van Houdt R, Bruisten S M, Koedijk F D H, Dukers N H T M, Op de Coul E L M, Mostert M C, Niesters H G M, Richardus J H, de Man R A, van Doornum G J J, van den Hoek J A R, Coutinho R A, van de Laar M J W, Boot H J
GGD Public Health Service, Department of Infectious Diseases, Amsterdam, The Netherlands.
J Med Virol. 2007 Jul;79(7):895-901. doi: 10.1002/jmv.20820.
To gain insight into hepatitis B virus (HBV) transmission in the Netherlands, epidemiological data and sera were collected from reported cases of acute HBV infections in the Netherlands in 2004. Cases were classified according to mode of transmission. A fragment of the S-gene of HBV (648 bp) was amplified, sequenced, and subjected to phylogenetic analysis. Of the 291 acute HBV cases reported in 2004, 158 (54%) were available for genotyping. Phylogenetic analysis identified 6 genotypes: A (64%), B (3%), C (3%), D (21%), E (5%) and F (5%). Of HBV infected men having sex with men, 86% were infected with genotype A, accounting for 43% of all patients infected with this genotype. There were only three reported cases of injecting drug use of which one was available for sequencing (genotype A). Unlike the genotype A cluster, sequences within the genotype B-E clusters were heterogenic. Within genotype F, several isolates had identical sequences, but patients could not be epidemiologically linked. Sexual transmission, particularly by men having sex with men was the most important transmission route for HBV. Injecting drug use plays a minor role. Genotype A is predominant in the Netherlands, especially among men having sex with men. In addition to imported strains, there seems to be a pool of related but non-identical strains circulating among chronic carriers in the migrant population, from which occasionally new patients are infected, primarily by heterosexual transmission.
为深入了解荷兰的乙型肝炎病毒（HBV）传播情况，收集了2004年荷兰急性HBV感染报告病例的流行病学数据和血清。病例按传播方式分类。对HBV的S基因片段（648 bp）进行扩增、测序并进行系统发育分析。在2004年报告的291例急性HBV病例中，158例（54%）可用于基因分型。系统发育分析确定了6种基因型：A（64%）、B（3%）、C（3%）、D（21%）、E（5%）和F（5%）。在男同性恋HBV感染者中，86%感染了A基因型，占该基因型所有感染者的43%。仅报告了3例注射吸毒病例，其中1例可用于测序（A基因型）。与A基因型簇不同，B - E基因型簇内的序列具有异质性。在F基因型内，几个分离株具有相同序列，但患者在流行病学上无关联。性传播，尤其是男同性恋之间的传播是HBV最重要的传播途径。注射吸毒起次要作用。A基因型在荷兰占主导地位，尤其是在男同性恋者中。除了输入性毒株外，在移民群体的慢性携带者中似乎有一组相关但不完全相同的毒株在传播，偶尔有新患者被感染，主要是通过异性传播。
