Prevalence of Hepatitis B Virus Infection in Shenzhen, China, 2015-2018

Jian Tao, Weimin Zhang, Huakui Yue, Guohun Zhu, Wenyuan Wu, Wenbo Gong, Honghui Fang, Guirong He, Xiaoyun Hu, Hongyue Zhao, Aiqin Liu, Jian Tao, Weimin Zhang, Huakui Yue, Guohun Zhu, Wenyuan Wu, Wenbo Gong, Honghui Fang, Guirong He, Xiaoyun Hu, Hongyue Zhao, Aiqin Liu

Abstract

China has nearly 10% of the general HBV carrier population in the world; this infection is the most common cause of chronic liver disease. Understanding HBV epidemiology is essential for future infection control, evaluation, and treatment. This study determined the prevalence of HBV infection in Shenzhen by serological testing and analysis in 282,166 HBV screening cases for the following: HBcAb, indicative of previous HBV infection; HBsAg, indicative of chronic (current) infection; HBsAb, indicative of immunity from vaccination; and 34,368 HBV etiological screening cases for HBV-DNA, indicative of virus carriage, in which 1,204 cases were genotyped and mutation analyzed for drug-resistance evaluation. Shenzhen was a highly endemic area of HBV throughout the study period (prevalence 9.69%). HBV infections were almost entirely in the 20 and older age groups with a male-to-female ratio of 1.16:1 which is approximately the same as the male-to-female ratio of the general population in China. However, only 71.25% of the general population retained HBV immune protection. Genotype B and C were identified as the most common agents; recombinant B/C and B/D also existed; some cases, however, could not be genotyped. NAs resistant mutation occurrence patterns were multitudinous; single mutation patterns of rtM204I/V and rtL180M occurrences accounted for majority, followed by the combinational mutation pattern L180M + M204I/V. Drug-resistance was prevalent, mainly occurring in the cross resistance patterns LAM + LdT and LAM + LdT + ETV, and significantly more critical in males. These results demonstrate that all people free from HBV infection should obtain injections of the vaccine or booster shots, and conventional virologic detection in a clinical laboratory center should incorporate genotype and mutation alongside the serological factors for etiology and develop better classification methods, such as sequencing.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow Diagram of HBV patients in whom epidemiology was investigated.
Figure 2
Figure 2
HBV serological factors detection by age group in residents of Shenzhen, China, 2015–18.
Figure 3
Figure 3
HBV genotypes distribution by age group in residents of Shenzhen, China, 2015–18.
Figure 4
Figure 4
HBV mutations distribution by age group in residents of Shenzhen, China, 2015–18.
Figure 5
Figure 5
Patterns of NAs resistance happened in HBV patients in Shenzhen, China, 2015–18

