Distribution of Hepatitis B Virus Genotypes among Patients with Chronic Infection in Japan Shifting toward an Increase of Genotype A
Distribution of Hepatitis B Virus Genotypes among Patients with Chronic Infection in Japan Shifting toward an Increase of Genotype A
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DOI：
10.1128/jcm.02081-08
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发表时间：
2009-05-01
影响因子：
9.4
通讯作者：
Mizokami, Masashi
中科院分区：
文献类型：
--
作者：
Matsuura, Kentaro;Tanaka, Yasuhito;Mizokami, Masashi
通过滥交性接触感染急性乙型肝炎病毒（HBV）呈上升趋势，乙型肝炎病毒基因型（HBV/A）在日本急性乙型肝炎（AHB）患者中较为常见。为了比较2005年至2006年和2000年至2001年日本慢性乙型肝炎（CHB）患者中HBV基因型的地理分布，特别关注HBV/A比例的变化，进行了一项队列研究，调查日本16家医院慢性乙型肝炎（CHB）患者基因型的变化。此外，我们研究了每个基因型的临床特征，并通过分子进化分析检测了HBV/A分离株的基因组特征。在1271例患者中，3.5%、14.1%和82.3%分别感染HBV/A、-B和-C。与我们之前在2000年和2001年的调查相比，HBV/A的发生率增加了一倍（3.5%对1.7%;P = 0.02）。HBV/A患者的平均年龄低于HBV/B或c患者。根据来自患者的11个全基因组和29个前s2 /S区序列的系统发育分析，HBV/A分离株来自欧洲和美国，以及菲律宾和印度。它们与来自AHB患者的HBV/A聚集在一起，并在日本各地蔓延。HBV/A在日本慢性乙型肝炎患者中呈上升趋势，这是由于乙型肝炎病毒通过滥交性接触在年轻一代中传播，再加上HBV/A诱发慢性肝炎的趋势。乙型肝炎病毒/甲型感染在日本的传播应通过普及疫苗接种计划加以预防。
Acute hepatitis B virus (HBV) infection has been increasing through promiscuous sexual contacts, and HBV genotype A (HBV/A) is frequent in patients with acute hepatitis B (AHB) in Japan. To compare the geographic distribution of HBV genotypes in patients with chronic hepatitis B (CHB) in Japan between 2005 and 2006 and between 2000 and 2001, with special attention to changes in the proportion of HBV/A, a cohort study was performed to survey changes in genotypes of CHB patients at 16 hospitals throughout Japan. Furthermore, we investigated the clinical characteristics of each genotype and examined the genomic characteristics of HBV/A isolates by molecular evolutionary analyses. Of the 1,271 patients, 3.5%, 14.1%, and 82.3% were infected with HBV/A, -B, and -C, respectively. In comparison with our previous survey during 2000 and 2001, HBV/A was twice as frequent (3.5% versus 1.7%; P = 0.02). The mean age was lower in the patients with HBV/A than in those with HBV/B or -C. Based on phylogenetic analyses of 11 full-length genomes and 29 pre-S2/S region sequences from patients, HBV/A isolates were imported from Europe and the United States, as well as the Philippines and India. They clustered with HBV/A from AHB patients and have spread throughout Japan. HBV/A has been increasing in CHB patients in Japan as a consequence of AHB spreading in the younger generation through promiscuous sexual contacts, aided by a tendency of HBV/A to induce chronic hepatitis. The spread of HBV/A infection in Japan should be prevented by universal vaccination programs.