Hepatitis B virus (HBV) infection and recombination between HBV genotypes D and E in asymptomatic blood donors from Khartoum, Sudan

Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV blood safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-H...

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Published in:Journal of clinical microbiology Vol. 49; no. 1; p. 298
Main Authors: Mahgoub, Shaza, Candotti, Daniel, El Ekiaby, Magdy, Allain, Jean-Pierre
Format: Journal Article
Language:English
Published: United States 01.01.2011
Subjects:
Adolescent
Adult
Blood Donors
Carrier State - virology
DNA, Viral - blood
DNA, Viral - chemistry
DNA, Viral - genetics
Female
Genotype
Hepatitis B - virology
Hepatitis B Antibodies - blood
Hepatitis B Surface Antigens - blood
Hepatitis B virus - classification
Hepatitis B virus - genetics
Hepatitis B virus - isolation & purification
Humans
Male
Middle Aged
Molecular Sequence Data
Recombination, Genetic
Sequence Analysis, DNA
Sudan
Young Adult
Sudan
ISSN:1098-660X, 1098-660X
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Abstract Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV blood safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg(-)/anti-HBc(+)/anti-HBs(+) and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable blood safety strategy because of the cost and the negative impact on the Sudanese blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.
AbstractList Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV blood safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg(-)/anti-HBc(+)/anti-HBs(+) and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable blood safety strategy because of the cost and the negative impact on the Sudanese blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV blood safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg(-)/anti-HBc(+)/anti-HBs(+) and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable blood safety strategy because of the cost and the negative impact on the Sudanese blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.
Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV blood safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg(-)/anti-HBc(+)/anti-HBs(+) and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable blood safety strategy because of the cost and the negative impact on the Sudanese blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.
Author Candotti, Daniel
El Ekiaby, Magdy
Allain, Jean-Pierre
Mahgoub, Shaza
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– reference: 16032729 - J Med Virol. 2005 Sep;77(1):47-52
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– reference: 20196797 - J Viral Hepat. 2011 Feb;18(2):91-101
– reference: 19843290 - Transfusion. 2010 Feb;50(2):433-42
– reference: 17133474 - Hepatology. 2006 Dec;44(6):1666-74
– reference: 17627641 - Hepatol Res. 2007 Jul;37(s1):S9-S19
– reference: 15216479 - J Infect Dis. 2004 Jul 15;190(2):400-8
– reference: 18602718 - J Hepatol. 2008 Oct;49(4):537-47
– reference: 19339480 - J Gen Virol. 2009 Jul;90(Pt 7):1622-8
– reference: 19392770 - Transfusion. 2009 Jun;49(6):1126-35
– reference: 18922739 - J Clin Virol. 2008 Dec;43(4):376-80
– reference: 7992329 - Trans R Soc Trop Med Hyg. 1994 Sep-Oct;88(5):534-6
– reference: 17958904 - Virol J. 2007;4:104
– reference: 19535503 - J Gen Virol. 2009 Oct;90(Pt 10):2442-51
– reference: 9847317 - J Virol. 1999 Jan;73(1):152-60
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– reference: 15023176 - Vox Sang. 2004 Feb;86(2):83-91
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– reference: 19858618 - Saudi J Gastroenterol. 2007 Apr-Jun;13(2):81-3
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Snippet Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of blood donors are chronically infected. To examine potential strategies to improve HBV...
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SubjectTerms Adolescent
Adult
Blood Donors
Carrier State - virology
DNA, Viral - blood
DNA, Viral - chemistry
DNA, Viral - genetics
Female
Genotype
Hepatitis B - virology
Hepatitis B Antibodies - blood
Hepatitis B Surface Antigens - blood
Hepatitis B virus - classification
Hepatitis B virus - genetics
Hepatitis B virus - isolation & purification
Humans
Male
Middle Aged
Molecular Sequence Data
Recombination, Genetic
Sequence Analysis, DNA
Sudan
Young Adult
Title Hepatitis B virus (HBV) infection and recombination between HBV genotypes D and E in asymptomatic blood donors from Khartoum, Sudan
URI https://www.ncbi.nlm.nih.gov/pubmed/21048009
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