MRC/University Molecular Hepatology Research Unit, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Hepatol Res. 2007 Jul;37(s1):S9-S19. doi: 10.1111/j.1872-034X.2007.00098.x.
Of approximately 360 million people in the world chronically infected with hepatitis B virus (HBV), 65 million reside in Africa. Thus, Africa, with 12% of the world's population, carries approximately 18% of the global burden of HBV infection, with hepatocellular carcinoma and cirrhosis accounting for 2% of the continent's annual deaths. Despite HBV being endemic or hyperendemic in Africa, there is a paucity of data on the genotypes and their distribution. Genotype A is found mainly in southern, eastern and central Africa. Most African genotype A strains belong to subgenotype A1, with subgenotype A3 found in western Africa. Genotype D prevails in northern countries and genotype E in western and central Africa. Ithas become increasingly evident that heterogeneity in the global distribution of HBV genotypes may be responsible for differences in the clinical outcomes of HBV infections and the response to antiviral treatment and vaccination. A limited number of studies have been published relating genotypes to clinical outcomes in African countries. Because observations from other regions of the world can not be extrapolated from one locale to another, the HBV strains circulating in Africa should be studied and related to clinical outcomes.
在全球约 3.6 亿慢性乙型肝炎病毒 (HBV) 感染者中，有 6500 万人居住在非洲。因此，非洲拥有世界 12%的人口，却承担着全球约 18%的 HBV 感染负担，其肝癌和肝硬化导致的死亡人数占非洲大陆年总死亡人数的 2%。尽管 HBV 在非洲流行或高度流行，但关于其基因型及其分布的数据却很少。基因型 A 主要分布在非洲南部、东部和中部。大多数非洲基因型 A 株属于亚基因型 A1，而亚基因型 A3 则分布在西非。基因型 D 主要流行于北部国家，基因型 E 则流行于西部和中部非洲。HBV 基因型在全球的分布存在差异，这可能是导致 HBV 感染的临床结局和抗病毒治疗及疫苗接种反应存在差异的原因，这一点已变得越来越明显。已经发表了一些关于基因型与非洲国家临床结局关系的研究，但由于其他地区的观察结果不能从一个地方外推到另一个地方，因此应该对在非洲流行的 HBV 株进行研究，并将其与临床结局联系起来。
