HBsAg subtype distribution among different populations of HBsAg carriers in Spain.

Data concerning the HBsAg subtype distribution in Spain are out-of-date and confined to a restricted geographical area. Furthermore, the complex distribution observed in the countries surrounding Spain prevents any prediction. To obtain further data on HBsAg subtype distribution among Spanish HBsAg carriers, subtyping analysis (d and y determinants) was performed in 670 samples from subjects belonging to various epidemiological risk groups and coming from different geographical areas of the country. Similar frequencies were found for both mutually exclusive d/y subtype determinants among non-risk, normal HBsAg carriers from almost all geographical areas studied. In contrast, the ay subtype was clearly predominant (79-87%) among intravenous drug users, irrespective of their geographical origin. Thirteen different institutions for mentally retarded patients behaved as closed communities for HBV circulation, showing independent subtype distributions. Thus, no significant geographical variations were found for HBsAg subtype distribution in Spain. The prevalence of each particular subtype is mainly dependent on the epidemiological characteristics of the carriers studied. Subtype distribution was independent of the presence of HBeAg or HDV infection serum markers when homogeneous groups were considered separately. Atypical HBsAg phenotypes, either with coexistence or absence of both subtype determinants, were found in some cases.