Molecular Characteristic-Based Epidemiology of Hepatitis B, C, and E Viruses and GB Virus C/Hepatitis G Virus in Myanmar

Abstract

We carried out a molecular characteristic-based epidemiological survey of various hepatitis viruses, including hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and GB virus C (GBV-C)/hepatitis G virus (HGV), in Myanmar. The study population of 403 subjects consisted of 213 healthy individuals residing in the city of Yangon, Myanmar, and the surrounding suburbs and 190 liver disease patients (155 virus-related liver disease patients and 35 nonviral disease patients). The infection rates of the viruses among the 213 healthy subjects were as follows: 8% for HBV (16 patients), 2% for HCV (4 patients), and 8% for GBV-C/HGV (17 patients). In contrast, for 155 patients with acute hepatitis, chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma, the infection rates were 30% for HBV (46 patients), 27% for HCV (41 patients), and 11% for GBV-C/HGV (17 patients). In the nonviral liver disease group of 35 patients with alcoholic liver disease, fatty liver, liver abscess, and biliary disease, the infection rates were 6% for HBV (2 patients), 20% for HCV (7 patients), and 26% for GBV-C/HGV (9 patients). The most common viral genotypes were type C of HBV (77%), type 3b of HCV (67%), and type 2 of GBV-C/HGV (67%). Moreover, testing for HEV among 371 subjects resulted in the detection of anti-HEV immunoglobulin G (IgG) in 117 patients (32%). The age prevalence of anti-HEV IgG was 3% for patients younger than 20 years and 30% or more for patients 20 years of age or older. Furthermore, a high prevalence of anti-HEV IgG (24%) was also found in swine living together with humans in Yangon. These results suggest that these hepatitis virus infections are widespread in Myanmar and have led to a high incidence of acute and chronic liver disease patients in the region.

Seroprevalence and Genotype of Hepatitis C Virus among Immigrant Workers from Cambodia and Myanmar in Thailand

“…Based on the results of this study, the trend of HCV infection could be extrapolated to the general population. Even though the HCV infection rate was lower than expected [10,11] , the predominance of genotype 3 (3a; 26.7% and 3b; 33.5%) of Myanmar immigrant workers in this survey was similar to previous studies [11,12] . HCV-3 is also the predominant genotype in Thailand followed by genotype 1b and genotype 6 ( fig.…”

“…In Myanmar, the first study conducted showed a high prevalence of HCV in thalassemia and liver disease patients [9] . Prevalence varies from approximately 2 to 11.6%, though most studies were performed based on a small sample size [10][11][12] . This variation may result from differences in geographical sampling area and target population.…”

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

“…HBV genotypes also have a characteristic geographic distribution (2,15,18,22,24,26). For example, genotypes A and D are predominant in western countries while genotypes B and C are prevalent in Asia.…”

“…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.…”

Bayesian Coalescent Analysis Reveals a High Rate of Molecular Evolution in GB Virus C

“…GBV-C is particularly notable in that it establishes a persistent, asymptomatic infection within hosts and is widely distributed in the healthy human population. The prevalence of GBV-C ranges between 1% and 14% in healthy blood donors (Moaven et al 1996;Nakai et al 2001;Abe 2001). GBV-C has also been isolated from chimpanzees (Adams et al 1998;Birkenmeyer et al 1998), and the related GBV-A and -B viruses from New World monkeys (Simons et al 1995;Bukh and Apgar 1997).…”