Molecular Epidemiology of Hepatitis B Virus in Turkish Cypriot

Abstract

There is an increased demand for molecular and epidemiological information regarding Hepatitis B Virus (HBV) infection as the disease severity depends on these specifications. We have aimed to analyze nucleos(t)ide analogues (NA) resistance and typical HBsAg escape mutations with the dispersion of HBV genotype/subgenotype/HBsAg serotypes on overlapping pol/S gene regions in the Turkish population. Samples were collected in Northern Cyprus. Reverse transcriptase (rt) region between 80–250 amino acids were amplified. Typical HBsAg escape mutations were determined as HBIg escape (6.48%), vaccine escape (8.34%), HBsAg misdiagnosis (9.25%), and immune escape mutations (8.34%). NAs resistances were determined as primary (2.78%), partial (2.78%), and compensatory mutations (26.85%) in overlapping pol/S gene region. The study patients were predominantly infected with HBV genotype D/D1 (98%). However, the predominant HBsAg serotype was ayw2 (99%). The most common NA resistance mutation was rtQ215H/P/S (16.67%), however, for S gene the misdiagnosis mutations were observed most frequently (9.25%). We can conclude that HBV D/D1 is the dominant strain and ayw2 is the dominant serotype in the Turkish Cypriot. Cyprus is an island located in the Eastern Mediterranean region, and it is, therefore, a key location for human trafficking and immigration; as a result of this reputation, it is necessary to analyze HBV phylogenetically for local dynamics, and our results indicate that treatment naïve population is prone to these pol/S gene mutations. However, if HBV strains were also analyzed among Greek Cypriots too, this would enable a complete island survey. With this work, we believe that we have enlightened this subject for further research.

Full-Length Genome Sequencing and Analysis of Hepatitis B Viruses Isolated from Iraqi Patients

“…In addition, the current study revealed that all HBV samples relevant to serotype ayw2 depend on HBsAg amino acids present at specific loci [ 13 ]. Other studies conducted in Iran and Turkey have shown the dominance of this serotype among the tested HBV samples [ 40 , 42 ].…”

Variable Proportions of Phylogenetic Clustering and Low Levels of Antiviral Drug Resistance among the Major HBV Sub-Genotypes in the Middle East and North Africa

“…This result appears plausible considering the previous evidence of genotype D dominance in the Eastern Mediterranean region [ 55 , 77 , 78 ]. Genotype D was previously reported to be the most dominant variant of HBV in Iran, Iraq, Syria, Jordan, Lebanon, Palestine, Turkey, and Northern Cyprus [ 46 , 50 , 53 , 79 , 80 , 81 ]. In Iran, two separate studies by Aghakhani et al and Pourkarim et al .…”

“…Likewise, Sumer and Sayan suggested that the HBV genetic diversity seen in Northern Cyprus can be related to the relatively large fraction of students and workers present there, with similar evidence by Arıkan et al . [ 53 , 88 ]. An important point to be considered in areas with extensive genetic diversity of the virus is the higher possibility of recombination, which might yield novel viral variants, that may impact the prophylaxis, diagnosis, and treatment of the disease [ 89 , 90 ].…”

“…In addition, CHB was reported as an important cause of HCC in the region [ 44 ]. Genotype D was found to dominate infections in the MENA region from various countries in different time periods [ 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. This appears as an expected distribution considering that the MENA region is the putative epicenter for genotype D of the virus, with widespread distribution of its SGTs in the region [ 54 , 55 , 56 ].…”

Significance of hepatitis B surface antigen, IgM/IgG core antibody and hepatitis B virus DNA in blood donors

“…In 2015, the World Health Organization reported that there were 275 million of people who live with hepatitis B virus and that 887,000 deaths were estimated from this infection, 4,5 which is why it constitutes a public health problem. Prevalence in this study was 0.2 % of blood donors who tested positive for surface antigen and HBV core antibodies (anti-HBc), with 2.1 % reactivity to anti-HBc alone, which is higher than that found in Brazilian donors in 2003 and 2016, which was 0.14 % for anti-HBc and HBsAg, 1.67 % for anti-HBc alone 6 and 1.63 for HbsAg alone.…”