of the Genotypic Profile of Hepatitis Delta Virus: Isolation of HDV Genotype-1 in the Western Amazon Region of Brazil

“…HDV-5, HDV-6, HDV-7, and HDV-8 genotypes are found in Africa [17,18]. Recently, HDV-8 was isolated from 2 native individuals in the countryside of the state of Maranhão (Brazil) [29]. HDV-3 is responsible for epidemics of severe and fulminant hepatitis, which are common in northeastern South America [12].…”

Prevalence, risk factors and genotypes of hepatitis B infection among HIV-infected patients in the State of MS, Central Brazil

“…In Brazil, HDV is highly endemic in the Amazonian region, but data in other regions from Brazil are scarce. 13,14 This study aimed to determine the prevalence of HBV and HDV infection, HIV-HBV coinfection and HBV genotype distribution in HIV-infected patients at a referral center for HIV/AIDS, in Campo Grande, Mato Grosso do Sul, Central-West Region of Brazil. Additionally, epidemiological data regarding risk factors and vaccinal status was assessed.…”