Abstract:
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Background:
Hepatitis B virus is hyperendemic in Sudan. Our aim was to molecularly characterize hepatitis B virus
from Sudanese individuals, with and without liver disease, because genotypes play an important role in clinical
manifestation and treatment management.
Methods:
Ninety-nine patients - 30 asymptomatic, 42 cirrhotic, 15 with hepatocellular carcinoma, 7 with acute
hepatitis and 5 with chronic hepatitis- were enrolled. Sequencing of surface and basic core promoter/precore
regions and complete genome were performed.
Results:
The mean ± standard deviation, age was 45.7±14.8 years and the male to female ratio 77:22. The median
(interquartile range) of hepatitis B virus DNA and alanine aminotransferase levels were 2.8 (2.2-4.2) log IU/ml and 30
(19
–
49) IU/L, respectively. Using three genotyping methods, 81/99 (82%) could be genotyped. Forty eight percent of
the 99 patients were infected with genotype D and 24% with genotype E, 2% with putative D/E recombinants and 7%
with genotype A. Patients infected with genotype E had higher frequency of hepatitis B e antigen-positivity and higher
viral loads compared to patients infected with genotype D. Basic core promoter/precore region mutations, including
the G1896A in 37% of HBeAg-negative individuals, could account for hepatitis B e antigen-negativity. Pre-S deletion
mutants were found in genotypes D and E. Three isolates had the vaccine escape mutant sM133T.
Conclusion:
Sudanese hepatitis B virus carriers were mainly infected with genotypes D or E, with patients infected
with genotype E having higher HBeAg-positivity and higher viral loads. This is the first study to molecularly characterize
hepatitis B virus from liver disease patients in Sudan |