Chowdhury Abhijit, Santra Amal, Chakravorty Runu, Banerji Arup, Pal Suparna, Dhali Gopal K, Datta Sibnarayan, Banerji Soma, Manna Byomkesh, Chowdhury Susanta Roy, Bhattacharya Sujit K, Mazumder Debendranath Guha
Department of Gastroenterology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
J Gastroenterol Hepatol. 2005 Nov;20(11):1712-20. doi: 10.1111/j.1440-1746.2005.04070.x.
There is a paucity of population-based epidemiological information regarding hepatitis B virus (HBV) infection in India. The present study was planned to outline the magnitude and pattern of HBV infection, hepatitis B e antigen (HBeAg)-negative infection and the associated viral mutants in India.
A community-based epidemiological study of HBV infection was carried out in West Bengal, India. Serological markers of infection and potential risk factors for HBV transmission were determined. Among the infected individuals, HBV-DNA, genotypes and mutations in the precore (PC) stop codon and basal core promoter (BCP) regions were determined by DNA sequencing and polymerase chain reaction (PCR) restriction fragment length polymorphism methods.
Of the 7653 people included in the study, 227 (2.97%) tested positive for hepatitis B surface antigen (HBsAg), of whom 204 (90%) were HBeAg-negative and hepatitis B e antibody (anti-HBe)-positive, and 78% had normal alanine aminotransferase (ALT) levels. HBV-DNA could be detected by PCR in only 32% of people. G1896A PC stop codon mutants were present in 12% of people, BCP mutants in 18% and the remainder (70%) of the HBeAg-negative infections were associated with wild type sequences in these regions.
This first general population-based epidemiological study of HBV infection from India suggests that HBV acquisition starts in early childhood and peaks in adulthood. Most infections in the community are e-negative and inactive. The point prevalence of PC stop codon and BCP mutants is low in this primarily inactive and asymptomatic HBV-infected population sample in eastern India.
关于印度乙型肝炎病毒（HBV）感染，缺乏基于人群的流行病学信息。本研究旨在概述印度HBV感染的程度和模式、乙型肝炎e抗原（HBeAg）阴性感染及相关病毒突变体情况。
在印度西孟加拉邦开展了一项基于社区的HBV感染流行病学研究。确定了感染的血清学标志物及HBV传播的潜在危险因素。在感染个体中，通过DNA测序和聚合酶链反应（PCR）限制性片段长度多态性方法，确定了HBV-DNA、基因型以及前核心（PC）终止密码子和核心启动子基础区域（BCP）的突变情况。
在纳入研究的7653人中，227人（2.97%）乙型肝炎表面抗原（HBsAg）检测呈阳性，其中204人（90%）HBeAg阴性且乙型肝炎e抗体（抗-HBe）阳性，78%的人丙氨酸转氨酶（ALT）水平正常。仅32%的人可通过PCR检测到HBV-DNA。12%的人存在G1896A PC终止密码子突变体，18%的人存在BCP突变体，其余70%的HBeAg阴性感染在这些区域与野生型序列相关。
这项来自印度的首次基于普通人群的HBV感染流行病学研究表明，HBV感染始于儿童早期，在成年期达到高峰。社区中的大多数感染为e抗原阴性且不活跃。在印度东部这个主要为不活跃和无症状的HBV感染人群样本中，PC终止密码子和BCP突变体的点患病率较低。
