Transmission of Hepatitis B and D Viruses in an African Rural Community

ABSTRACT According to the World Health Organization (WHO), an estimated 257 million people worldwide are chronically infected with hepatitis B virus (HBV), with approximately 15 million of them being coinfected with hepatitis D virus (HDV). To investigate the prevalence and transmission of HBV and H...

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Autores principales:	Carlos Augusto Pinho-Nascimento, Martin W. Bratschi, Rene Höfer, Caroline Cordeiro Soares, Louisa Warryn, Jūlija Pečerska, Jacques C. Minyem, Izabel C. N. P. Paixão, Marcia Terezinha Baroni de Moraes, Alphonse Um Boock, Christian Niel, Gerd Pluschke, Katharina Röltgen
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2018
Materias:	hepatitis B virus molecular epidemiology transmission Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/696b90e5ac4c4393a4ded67b9472810f
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spelling	oai:doaj.org-article:696b90e5ac4c4393a4ded67b9472810f2021-12-02T19:47:34ZTransmission of Hepatitis B and D Viruses in an African Rural Community10.1128/mSystems.00120-182379-5077https://doaj.org/article/696b90e5ac4c4393a4ded67b9472810f2018-10-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSystems.00120-18https://doaj.org/toc/2379-5077ABSTRACT According to the World Health Organization (WHO), an estimated 257 million people worldwide are chronically infected with hepatitis B virus (HBV), with approximately 15 million of them being coinfected with hepatitis D virus (HDV). To investigate the prevalence and transmission of HBV and HDV within the general population of a rural village in Cameroon, we analyzed serum samples from most (401/448) of the villagers. HBV surface antigen (HBsAg) was detected in 54 (13.5%) of the 401 samples, with 15% of them also containing anti-HDV antibodies. Although Cameroon has integrated HBV vaccination into their Expanded Program on Immunization for newborns in 2005, an HBsAg carriage rate of 5% was found in children below the age of 5 years. Of the 54 HBsAg-positive samples, 49 HBV pre-S/S sequences (7 genotype A and 42 genotype E sequences) could be amplified by PCR. In spite of the extreme geographical restriction in the recruitment of study participants, a remarkable genetic diversity within HBV genotypes was observed. Phylogenetic analysis of the sequences obtained from PCR products combined with demographic information revealed that the presence of some genetic variants was restricted to members of one household, indicative of intrafamilial transmission, which appears to take place at least in part perinatally from mother to child. Other genetic variants were more widely distributed, reflecting horizontal interhousehold transmission. Data for two households with more than one HBV-HDV-coinfected individual indicate that the two viruses are not necessarily transmitted together, as family members with identical HBV sequences had different HDV statuses. IMPORTANCE This study revealed that the prevalence of HBV and HDV in a rural area of Cameroon is extremely high, underlining the pressing need for the improvement of control strategies. Systematic serological and phylogenetic analyses of HBV sequences turned out to be useful tools to identify networks of virus transmission within and between households. The high HBsAg carriage rate found among children demonstrates that implementation of the HBV birth dose vaccine and improvement of vaccine coverage will be key elements in preventing both HBV and HDV infections. In addition, the high HBsAg carriage rate in adolescents and adults emphasizes the need for identification of chronically infected individuals and linkage to WHO-recommended treatment to prevent progression to liver cirrhosis and hepatocellular carcinoma.Carlos Augusto Pinho-NascimentoMartin W. BratschiRene HöferCaroline Cordeiro SoaresLouisa WarrynJūlija PečerskaJacques C. MinyemIzabel C. N. P. PaixãoMarcia Terezinha Baroni de MoraesAlphonse Um BoockChristian NielGerd PluschkeKatharina RöltgenAmerican Society for Microbiologyarticlehepatitis B virusmolecular epidemiologytransmissionMicrobiologyQR1-502ENmSystems, Vol 3, Iss 5 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	hepatitis B virus molecular epidemiology transmission Microbiology QR1-502
