Prevalence of Hepatitis B Virus Infection in Shenzhen, China, 2015\u20132018

Jian Tao,Aiqin Liu,Wenyuan Wu,Huakui Yue,Guirong He,Wenbo Gong,Honghui Fang,Hongyue Zhao,Weimin Zhang,Xiaoyun Hu,Guohun Zhu

doi:10.1038/s41598-019-50173-5

Jian Tao, Aiqin Liu + Show 9 more

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https://doi.org/10.1038/s41598-019-50173-5

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Abstract

China has nearly 10% of the general HBV carrier population in the world; this infection is the most common cause of chronic liver disease. Understanding HBV epidemiology is essential for future infection control, evaluation, and treatment. This study determined the prevalence of HBV infection in Shenzhen by serological testing and analysis in 282,166 HBV screening cases for the following: HBcAb, indicative of previous HBV infection; HBsAg, indicative of chronic (current) infection; HBsAb, indicative of immunity from vaccination; and 34,368 HBV etiological screening cases for HBV-DNA, indicative of virus carriage, in which 1,204 cases were genotyped and mutation analyzed for drug-resistance evaluation. Shenzhen was a highly endemic area of HBV throughout the study period (prevalence 9.69%). HBV infections were almost entirely in the 20 and older age groups with a male-to-female ratio of 1.16:1 which is approximately the same as the male-to-female ratio of the general population in China. However, only 71.25% of the general population retained HBV immune protection. Genotype B and C were identified as the most common agents; recombinant B/C and B/D also existed; some cases, however, could not be genotyped. NAs resistant mutation occurrence patterns were multitudinous; single mutation patterns of rtM204I/V and rtL180M occurrences accounted for majority, followed by the combinational mutation pattern L180M + M204I/V. Drug-resistance was prevalent, mainly occurring in the cross resistance patterns LAM + LdT and LAM + LdT + ETV, and significantly more critical in males. These results demonstrate that all people free from HBV infection should obtain injections of the vaccine or booster shots, and conventional virologic detection in a clinical laboratory center should incorporate genotype and mutation alongside the serological factors for etiology and develop better classification methods, such as sequencing.

Highlights

China has nearly 10% of the general Hepatitis B virus (HBV) carrier population in the world; this infection is the most common cause of chronic liver disease
Drug-resistance was prevalent, mainly occurring in the cross resistance patterns LAM + LdT and LAM + LdT + ETV, and significantly more critical in males. These results demonstrate that all people free from HBV infection should obtain injections of the vaccine or booster shots, and conventional virologic detection in a clinical laboratory center should incorporate genotype and mutation alongside the serological factors for etiology and develop better classification methods, such as sequencing
The clinical and laboratory data was extracted from medical records, including basic demographic information, date of illness onset, sample type, symptoms, date of symptoms onset, diagnosis, date of diagnosis, date of sampling, method used for HBV test, results at the time of sampling, HBV-DNA level, virus genotype, and mutation

Summary

Introduction

China has nearly 10% of the general HBV carrier population in the world; this infection is the most common cause of chronic liver disease. This study determined the prevalence of HBV infection in Shenzhen by serological testing and analysis in 282,166 HBV screening cases for the following: HBcAb, indicative of previous HBV infection; HBsAg, indicative of chronic (current) infection; HBsAb, indicative of immunity from vaccination; and 34,368 HBV etiological screening cases for HBV-DNA, indicative of virus carriage, in which 1,204 cases were genotyped and mutation analyzed for drug-resistance evaluation. Drug-resistance was prevalent, mainly occurring in the cross resistance patterns LAM + LdT and LAM + LdT + ETV, and significantly more critical in males These results demonstrate that all people free from HBV infection should obtain injections of the vaccine or booster shots, and conventional virologic detection in a clinical laboratory center should incorporate genotype and mutation alongside the serological factors for etiology and develop better classification methods, such as sequencing. If left unmonitored or untreated, approximately one-third of these chronically infected individuals will develop terminal liver disease, such as cirrhosis or HBV-related HCC (HBV-HCC)[4,5,6,7]

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