Evolutionary dynamics of HBV‐D1 genotype epidemic in Turkey

Abstract

Hepatitis B virus (HBV), is the leading cause of liver diseases infecting an estimated 240 million persons worldwide. The HBV prevalence rates are variables between different countries, with an high level of endemicity in the south-eastern part of Europe. Seven main HBV-D subgenotypes have been described until now (D1-D7). Turkey, seems to have played an important role in the penetration of HBV-D1 in the Mediterranean area. The importance of Turkey in the European epidemiology of HBV is also suggested by the observation that the highest spread of HBV infection in the Continent are reported in Turkey with Romania, Bulgaria, Greece, Albania and some southern regions of Italy. In this paper the molecular epidemiology and the epidemiological history of HBV-D in Turkey was studied, by characterizing 34 new Turkish isolates and performing a phylogeographic reconstruction. By using a phylodynamic and phylogeographic Bayesian approach, the analysis suggested that HBV-D1 originated in Turkey about in the early 1940s. The large prevalence of D1 in comparison to the other subgenotypes in Turkey confirms the importance of this Country as epidemiological reservoir of HBV-D1 dispersion. The phylogeny suggests that after each initial introduction of the virus in a specific population, separate transmission clusters have been evolving along independent phylogenetic lineages. Better characterization and continuous monitoring of such groups are going to be crucial to understand in detail the epidemiology of HBV-D1 subgenotype in Turkey and to assess the efficacy of prevention, vaccination and therapy in controlling the epidemic.

Genotype I hepatitis A virus introduction in Italy: Bayesian phylogenetic analysis to date different epidemics

“…The sequences of the data sets were aligned using MAFFT, followed by manual editing using the Bioedit program v7.2.5 as already described …”

Epidemiology of HBV subgenotypes D

“…It is a common genotype in southern Europe, North Africa, India, China, and West and South Africa [76,77]. Genotype D makes up around 100% of the HBV cases in countries, including Greece [78], Italy [79], Serbia [44,45], Albania [41,80], Turkey [46][47][48][49][50][51], Lebanon [36] and Iran [27][28][29][30][31][32][33][34].…”

Hepatitis B virus genotype and subgenotype prevalence and distribution in Montenegro

“…In addition to health problems, these diseases cause broader social and economic problems. The Mediterranean area and the Balkans in particular show the highest level of genetic heterogeneity of HBV in Europe, with subgenotype D1 being the most prevalent in Greece, Turkey, Bulgaria [Zehender et al, 2012b;Ciccozzi et al, 2013Ciccozzi et al, 2014; subgenotype D2 being widespread in Albania [Zehender et al, 2012a]; and D3 the most prevalent in Serbia and Italy [Lazarevic et al, 2007;Zehender et al, 2012b]. The present study analyzed 136 HBV Pol gene sequences from the 150 chronic patients' serum of HBsAg-positive inhabitants in Montenegro.…”