Serological markers and molecular analysis of hepatitis B infection in a tertiary care hospital at Kathmandu, Nepal
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ORIGINAL ARTICLE
Serological markers and molecular analysis of hepatitis B infection in a tertiary care hospital at Kathmandu, Nepal Smita Shrestha 1 & Sila Mahatara 1 & Sher Bahadur Pun 2 & Mitesh Shrestha 3 & Rajindra Napit 4 & Krishna Das Manandhar 1 Received: 18 September 2019 / Accepted: 7 May 2020 # Indian Society of Gastroenterology 2020
Abstract Aim To analyze the serology and molecular markers of the hepatitis B-infected patients from the tertiary care hospital at Kathmandu in Nepal. Methods A total of 399 blood samples of patients from Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, were collected. Samples were tested for HBsAg, HBeAg, and IgM anti-HBc using ELISA method. The samples were further categorized as acute and chronic. The genotyping was performed by real-time polymerase chain reaction (real-time PCR) and further validated by sequencing. Results Out of 399 samples that were collected, 271 and 128 samples were acute and chronic cases respectively. Fifty-six samples were genotyped by qPCR, out of which 40 samples belonged to genotype D, 4 to C/D recombinant, 5 to genotype C, 3 to genotype B, and 4 were genotype A respectively. From these, 15 samples were used for sequencing of P (polymerase) gene and S (surface) genes. Thus, obtained sequences were used to construct neighbor-joining tree using Tamura-Nei model evolution and further validated by Bayesian analysis. A total of four sub-genotypes namely A1, C1, D1, and D5 were detected. Conclusion Hepatitis B virus infection is a global health problem affecting about 257 million people worldwide. In Nepal, there are few reports on the molecular and phylogenetic analysis of this virus. In this study, we report the circulation of seropositive occult hepatitis as well as CD-recombinant genotype in Nepalese population. Keywords Chronic hepatitis . Cirrhosis . Genotype . Hepatitis B virus . Hepatocellular cancer . HBV vaccine . Nepal . Occult hepatitis . Portal hypertension . Viral hepatitis
Introduction Viral hepatitis has emerged as one of the major causes of mortality due to communicable diseases [1]. Worldwide, 257 million people are affected and more than a million deaths have been attributed to cirrhosis, liver failure, and hepatocellular carcinoma (HCC) [2, 3]. Among the responsible pathogens, hepatitis B virus (HBV), a double-stranded DNA virus belonging to Hepadnaviridae family, is considered to be one
of the main causative agents for liver injury. In conjunction with hepatitis C virus, it accounts for over 90% of the related disability-adjusted life years (DALYs) [4]. According to World Health Organization (WHO), acute hepatitis may be defined as new onset of hepatitis B infection that may or may not be symptomatic. The diagnosis is based on the detection of hepatitis B surface antigen (HBsAg) and IgM antibodies to hepatitis core antigen (anti-HBc). However, chronic hepatitis B may be defined as the presence of HBsAg for
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12664-
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