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Emergence of Hepatitis B Virus Genotype F in Aligarh Region of North India

DOI: 10.1155/2013/846849

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Introduction. HBV genotypes and subtypes are useful clinical and epidemiological markers. In this study prevalent HBV genotypes were assessed in relation to serological profile and clinical status. Material & Methods. 107 cases of HBV were genotyped. Detailed clinical history was elicited from them. HBsAg, HBeAg, anti-HBs, anti-HBe, and anti-HBc-IgM were assessed. HBV genotyping was performed using Kirschberg's type specific primers (TSP-PCR), heminested PCR, and Naito's monoplex PCR. Nucleotide sequencing was performed. Results. A total of 97 (91%) were genotyped following the methods of Kirschberg et al./Naito et al. Genotype D was by far the most prevalent genotype 91 (85.04%) in this region. A surprising finding was the detection of genotype F in 5 (4.67%) of our patients. Genotype A strangely was observed only in one case. In 85.7% genotype D was associated with moderate to severe liver disease, 43.9% HBeAg, and 18.7% anti-HBc-IgM positivity. Majority of genotype F (80%) was seen in mild to moderate liver disease. It was strongly associated with HBeAg 60% and 20% anti-HBc-IgM positivity. Conclusion. Emergence of genotype F in India merits further study regarding its clinical implications and treatment modalities. Knowledge about HBV genotypes can direct a clinician towards more informed management of HBV patients. 1. Introduction Hepatitis B virus (HBV) is one of the major public health problems worldwide. About 30% of the world population has serological evidence of current and past infection with HBV [1] and approximately 1 million persons die annually from HBV related chronic liver diseases including severe complications such as liver cirrhosis and hepatocellular carcinoma [2]. Every year there are over 4 million acute clinical cases of HBV and about 25% of carriers. Approximately one million people a year die from chronic active hepatitis, cirrhosis, or primary liver cancer [3]. Genotypically, HBV is divided into 8 groups, A–H. HBV genotypes represent naturally occurring strains of HBV that have evolved over the years in the world. The genotypes and subtypes were identified on the basis of intergroup divergence of 8% or 4% in gene (S) sequence, respectively. They are useful clinical and epidemiological markers [4]. It is also well known that genotypes vary geographically and correlate strongly with ethnicity [5]. Genotype correlation has been associated with HBV core antigen, HBe antigen seroconversion, activity of liver disease, and treatment response with chronic HBV infections [6, 7]. Type A is prevalent in Europe, Africa, and southeast


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