Temporal and geographic spreading of hepatitis B virus genotype A (HBV‐A) in Brazil and the Americas

Wolf, Jonas Michel; Pereira, Vagner Reinaldo Zingalli Bueno; Simon, Daniel; Lunge, Vagner Ricardo

doi:10.1111/jvh.13527

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…This agrees with previous studies in our country (19,25). This sub-genotype has been associated to HBV/HIV co-infection, as demonstrated in previous reports (19,37,38). Accordingly, in this study the frequency of subgenotype A2 was higher in HBV/HIV co-infected patients than in mono-infected patients.…”

Section: Acute Hepatitis B (Ahb)supporting

confidence: 93%

Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV

et al. 2023

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IntroductionGenomic analysis of hepatitis B virus (HBV) identifies phylogenetic variants, which may lead to distinct biological and clinical behaviors. The satellite hepatitis D virus (HDV) may also influence clinical outcomes in patients with hepatitis B. The aim of this study was to investigate HBV genetic variants, including clinically relevant mutations, and HDV infection in acute and chronic hepatitis B patients in central Argentina.MethodsA total of 217 adult HBV infected patients [acute (AHB): n = 79; chronic (CHB): n = 138] were studied; 67 were HBV/human immunodeficiency virus (HIV) coinfected. Clinical and demographic data were obtained from medical records. Serological markers were determined. Molecular detection of HBV and HDV was carried out by RT-Nested PCR, followed by sequencing and phylogenetic analysis.ResultsOverall, genotype (gt) F [sub-genotype (sgt) F1b] was the most frequently found. In AHB patients, the gts/sgts found were: F1b (74.7%) > A2 (13.9%) > F4 (7.6%) > C (2.5%) > A1 (1.3%). Among CHB patients: F1b (39.1%) > A2 (23.9%) > F4 (18.2%) > D (9.4%) > C and F6 (3.6% each) > A1, A3 and B2 (0.7% each). The distribution of sgt A2 and gt D was significantly different between HBV mono and HBV/HIV coinfected patients [A2: 15.9% vs. 35.7% (p < 0.05), respectively and D: 14.6% vs. 1.8% (p < 0.05), respectively]. Mutation frequency in basal core promoter/pre-Core (BCP/pC) region was 35.5% (77/217) [AHB: 20.3% (16/79), CHB: 44.2% (61/138)]. In the open reading frame (ORF) S, mutations associated with vaccine escape and diagnostic failure were detected in 7.8% of the sequences (17/217) [AHB: 3.8% (3/79), CHB: 10.1% (14/138)]. ORF-P amino acid substitutions associated with antiviral resistance were detected in 3.2% of the samples (7/217) [AHB: 1.3% (1/79), CHB 4.3%, (6/138)]. The anti-HDV seropositivity was 5.2% (4/77); one sample could be sequenced, belonging to gt HDV-1 associated with sgt HBV-D3.DiscussionWe detected an increase in the circulation of genotype F in Central Argentina, particularly among AHB patients, suggesting transmission advantages over the other genotypes. A low rate of mutations was detected, especially those with antiviral resistance implications, which is an encouraging result. The evidence of HDV circulation in our region, reported for the first time, alerts the health system for its search and diagnosis.

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Section: Acute Hepatitis B (Ahb)supporting

confidence: 93%

Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV

et al. 2023

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“…Although previous studies have reported higher rates of HBsAg and HBeAg loss in patients with genotype A (18–21), those studies did not evaluate responses by HBV subgenotype. Epidemiologic data regarding subgenotypes of A indicate that A2 is most common in Northern Europeans with CHB, whereas A1 is found largely in African, Middle Eastern, and Asian patients (22,23). In this study, HBsAg loss occurred in 4 of 6 HBeAg positive patients with genotype A2 treated with TDF alone (at weeks 71–217) and in all 3 such patients receiving combination therapy (at weeks 25–121).…”

Section: Discussionmentioning

confidence: 99%

“…By treatment arm, the percentages of participants experiencing flares in the withdrawal phase was 16 of 51 (31.4%) in the TDF arm and 11 of 60 (18.3%) in the combination arm (P 5 0.13). The percentages of participants with flares during the withdrawal phase did not differ significantly by HBeAg status at randomization (HBeAg positive: 11/36 [30.6%] vs HBeAg negative: 16/75 [21.3%], P 5 0.34).In the subset of participants who met the amended eligibility criteria and withdrew from treatment and did not have HBsAg loss before withdrawal (n 5 92),23 (25%) participants had flares after withdrawal. Most (20/23) of these participants had their first flare at or before week 208 visit.…”

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confidence: 93%

Randomized Trial of Tenofovir With or Without Peginterferon Alfa Followed by Protocolized Treatment Withdrawal in Adults With Chronic Hepatitis B

et al. 2022

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Hepatitis B surface antigen (HBsAg) loss is associated with improved long-term outcomes of patients with chronic hepatitis B but is infrequently achieved with current monotherapies. We assessed whether combination strategies that included treatment withdrawal enhanced HBsAg loss. METHODS:A randomized (1:1) trial of tenofovir disoproxil fumarate (TDF) for 192 weeks with or without peginterferon (PegIFN) alfa-2a for the first 24 weeks, followed by withdrawal of TDF at week 192 with 48 weeks of off-treatment follow-up to week 240. The primary end point was HBsAg loss at week 240. RESULTS:Of 201 participants (52% HBeAg positive, 12%/6% genotype A/A2, 7% cirrhosis) randomized to TDF 1 PegIFN (n 5 102) or TDF alone (n 5 99), 6 participants had lost HBsAg at the end of the treatment phase (week 192), 5 (5.3%) in the combination group, and 1 (1.0%) in the TDF alone group (P 5 0.09). By week 240, 9 participants had cleared HBsAg, 5.3% in combination, and 4.1% in monotherapy arms (P 5 0.73). HBsAg decline and loss occurred earlier with TDF 1 PegIFN than TDF, with a ‡1-logIU/mL qHBsAg decline by week 24 in 28% in TDF 1 PegIFN compared with 6% in TDF (P 5 0.04). HBsAg loss occurred in 7 of 12 (58%) with hepatitis B virus subgenotype A2 (all HBeAg positive) compared with only 2 of 189 (1%) with other hepatitis B virus genotypes and in 8 of 93 (8.6%) HBeAg positive vs 1 of 87 (1.1%) HBeAg negative. DISCUSSION:PegIFN combined TDF followed by protocolized TDF withdrawal led to earlier but not higher percentages of HBsAg clearance. Pretreatment HBeAg positivity and subgenotype A2 were strongly associated with HBsAg clearance.

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“…Wolf et al 28 demonstrated that the subgenotypes A1 and A2 were introduced in Brazil between the 16 th and 20 th centuries. The spread of HBV-A1 across the country probably occurred between 1600 and 1740, introduced directly from Africa through the slave trade.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B in the Northwestern region of Sao Paulo State: genotypes and resistance mutations

Meneghello

Soares

Silva

et al. 2021

Rev. Inst. Med. trop. S. Paulo

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Temporal and geographic spreading of hepatitis B virus genotype A (HBV‐A) in Brazil and the Americas

Cited by 6 publications

References 39 publications

Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV

Acute and chronic HBV infection in central Argentina: High frequency of sub-genotype F1b, low detection of clinically relevant mutations and first evidence of HDV

Randomized Trial of Tenofovir With or Without Peginterferon Alfa Followed by Protocolized Treatment Withdrawal in Adults With Chronic Hepatitis B

Hepatitis B in the Northwestern region of Sao Paulo State: genotypes and resistance mutations

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