References

    1. Papastergiou V, et al. Global epidemiology of hepatitis B virus (HBV) infection. Curr Hepatol Rep. 2015;14:171–178. doi: 10.1007/s11901-015-0269-3.
    1. Zou L, et al. Modeling the transmission dynamics and control of hepatitis B virus in China. J Theor Biol. 2017;262:330–338. doi: 10.1016/j.jtbi.2009.09.035.
    1. Liang X, et al. Epidemiological serosurvey of hepatitis B in China–declining HBV prevalence due to hepatitis B vaccination. Vaccine. 2013;31:J21–J28. doi: 10.1016/j.vaccine.2013.08.012.
    1. Bruix J, et al. Management of hepatocellular carcinoma: An update. Hepatology. 2011;53:1020–1022. doi: 10.1002/hep.24199.
    1. EASL–EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol56, 908–943 (2012).
    1. Lok ASF, et al. Chronic hepatitis B: Update 2009. Hepatology. 2009;50:661–662. doi: 10.1002/hep.23190.
    1. Bosch FX, et al. Epidemiology of hepatocellular carcinoma. Clin Liver Dis. 2005;9:191–211. doi: 10.1016/j.cld.2004.12.009.
    1. Sun YT, et al. Clinical characteristics and current management of hepatitis B and C in China. World J Gastroent. 2014;20:13582–13590. doi: 10.3748/wjg.v20.i37.13582.
    1. Testoni B, et al. Challenges to a cure for HBV infection. Semin Liver Dis. 2017;37:231–242. doi: 10.1055/s-0037-1606212.
    1. Kim SS, et al. Multidrug-resistant hepatitis B virus resulting from sequential monotherapy with lamivudine, adefovir, and entecavir: clonal evolution during lamivudine plus adefovir therapy. J Med Virol. 2012;85:55–64. doi: 10.1002/jmv.23440.
    1. Colagrossi L, et al. Immune-escape mutations and stop-codons in HBsAg develop in a large proportion of patients with chronic HBV infection exposed to anti-HBV drugs in Europe. Bmc Infect Dis. 2018;18:251. doi: 10.1186/s12879-018-3161-2.
    1. Aragri M, et al. Multiple HBV quasispecies and immune-escape mutations are present in HBV surface antigen and reverse transcriptase of patients with acute Hepatitis B. J Infect Dis. 2016;213:jiw049. doi: 10.1093/infdis/jiw049.
    1. Jafari. S, et al. Serological investigation against recombinant hepatitis B virus surface mutants in vaccinated healthcare workers and HBV chronic carriers with Anti-HBs. Imedp J. 2017;5:194.
    1. Lin CL, et al. The clinical implications of hepatitis B virus genotype: Recent advances. J Gastroen & Hepat. 2011;109:123–130. doi: 10.1111/j.1440-1746.2010.06541.x.
    1. Cui Y, et al. Update on epidemiology of hepatitis B and C in China. J Gastroen & Hepat. 2013;28:7–10. doi: 10.1111/jgh.12220.
    1. Qi Z, et al. Epidemiology study of HBV genotypes and antiviral drug resistance in multi-ethnic regions from Western China. Sci Rep. 2015;5:17413. doi: 10.1038/srep17413.
    1. Li DD, et al. Prevalence of hepatitis B virus genotypes and their relationship to clinical laboratory outcomes in Tibetan and Han Chinese. J Int Med Res. 2010;38:195. doi: 10.1177/147323001003800122.
    1. Kao JH, et al. HBV genotypes and outcome of HBV infection. Hepatology. 2005;41:216. doi: 10.1002/hep.20500.
    1. Ren N, et al. Association of specific genotypes in metastatic suppressor HTPAP with tumor metastasis and clinical prognosis in hepatocellular carcinoma. Cancer Res. 2011;71:3278–86. doi: 10.1158/0008-5472.CAN-10-3100.
    1. Feng Jia-fu, Yang Yu-wei, Wang Dong, Tang Jie, Xie Gang, Fan Ling-ying. Relationship between oxidative stress in patients with HBV-induced liver disease and HBV genotype/drug-resistant mutation. Frontiers in Laboratory Medicine. 2017;1(4):211–216. doi: 10.1016/j.flm.2017.12.005.
    1. European association for the study of the liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol (2017).
    1. Ott JJ, et al. Time trends of chronic HBV infection over prior decades - a global analysis. J Hepatol. 2017;66:48–54. doi: 10.1016/j.jhep.2016.08.013.
    1. Jianpeng X, et al. Disease burden from hepatitis B virus infection in Guangdong province, China. Inter J Env Res Pub Heal. 2015;12:14055–14067. doi: 10.3390/ijerph121114055.
    1. Lu WP, et al. Simultaneously high prevalences of hepatitis B and C virus infections in a population in Putian County, China. J Clin Microbiol. 2012;50:2142–2144. doi: 10.1128/JCM.00273-12.
    1. Sheng QJ, et al. Hepatitis B virus serosurvey and awareness of mother-to-child transmission among pregnant women in Shenyang, China: An observational study. Medicine. 2018;97:e10931. doi: 10.1097/MD.0000000000010931.
    1. Lin S, et al. HBV serum markers of 49164 patients and their relationships to HBV genotype in Fujian Province of China. J Clin Lab Anal. 2013;27:130–136. doi: 10.1002/jcla.21573.
    1. Fang ZL, et al. Prevalence of hepatitis B virus infection in a highly endemic area of southern China after catch-up immunization. J Med Virol. 2012;84:878–884. doi: 10.1002/jmv.23278.
    1. Mendy ME, et al. Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa. J Viral Hepatitis. 2010;17:115–122. doi: 10.1111/j.1365-2893.2009.01168.x.
    1. Zhang H, et al. Seroprevalence and risk factors for hepatitis B infection in an adult population in Northeast China. Int J Med Sci. 2011;8:321–331. doi: 10.7150/ijms.8.321.
    1. Zhuang H. Updates of EASL clinical practice guidelines: management of chronic hepatitis B virus infection. Zhonghua Gan Zang Bing Za Zhi. 2012;20:427–429.
    1. Kim BK, et al. HBV genotypes: relevance to natural history, pathogenesis and treatment of chronic hepatitis B. Antivir Ther. 2011;16:1169. doi: 10.3851/IMP1982.
    1. Szabó I, et al. Global perspective on the natural history of chronic hepatitis B: role of hepatitis B virus genotypes A to J. Semin Liver Dis. 2013;33:097–102. doi: 10.1055/s-0033-1345716.
    1. Narayanan K, et al. Predominance of HBV genotype D in southern part of India. Bmc Infect Dis. 2014;14:1. doi: 10.1186/1471-2334-14-1.
    1. Guo X, et al. Trends in hepatitis B virus resistance to nucleoside/nucleotide analogues in North China from 2009-2016: A retrospective study. Int J Antimicrob Ag. 2018;52:201. doi: 10.1016/j.ijantimicag.2018.04.002.
    1. Liu Y, et al. Genotypic resistance profile of hepatitis B virus (HBV) in a large cohort of nucleos(t)ide analogue-experienced Chinese patients with chronic HBV infection. J Viral Hepatitis. 2015;18:e29–e39. doi: 10.1111/j.1365-2893.2010.01360.x.
    1. Sede M, et al. Long-term monitoring drug resistance by ultra-deep pyrosequencing in a chronic hepatitis B virus (HBV)-infected patient exposed to several unsuccessful therapy schemes. Antivir Res. 2012;94:184–187. doi: 10.1016/j.antiviral.2012.03.003.
    1. Locarnini S. Primary resistance, multidrug resistance, and cross-resistance pathways in HBV as a consequence of treatment failure. J Hepatol. 2008;46:S192–S192. doi: 10.1016/S0168-8278(07)62104-7.
    1. Ott JJ, et al. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30:2212–2219. doi: 10.1016/j.vaccine.2011.12.116.

Source: PubMed

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