Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) - Universidad de Buenos Aires (UBA), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPAM), Paraguay 2155 P11 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina.
Laboratorio de Virología, Hospital Interzonal General de Agudos "Dr. Pedro Fiorito", Avellaneda, Buenos Aires, Argentina.
Virus Genes. 2021 Aug;57(4):327-337. doi: 10.1007/s11262-021-01850-z. Epub 2021 Jun 6.
Argentina exhibits low serological prevalence for Hepatitis B virus (HBV); however, occult hepatitis B infection (OBI) has been reported in blood donors, Amerindians and individuals coinfected with hepatitis C virus (HCV), and/or human immunodeficiency virus (HIV). The aim of this study was to analyze the genetic diversity of HBV and to evaluate serological marker associations and coinfections with HCV and HIV in patients attending and treated in a public hospital in the province of Buenos Aires, Argentina. A total of 189 HBV reactive samples (HBsAg and/or anti-HBc) were analyzed for HBV DNA characterization. All reactive samples were tested for anti-HCV and HIV-antigen/antibody using CMIA assays. Thirty-six samples exhibited detectable HBV DNA, 7 of which were OBI. HBV sequences were classified as subgenotypes A1, A2, B2, D3, F1b, F3 and F4. Mutations related to the ability to escape the host's immune response, resistance to antiviral therapy and progression to disease were found in patients, partly due to the variable sensitivity of HBsAg, the reverse transcriptase, the basal core promoter and the preCore. HCV and HIV prevalence was 10% and most of the genotypes found in the sequences were genotype 1 and B/F recombinant subtype, respectively. Of the total samples analyzed, 7 exhibited coinfections. This study shows the frequency of OBI, subgenotype distribution, HBV mutations and coinfections, which may have important clinical implications in public hospital patients. Planned prevention, detection and treatment adherence are needed to reduce transmission and morbidity in vulnerable populations.
阿根廷的乙型肝炎病毒（HBV）血清流行率较低；然而，在献血者、美洲印第安人和同时感染丙型肝炎病毒（HCV）和/或人类免疫缺陷病毒（HIV）的个体中，已报告存在隐匿性乙型肝炎感染（OBI）。本研究旨在分析 HBV 的遗传多样性，并评估在阿根廷布宜诺斯艾利斯省一家公立医院就诊和治疗的患者中，与 HCV 和 HIV 感染相关的血清标志物关联和合并感染情况。对 189 份 HBV 反应性样本（HBsAg 和/或抗-HBc）进行了 HBV DNA 特征分析。所有反应性样本均采用 CMIA 法检测抗-HCV 和 HIV 抗原/抗体。36 份样本检测到可检测的 HBV DNA，其中 7 份为 OBI。HBV 序列被分类为亚基因型 A1、A2、B2、D3、F1b、F3 和 F4。在患者中发现了与逃避宿主免疫反应、抗病毒治疗耐药性和疾病进展相关的突变，部分原因是 HBsAg、逆转录酶、基本核心启动子和前核心的变异性敏感性。HCV 和 HIV 的流行率分别为 10%，在序列中发现的大多数基因型分别为基因型 1 和 B/F 重组亚型。在分析的总样本中，有 7 份样本显示合并感染。本研究显示了 OBI 的频率、亚基因型分布、HBV 突变和合并感染情况，这可能对公立医院患者具有重要的临床意义。需要计划预防、检测和治疗依从性，以减少弱势群体的传播和发病。
