Distribution of hepatitis B virus genotypes in the general population of Myanmar via nationwide study

Yi Yi Kyaw,Jaehun Cheong,Hlaing Myat Thu,Khin Saw Aye,Kyaw Zin Thant,Aye Aye Lwin,Hyeon Jeong Hwang,Moh Moh Htun,Hnin Ohmar Soe,Kay Thi Aye

doi:10.1186/s12879-020-05269-z

Yi Yi Kyaw, Jaehun Cheong + Show 8 more

Open Access

https://doi.org/10.1186/s12879-020-05269-z

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Abstract

BackgroundHepatitis B virus (HBV) infections are a severe health concern worldwide. HBV is a DNA virus with a rapid rate of mutation. Based on heterogeneity of the nucleotide sequence, the HBV strains are divided into nine genotypes, each with a characteristic geographical distribution. Identifying and tracking alterations of HBV genotypes is important in epidemiological and transmission studies, and contributes to predicting the risk for development of severe liver disease and response to antiviral treatment. The present study was undertaken to detect HBV genotypes and sub-genotypes in the general population of different states and regions in Myanmar.MethodsIn 2015, a total of 5547 adults of the general population, residing in seven states, seven regions and the Nay Pyi Taw Union Territory, were screened for Hepatitis B Surface antigen (HBsAg) by the immunochromatographic test (ICT). Of the 353 HBsAg positive samples, the HBVDNA was identified using polymerase chain reactions (PCR) targeting the DNA sequences encoding the Pre-S region. A total of 153 PCR positive samples were subsequently subjected to genotyping by partial genome sequencing in both directions. The resulting sequences were then edited, aligned, and compared with reference sequences using the National Centre for Biotechnology Information (NCBI) web-based genotyping tool.ResultsThree HBV genotypes (HBV genotype B, genotype C and genotype D) were detected in Myanmar, of which genotype HBV genotype C (66.7%) was the most prevalent, followed by HBV genotype D (32%) and HBV genotype B (1.3%). Sub-genotyping revealed a total of 7 variants within the B, C and D genotypes: 2 (B4 and B5) in HBV genotype B, 3 (C1, C5 and C7) in HBV genotype C, and 2 (D3 and D6) in HBV genotype D.ConclusionHBV genotype C, sub-genotype C1 was predominantly distributed in all states and regions of Myanmar. This study is the first report on the nationwide distribution of HBV genotypes and sub-genotypes in Myanmar. We believe our findings will enable huge support for the hepatitis disease surveillance program, since HBV infection is one of the National Priority Diseases in Myanmar.

Highlights

Hepatitis B virus (HBV) infections are a severe health concern worldwide
In 2015, hepatitis B infection resulted in 887,000 deaths, mostly from complications that include cirrhosis and hepatocellular carcinoma [1]
Distribution of HBV genotypes among the study population All 353 Hepatitis B Surface antigen (HBsAg) positive serum samples tested positive by HBV ELISA

Summary

Introduction

Hepatitis B virus (HBV) infections are a severe health concern worldwide. Identifying and tracking alterations of HBV genotypes is important in epidemiological and transmission studies, and contributes to predicting the risk for development of severe liver disease and response to antiviral treatment. The present study was undertaken to detect HBV genotypes and sub-genotypes in the general population of different states and regions in Myanmar. The Hepatitis B virus (HBV) belongs to the genus Orthohepadnavirus of the Hepadnaviridae family and its liver infection can cause both acute and chronic diseases. An estimated 257 million people are living with hepatitis B virus (HBV) infection. The World Health Organization (WHO) estimated that the global prevalence of HBV infections in the general population was 3.5%. The proportion of persons living with chronic HBV infection remains high among those born before availability of the hepatitis B vaccine. The prevalence varied with geographic locations, with highest prevalence in the Yangon Region (10%) and lowest in Kayah State (4.2%) [3]

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