spellingShingle	hepatitis B virus molecular epidemiology transmission Microbiology QR1-502 Carlos Augusto Pinho-Nascimento Martin W. Bratschi Rene Höfer Caroline Cordeiro Soares Louisa Warryn Jūlija Pečerska Jacques C. Minyem Izabel C. N. P. Paixão Marcia Terezinha Baroni de Moraes Alphonse Um Boock Christian Niel Gerd Pluschke Katharina Röltgen Transmission of Hepatitis B and D Viruses in an African Rural Community
description	ABSTRACT According to the World Health Organization (WHO), an estimated 257 million people worldwide are chronically infected with hepatitis B virus (HBV), with approximately 15 million of them being coinfected with hepatitis D virus (HDV). To investigate the prevalence and transmission of HBV and HDV within the general population of a rural village in Cameroon, we analyzed serum samples from most (401/448) of the villagers. HBV surface antigen (HBsAg) was detected in 54 (13.5%) of the 401 samples, with 15% of them also containing anti-HDV antibodies. Although Cameroon has integrated HBV vaccination into their Expanded Program on Immunization for newborns in 2005, an HBsAg carriage rate of 5% was found in children below the age of 5 years. Of the 54 HBsAg-positive samples, 49 HBV pre-S/S sequences (7 genotype A and 42 genotype E sequences) could be amplified by PCR. In spite of the extreme geographical restriction in the recruitment of study participants, a remarkable genetic diversity within HBV genotypes was observed. Phylogenetic analysis of the sequences obtained from PCR products combined with demographic information revealed that the presence of some genetic variants was restricted to members of one household, indicative of intrafamilial transmission, which appears to take place at least in part perinatally from mother to child. Other genetic variants were more widely distributed, reflecting horizontal interhousehold transmission. Data for two households with more than one HBV-HDV-coinfected individual indicate that the two viruses are not necessarily transmitted together, as family members with identical HBV sequences had different HDV statuses. IMPORTANCE This study revealed that the prevalence of HBV and HDV in a rural area of Cameroon is extremely high, underlining the pressing need for the improvement of control strategies. Systematic serological and phylogenetic analyses of HBV sequences turned out to be useful tools to identify networks of virus transmission within and between households. The high HBsAg carriage rate found among children demonstrates that implementation of the HBV birth dose vaccine and improvement of vaccine coverage will be key elements in preventing both HBV and HDV infections. In addition, the high HBsAg carriage rate in adolescents and adults emphasizes the need for identification of chronically infected individuals and linkage to WHO-recommended treatment to prevent progression to liver cirrhosis and hepatocellular carcinoma.
format	article
author	Carlos Augusto Pinho-Nascimento Martin W. Bratschi Rene Höfer Caroline Cordeiro Soares Louisa Warryn Jūlija Pečerska Jacques C. Minyem Izabel C. N. P. Paixão Marcia Terezinha Baroni de Moraes Alphonse Um Boock Christian Niel Gerd Pluschke Katharina Röltgen
author_facet	Carlos Augusto Pinho-Nascimento Martin W. Bratschi Rene Höfer Caroline Cordeiro Soares Louisa Warryn Jūlija Pečerska Jacques C. Minyem Izabel C. N. P. Paixão Marcia Terezinha Baroni de Moraes Alphonse Um Boock Christian Niel Gerd Pluschke Katharina Röltgen
author_sort	Carlos Augusto Pinho-Nascimento
title	Transmission of Hepatitis B and D Viruses in an African Rural Community
title_short	Transmission of Hepatitis B and D Viruses in an African Rural Community
title_full	Transmission of Hepatitis B and D Viruses in an African Rural Community
title_fullStr	Transmission of Hepatitis B and D Viruses in an African Rural Community
title_full_unstemmed	Transmission of Hepatitis B and D Viruses in an African Rural Community
title_sort	transmission of hepatitis b and d viruses in an african rural community
publisher	American Society for Microbiology
publishDate	2018
url	https://doaj.org/article/696b90e5ac4c4393a4ded67b9472810f
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Transmission of Hepatitis B and D Viruses in an African Rural Community

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