National survey of hepatitis B virus (HBV) polymorphism in asymptomatic HBV blood donors from 1999 to 2007 in France

Abstract

This extensive study shows that HBV genotype evolution is closely linked to the geographical origin of subjects and that the occurrence of viral envelope mutants is not an exceptional event in healthy HBV chronic carriers. Blood donors rarely recruited in HBV studies provide further relevant information on the characteristics of HBV diversity.

Overestimation of Incidence of Hepatitis B Virus Mixed-Genotype Infections by Use of the New Line Probe INNO-LiPA Genotyping Assay

“…Moreover, the high proportion of genotype H infection observed with INNO-LiPA and never confirmed by molecular cloning appears erroneous and has widely contributed to the overestimation of mixed infection. Indeed, genotype H is restricted to South and Central America (1, 2) and was not detected in a set of 940 French blood donors (15). If the 9 genotype H isolates are excluded, the frequency of mixed-genotype infection decreases from 14.1 to 10.6%, which is more in agreement with the 8% prevalence (7 of 93) observed in blood donors in Belgium (10).…”

“…The INNO-LiPA results obtained in the 200 included samples were compared to those previously obtained by the direct sequencing of the S-PCR product (nt 108 to 552 of the S gene) (15). In the case of mixed infections or indeterminate or singlegenotype profiles associated with an isolated reactivity with INNO-LiPA, sequencing after molecular cloning of PCR DNA products was performed in the TOPO-TA vector (Invitrogen, Cergy-Pontoise, France) according to the manufacturer's instructions.…”

“…Such mixed infections have been identified using a commercial assay based on reverse hybridization on strips carrying genotypespecific probes, the INNO-LiPA HBV genotyping assay (Innogenetics, Ghent, Belgium) (4,5,14). The aim of the study was to evaluate the reliability of a new version of INNO-LiPA HBV genotyping assay in the detection of mixed-genotype infections by comparison with sequencing of PCR-amplified HBV DNA, before and after molecular cloning, in a population of 200 HBV surface antigen (HBsAg)-and anti-HBc-HBV-DNA-positive French blood donors who were selected in accordance with the HBV genotype distribution previously described in this population (15). The INNO-LiPA was used according to the manufacturer's instructions using biotinylated primers specific for gene S. The hybridization patterns were interpreted according to the chart provided: (i) a single genotype when at least one genotype-specific probe was reactive; (ii) a mixed-genotype infection when multiple genotype-specific lines were reactive for more than one genotype; (iii) an indeterminate profile when single lines were observed for more than one genotype, except for the combination of two probes (one D probe and one F probe), which was classified as genotype H (this genotype has no specific probes); and (iv) a single genotype (the one with a complete hybridization profile) when an isolated reactivity for a second genotype was observed.…”

Hepatitis B Genotypes: Role of Testing in Clinical Practice

“…The response in other genotypes is also good, with 12% of patients losing HBsAg 5 years after treatment. 10. This recent review of HBV genotypes discusses ethnic groups and natural history, and tries to analyze why, despite the growing body of evidence that genotypes influence response to therapy, the three regional organizations do not recommend genotyping.…”

“…In South America, genotypes A, D, and F are most common. In France, an 8-year blood donor study reflects these migration patterns, with genotypes A, D, and F being most common and a small number only with B or C [10]. Genotype G appears defective, and usually occurs together with another genotype, which provides transcription factors necessary for replication.…”