Molecular epidemiology of HBV infection in chronic hepatitis B virus infected patients in northeast India

Abstract

The present study aimed to evaluate the molecular epidemiology of HBV in chronic HBV infected cases from northeast India (NEI), since scanty data are available from the region which has a predominant ethnically distinct tribal population. A total of 523 clinically diagnosed index chronic HBV infected cases and 172 asymptomatic patients (based on family screening) were enrolled with informed consent. Patients were stratified based on serology, imaging, pathology, and clinical data and grouped as chronic HBV and cirrhotic cohorts. Analysis for serum HBV DNA levels and HBV genotyping was performed, and was statistically co-related with disease severity. Males were more prone to chronic HBV infection. Majority of the patients who had Chronic HBV infection based on family screening were females (59.88%), majorly wives of index patients. Mean viral load in Chronic HBV patients was almost 4.5-folds higher than cirrhosis patients, and was significantly associated with e-antigen positive status(P < 0.001) in both groups. HBV genotype D was the most prevalent genotype (62.30%) in NEI. Mixed genotype infection of A + D was found from Assam, along with C + D cases (1.29%) cumulatively. There is a high prevalence of HBV genotype C (13.96%) in our studied cohort which was found to be associated with higher viral load(P = 0.018), e-antigen positivity(P = 0.043), and increased cirrhosis risk compared to Chronic HBV cases [OR = 1.670]. Family contacts in NEI are prone to infection with HBV and development of Chronic HBV. Higher presence of e-positive cases and genotype C along with the mixed genotypes in NEI is unique and of significance with reference to predisposition to disease severity and even response to antiviral therapy.

Molecular characterization of hepatitis B virus in Bangladesh reveals a highly recombinant population

“…The progression to chronic HBV infection has been shown to be commonly associated with genotypes A and D then with other genotypes [ 31 ]. Our data is in agreement with recently published HBV genotyping data from Bangladesh, and data from neighboring countries including India [ 32 ] [ 33 ]. Genotypes A and D are known to be horizontally transmitted, more than half of the HBV identified here were genotype A or D, indicating possible horizontal transmission through blood or blood products [ 31 ].…”

Hepatitis B genotyping: The utility for the clinicians

“…The HBV genotype landscape in India, with its multiethnic population, is likely to be diverse. Many reports from India have documented HBV genotypes in infected individuals in specific regions of the country [61][62][63][64][65][66][67][68][69][70][71][72]. In this context, a pan-Indian study on the regional variations in HBV genotypes in this issue of the Journal is laudable [73].…”

Current Scenario of Hepatitis B and Its Treatment in India

“…This may be partially related to the relation of genotype to different viral mutations, which can influence the type of liver disease manifested. 51 , 54 , 61 , 63 Also, the patients might be harbouring different genotypes (in blood and liver tissue) simultaneously, but one could be predominant and thereby be the detectable one, as has been exemplified in (a) liver tissue harbouring genotype C whereas peripheral blood harbours genotype D, 64 (b) presence of viral reverse transcriptase mutation in treatment-naïve patients (which is genotype related 67 ) and (c) genotype switch while on therapy. 62 Genotype may also determine the mode of transmission (horizontal vs. vertical).…”