Hepatitis B virus (HBV) places a substantial health burden
on Africa. Here, we investigated genetic diversity of HBV variants circulating
in 4 countries of sub-Saharan Africa using archived samples. In total, 1492
plasma samples were tested from HIV-infected individuals and pregnant women,
among which 143 (9.6%) were PCR-positive for HBV DNA (Côte d’Ivoire, 70/608
[11.5%]; Ghana, 13/444 [2.9%]; Cameroon, 33/303 [10.9%]; and Uganda, 27/137
[19.7%]).
Phylogenetic analysis of the S-gene sequences identified HBV genotypes E (HBV/E, n = 96) and A (HBV/A, n = 47) distributed as follows: 87% of
HBV/E and 13% of HBV/A in Côte d’Ivoire; 100% of HBV/E in Ghana; 67% of HBV/E
and 33% of HBV/A in Cameroon; and 100% of HBV/A in Uganda. The average and
maximal nucleotide distances among HBV/E sequences were 1.9% and 6.4%,
respectively, suggesting a greater genetic diversity for this genotype than
previously reported (p <
0.001). HBV/A strains were classified into subgenotypes HBV/A1, HBV/A2 and
HBV/A3. In Uganda, 93% of HBV/A strains belonged to HBV/A1 whereas HBV/A3 was
the only subgenotype of HBV/A found in Cameroon. In Côte d’Ivoire, HBV/A
strains were classified as HBV/A1 (11.1%), HBV/A2 (33.3%) and HBV/A3 (55.6%).
Phylogeographic analysis of the sequences available from Africa supported
earlier suggestions on the origin of HBV/A1, HBV/A2 and HBV/A3 in East, South
and West/Central Africa, respectively. Using predicted amino acid sequences,
hepatitis B surface antigen (HBsAg) was classified into serotype ayw4 in 93% of HBV/E strains and adw2 in 68% of HBV/A strains. Also, 7.7% of
the sequences carried substitutions in HBsAg associated with immune escape.
The observations of pan-African and global dissemination of
HBV/A1 and HBV/A2, and the circulation of HBV/E and HBV/A3 almost exclusively
in West and Central Africa suggest a more recent increase in prevalence in
Africa of HBV/E and HBV/A3 compared to HBV/A1 and HBV/A2. The broad genetic
heterogeneity of HBsAg detected here may impact the efficacy of prevention and
control efforts in sub-Saharan Africa.
Below: Maximum likelihood tree of the HBV/A S-gene sequences. HBV/A1, HBV/A2 and HBV/A3 are subgenotypes of HBV/A. Sequences from Uganda, Cameroon and Côte d’Ivoire are noted with red, blue or green dots, respectively. Reference sequences are shown as branches without dots.
Below: Maximum likelihood tree of the HBV/A S-gene sequences determined in this study and those available in GenBank from other African countries: East Africa (red), Central Africa (Blue), West Africa (green), South Africa (yellow) and North Africa (cyan).
Full article at: http://goo.gl/mGh8pj
By: Joseph C. Forbi,a,* Yousr Ben-Ayed,a Guo-liang Xia,a Gilberto Vaughan,a Jan Drobeniuc,a William M. Switzer,b andYury E. Khudyakova
bLaboratory Branch, Division of HIV/AIDS, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
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