Factors affecting the changes in molecular epidemiology of acute hepatitis B

liver411

<http://www3.interscience.wiley.com/journal/122609227/abstract>

Journal of Viral Hepatitis
Volume 17 Issue 7, Pages 493 - 500
Published Online: 25 Sep 2009
© 2010 Blackwell Publishing Ltd


Factors affecting the changes in molecular epidemiology of acute hepatitis B
in a Southern Italian area

N. Coppola 1 , A. Masiello 1 , G. Tonziello 1 , R. Pisapia 1 , M. Pisaturo 1 ,
C. Sagnelli 1,2 , V. Messina 2 , V. Iodice 1 and E. Sagnelli 1,2

1 Department of Public Medicine, Section of Infectious Diseases, 2nd
University of, Naples ; and   2 Division of Infectious Diseases, Azienda
Ospedaliera Sant'Anna e San Sebastiano di Caserta, Caserta, Italy
Correspondence to Prof. Evangelista Sagnelli, Department of Public Medicine,
Section of Infectious Diseases, Second University of Naples, c/o Ospedale
Gesù e Maria, Via D. Cotugno 1, 80135 Naples, Italy. E-mail:
[email protected]
Copyright © 2010 Blackwell Publishing Ltd

ABSTRACT
Summary. To explore changes in molecular epidemiology of acute viral hepatitis
B (AVH-B), hepatitis B virus (HBV) genotypes were determined by direct
sequencing of the Pre-S-S region in 123 consecutive patients, with AVH-B
observed in Naples or its surroundings in the last decade (group AVH-B) and in
123 HBV chronic carriers [chronic carrier of HBV (CC-B) group] from the same
areas, who had been hepatitis B surface antigen-positive for more than 10
years. Genotype D was less frequently detected in patients with AVH-B than in
those in the CC-B group (76.4%vs 97.5%, P < 0.0001). In the AVH-B group,
intravenous drug addiction (IVDA) was the prevalent risk factor (55.3%) for
acquiring HBV in the 94 patients with HBV genotype D, but it was rarely
recorded (6.9%) in the 29 patients with genotypes non-D (P < 0.0001); unsafe
sexual intercourse was prevalent in patients with genotype non-D (72.3%) and
less frequent in those with genotype D (28.8%, P < 0.005). In the AVH-B group,
the prevalence of non-D genotypes increased during the observation period from
11.1% in 1999–2003 to 41.1% in 2004–2008 (P < 0.0005), paralleling the
increase in the prevalence of patients with unsafe sexual intercourse;
similarly, the progressive decrease in IVDA paralleled the decrease in the
prevalence of genotype D (from 88.3% in 1999–2003 to 11.7% in 2004–2008).
The prevalence of HBV non-D genotypes recorded in the last 10 years in AVH-B
in this area shows a progressive increase, most probably because of recent
changes in HBV epidemiology, namely, the HBV mass vaccination campaign and
increased immigration from areas with high HBV endemicity.

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Received May 2009; accepted for publication June 2009
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2893.2009.01201



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