Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Virology, Institute of Medical Microbiology and Virology, Leipzig University, Leipzig, Germany.
PLoS One. 2022 Nov 15;17(11):e0276687. doi: 10.1371/journal.pone.0276687. eCollection 2022.
Despite the availability of effective vaccines and treatments for hepatitis B virus (HBV), it continues to be a major public health problem in sub-Saharan Africa including Ethiopia. Routine screening for HBV in pregnant women is widely recommended, but there is lack of screening for HBV during pregnancy in Ethiopia. Therefore, this study aimed to assess viral load, and genetic diversity among pregnant women in the Amhara National Regional State, Ethiopia.
Hepatitis B surface antigen (HBsAg) testing was performed on 1846 pregnant women, 85 of who tested positive were included in this study. HBV DNA was isolated from 85 positive sera, and the partial surface/polymerase gene was amplified and sequenced. HBV genotypes, sub-genotypes, serotypes and mutations in surface genes and polymerase were studied.
Out of 85 pregnant womens HBsAg positive sera, 59(69.4%) had detectable viral DNA. The median viral load was 3.4 log IU/ml ranging from 2.6 to7.6 and 46 samples were successfully sequenced and genotyped. Genotypes A and D were identified in 39 (84.8%) and 7 (15.2%); respectively. All genotype A isolates were further classified into sub-genotype A1 and serotype adw2 (84.8%) whereas genotype D isolates were further classified into three sub genotypes; 2 (4.3%) D2, 1(2.2%) D4, and 4 (8.7%) D10 with serotypes ayw2 (10.9%), and ayw3 (4.3%). There were 19 (41.3%) surface gene mutations in the major hydrophilic region (MHR). Six (13.1%) of them were discovered in MHRs `a'-determinant region. Six polymerase gene mutations (13%) were identified.
Genotype A was the predominant genotype in the Amhara National Regional State. The surface and polymerase gene mutations identified in this study may lead to immune therapy failure, diagnostics escape and drug resistance. Thus, the data generated in this study will contribute to the planning of HBV diagnosis, vaccination and treatment, and most importantly to the prevention of vertical transmission of HBV in Ethiopia. Therefore, further molecular studies on HBV are warranted and continuous surveillance is important for patient management and for the prevention and control of HBV infection in the country.
尽管乙型肝炎病毒 (HBV) 有有效的疫苗和治疗方法，但在包括埃塞俄比亚在内的撒哈拉以南非洲，它仍然是一个主要的公共卫生问题。广泛建议对孕妇进行 HBV 常规筛查，但在埃塞俄比亚，孕妇在怀孕期间并未进行 HBV 筛查。因此，本研究旨在评估在埃塞俄比亚阿姆哈拉州的孕妇中 HBV 的病毒载量和遗传多样性。
对 1846 名孕妇进行了乙型肝炎表面抗原 (HBsAg) 检测，其中 85 名 HBsAg 阳性的孕妇被纳入本研究。从 85 份阳性血清中分离出 HBV DNA，并扩增和测序部分表面/聚合酶基因。研究了 HBV 基因型、亚基因型、血清型以及表面基因和聚合酶中的突变。
在 85 名孕妇的 HBsAg 阳性血清中，有 59 名（69.4%）可检测到病毒 DNA。中位病毒载量为 3.4 log IU/ml，范围为 2.6 至 7.6，46 个样本成功测序并分型。鉴定出基因型 A 和 D 分别为 39 个（84.8%）和 7 个（15.2%）；分别。所有基因型 A 分离株进一步分为亚基因型 A1 和血清型 adw2（84.8%），而基因型 D 分离株进一步分为三个亚基因型；2 个（4.3%）D2、1 个（2.2%）D4 和 4 个（8.7%）D10，血清型为 ayw2（10.9%）和 ayw3（4.3%）。在主要亲水区域（MHR）中有 19 个（41.3%）表面基因突变。其中 6 个（13.1%）发生在 MHR 的“a”-决定区。鉴定出 6 个聚合酶基因突变（13%）。
基因型 A 是阿姆哈拉州的主要基因型。本研究中发现的表面和聚合酶基因突变可能导致免疫治疗失败、诊断逃逸和耐药性。因此，本研究产生的数据将有助于 HBV 诊断、疫苗接种和治疗的规划，最重要的是有助于预防和控制埃塞俄比亚的 HBV 垂直传播。因此，有必要对 HBV 进行进一步的分子研究，持续监测对于患者管理以及预防和控制该国的 HBV 感染非常重要。
