Purpose To evaluate the association of hepatitis B virus (HBV) genotypes, basal core promoter (BCP)/precore (PC) and S gene mutations with the clinical-epidemiological characteristics of acute hepatitis B (AHB) in Italy. Methods During July 2005–January 2007, 103 symptomatic AHB patients were enrolled and prospectively followed up at 15 national hospitals. HBV genotypes, BCP/ PC and S gene variants were determined by nested-PCR and direct sequence analysis. Results Genotype D, A and F were detected in 49, 45 and 6 % of patients, respectively. BCP, PC, and BCP plus PC variants were found in 3.1, 11.3 and 7.2 % of patients, respectively. At enrollment, 68.3 % of patients were hepatitis B e antigen (HBeAg)-positive and 31.7 % HBeAg-negative. BCP/PC mutations were more common in HBeAg-negative than in HBeAg-positive patients (p < 0.0001). Compared to genotype D patients, those harboring non-D genotypes were more frequently males (p = 0.023), HBeAg-positive (p < 0.001), had higher bilirubin (p = 0.014) and viremia (p = 0.034) levels and less frequently carried BCP/PC mutations (p < 0.001). Non-D genotype patients more often were from Central Italy (p = 0.001) and reported risky sexual exposure (p = 0.021). Two patients had received vaccination before AHB: one harbored genotype F; the other showed a S gene mutation. Four patients developed fulminant AHB; mutations were found in 2 of 3 patients who underwent BCP/ PC sequencing. After a 6-month follow-up, only 2 (2.8 %) patients developed persistent infection. Conclusion AHB by non-D genotypes is increasing in Italy and is associated with risky sexual exposure. The ability of some genotypes to cause persistent and/or severe infection in Italy warrants larger studies for clarification

Clinical, epidemiological and virological features of acute hepatitis B in Italy / Zuccaro, Ornella; Romanã², Luisa; Mele, Alfonso; Mariano, Andrea; Clementi, Massimo; Tosti, Maria Elena; Taliani, Gloria; Galli, Claudio; Zanetti, Alessandro Remo; Spada, Enea. - In: INFECTION. - ISSN 0300-8126. - STAMPA. - 43:4(2015), pp. 431-441. [10.1007/s15010-015-0747-0]

Clinical, epidemiological and virological features of acute hepatitis B in Italy

Taliani, Gloria;
2015

Abstract

Purpose To evaluate the association of hepatitis B virus (HBV) genotypes, basal core promoter (BCP)/precore (PC) and S gene mutations with the clinical-epidemiological characteristics of acute hepatitis B (AHB) in Italy. Methods During July 2005–January 2007, 103 symptomatic AHB patients were enrolled and prospectively followed up at 15 national hospitals. HBV genotypes, BCP/ PC and S gene variants were determined by nested-PCR and direct sequence analysis. Results Genotype D, A and F were detected in 49, 45 and 6 % of patients, respectively. BCP, PC, and BCP plus PC variants were found in 3.1, 11.3 and 7.2 % of patients, respectively. At enrollment, 68.3 % of patients were hepatitis B e antigen (HBeAg)-positive and 31.7 % HBeAg-negative. BCP/PC mutations were more common in HBeAg-negative than in HBeAg-positive patients (p < 0.0001). Compared to genotype D patients, those harboring non-D genotypes were more frequently males (p = 0.023), HBeAg-positive (p < 0.001), had higher bilirubin (p = 0.014) and viremia (p = 0.034) levels and less frequently carried BCP/PC mutations (p < 0.001). Non-D genotype patients more often were from Central Italy (p = 0.001) and reported risky sexual exposure (p = 0.021). Two patients had received vaccination before AHB: one harbored genotype F; the other showed a S gene mutation. Four patients developed fulminant AHB; mutations were found in 2 of 3 patients who underwent BCP/ PC sequencing. After a 6-month follow-up, only 2 (2.8 %) patients developed persistent infection. Conclusion AHB by non-D genotypes is increasing in Italy and is associated with risky sexual exposure. The ability of some genotypes to cause persistent and/or severe infection in Italy warrants larger studies for clarification
2015
Acute infection; Epidemiology; Genotypes; Hepatitis B; Mutations; Risk factors; Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Follow-Up Studies; Genotype; Hepatitis B; Hepatitis B Core Antigens; Hepatitis B Vaccines; Hepatitis B virus; Humans; Italy; Male; Middle Aged; Prospective Studies; Young Adult; Microbiology (medical); Infectious Diseases
01 Pubblicazione su rivista::01a Articolo in rivista
Clinical, epidemiological and virological features of acute hepatitis B in Italy / Zuccaro, Ornella; Romanã², Luisa; Mele, Alfonso; Mariano, Andrea; Clementi, Massimo; Tosti, Maria Elena; Taliani, Gloria; Galli, Claudio; Zanetti, Alessandro Remo; Spada, Enea. - In: INFECTION. - ISSN 0300-8126. - STAMPA. - 43:4(2015), pp. 431-441. [10.1007/s15010-015-0747-0]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1047495
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