Predominance of HBV Genotype B and HDV Genotype 1 in Vietnamese Patients with Chronic Hepatitis.

Nghiem Xuan Hoan,Srinivas Reddy Pallerla,Chu Xuan Anh,Heiner Wedemeyer,Bui Tien Sy,Thirumalaisamy P Velavan,Le Thi Kieu Linh,Le Huu Song,Alexandru Tomazatos,Peter G Kremsner,Nguyen Linh Toan,C.-Thomas Bock,Christian G Meyer,Mai Thanh Binh,Mirjam Hoechel

doi:10.3390/v13020346

Abstract

Hepatitis delta virus (HDV) coinfection will additionally aggravate the hepatitis B virus (HBV) burden in the coming decades, with an increase in HBV-related liver diseases. Between 2018 and 2019, a total of 205 HBV patients clinically characterized as chronic hepatitis B (CHB; n = 115), liver cirrhosis (LC; n = 21), and hepatocellular carcinoma (HCC; n = 69) were recruited. HBV surface antigen (HBsAg), antibodies against surface antigens (anti-HBs), and core antigens (anti-HBc) were determined by ELISA. The presence of hepatitis B viral DNA and hepatitis delta RNA was determined. Distinct HBV and HDV genotypes were phylogenetically reconstructed and vaccine escape mutations in the “a” determinant region of HBV were elucidated. All HBV patients were HbsAg positive, with 99% (n = 204) and 7% (n = 15) of them being positive for anti-HBc and anti-HBs, respectively. Anti-HBs positivity was higher among HCC (15%; n = 9) compared to CHB patients. The HBV-B genotype was predominant (65%; n = 134), followed by HBV-C (31%; n = 64), HBV-D, and HBV-G (3%; n = 7). HCC was observed frequently among young individuals with HBV-C genotypes. A low frequency (2%; n = 4) of vaccine escape mutations was observed. HBV-HDV coinfection was observed in 16% (n = 33) of patients with the predominant occurrence of the HDV-1 genotype. A significant association of genotypes with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzyme levels was observed in HBV monoinfections. The prevalence of the HDV-1 genotype is high in Vietnam. No correlation was observed between HDV-HBV coinfections and disease progression when compared to HBV monoinfections.

Highlights

Safe and effective vaccines against infections with the hepatitis B virus (HBV) are available, it is estimated that in 2015, approximately 257 million people were living with chronic hepatitis B worldwide, with 887,000 fatalities [1]
Given the endemicity of HBV in Vietnam and the assumed high prevalence of hepatitis delta virus (HDV), the objectives of this study were to determine the distribution of HBV and HDV genotypes in HBV-infected patients from northern Vietnam, and to determine the impact of individual genotypes and HBV-HDV coinfection on the progression of HBV-related liver disease
The remarkably complex interaction of HBV with its host results in a multifaceted pathology pathology that is often aggravated by coinfection withother

Summary

Introduction

Safe and effective vaccines against infections with the hepatitis B virus (HBV) are available, it is estimated that in 2015, approximately 257 million people were living with chronic hepatitis B worldwide, with 887,000 fatalities [1]. Around 5% of these chronically HBV-infected individuals are estimated to be coinfected with the hepatitis delta virus (HDV) [2]. HBV is a hepatotropic enveloped DNA virus with a partially double-stranded circular genome containing four overlapping open reading frames [3]. HDV is an RNA virus unrelated to any other known RNA virus, which propagates as a satellite virus of HBV and accentuates the complications of viral hepatitis. HDV has a circular single-stranded negative RNA genome encoding the HDV antigen (HDAg) [4].

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