HBV基因型A和D以及重组基因型D/E在乌干达HBV高、低流行区不成比例分布:为区域特异性HBV管理敲响警钟

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
International Journal of Hepatology Pub Date : 2022-01-11 eCollection Date: 2022-01-01 DOI:10.1155/2022/3688547
Hussein Mukasa Kafeero, Dorothy Ndagire, Ponsiano Ocama, Charles Drago Kato, Eddie Wampande, Henry Kajumbula, David Kateete, Abdul Walusansa, Ali Kudamba, Kigozi Edgar, Fred Ashaba Katabazi, Maria Magdalene Namaganda, Jamilu E Ssenku, Hakim Sendagire
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引用次数: 5

摘要

背景:乙型肝炎病毒(HBV)是肝脏相关疾病的主要原因。在乌干达,乙型肝炎病毒负担存在地区差异。我们的研究旨在建立低流行区和高流行区流行基因型,为区域负担差异提供合理的解释,并指导未来的疾病管理。方法:采用方便抽样的方法,抽取血清hbsag阳性受试者200例。采用HBsAg快速试笔(Healgen Scientific Limited Liability Company, Houston, TX77047- USA)筛查HBsAg,采用罗氏机器(Roche, Basel Switzerland/Abbot Technologies (USA))检测病毒载量。化学分析仪B120(迈瑞,中国)用于化学分析。对于HBV基因分型,使用QIAamp®DNA提取试剂盒从全血中提取总DNA。采用Platinum Taq DNA Polymerase (Invitrogen Corporation, USA)进行巢式PCR扩增,扩增400bp HBV聚合酶基因。巢式PCR产物的纯化使用Purelink PCR产物纯化试剂盒(Life Technologies, USA)。使用BigDye Terminator v3.1 Cycle sequencing Kit,在3130 Genetic Analyzer (Applied Biosystems, USA)上进行自动DNA测序。NCBI HBV基因分型工具(https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi)用于测定每个HBV序列的基因型。采用皮尔逊卡方检验、多项逻辑回归和Mann-Whitney U检验进行分析。所有分析均使用SPSS 26.0版本和MedCalc 19.1.3版本软件完成,95% CI。p < 0.05为差异有统计学意义。结果:研究对象以女性(64.5%)、青年(51.0%)、已婚(62.0%)为主。总体而言,基因型A最为普遍(46%)。基因型D和重组基因型D/E分别在高流行区(38.2%)和低流行区(36.5%)分布较多。基因型在高发地区和老年人中更为普遍(p < 0.05)。基因型D与病毒载量和直接胆红素升高显著相关(p < 0.05)。重组基因型D/E与病毒载量升高显著相关(p < 0.05)。同样,基因型A与AST和GGT升高、病毒载量降低和直接胆红素水平正常显著相关(p < 0.05)。结论:A、D基因型和重组D/E基因型在乌干达低、高流行区分布不成比例。这可能可以解释为什么我国乙型肝炎病毒的流行差异,这表明需要有区域特异性的乙型肝炎病毒管理和控制策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management.

Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management.

Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management.

Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management.

Background: Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease.

Methods: A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson's chi-square, multinomial logistic regression, and Mann-Whitney U tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A p < 0.05 was considered statistically significant.

Results: Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (p < 0.05). Genotype D was significantly associated with elevated viral load and direct bilirubin (p < 0.05). The recombinant genotype D/E was significantly associated with elevated viral load (p < 0.05). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (p < 0.05).

Conclusion: There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.

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来源期刊
International Journal of Hepatology
International Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.80
自引率
0.00%
发文量
11
审稿时长
15 weeks
期刊介绍: International Journal of Hepatology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the medical, surgical, pathological, biochemical, and physiological aspects of hepatology, as well as the management of disorders affecting the liver, gallbladder, biliary tree, and pancreas.
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