Two simultaneous hepatitis B virus epidemics among injecting drug users and men who have sex with me

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http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2893.2008.00997.x

Journal of Viral Hepatitis

OnlineEarly Articles

doi:10.1111/j.1365-2893.2008.00997.x

Abstract

Two simultaneous hepatitis B virus epidemics among injecting drug users and men

who have sex with men in Buenos Aires, Argentina: characterization of the first

D/A recombinant from the American continent

J. Trinks1,2,*1Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina*These authors contributed equally to this

study., M. L. Cuestas1,*1Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina*These authors contributed equally to this study., Y.

Tanaka33Department of Clinical Molecular Informative Medicine, Nagoya City

University Graduate School of Medical Sciences, Kawasumi, Nagoya, Japan, V. L.

Mathet1,21Centro para el Estudio de Hepatitis Virales, Depto. de Microbiología,

Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos Acres,

Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina, M. L. Minassian1,21Centro para el Estudio de Hepatitis

Virales, Depto. de Microbiología, Fac. de Medicina, Universidad de Buenos Aires

(UBA), Buenos Acres, Argentina2Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina, C. W. Rivero1,21Centro para el

Estudio de Hepatitis Virales, Depto. de Microbiología, Fac. de Medicina,

Universidad de Buenos Aires (UBA), Buenos Acres, Argentina2Consejo Nacional de

Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina, J. A.

Benetucci44Fundación de Ayuda al Inmunodeficiente (FUNDAI), Buenos Aires,

Argentina, E. D. Gímenez55Hospital Zonal General de Agudos ‘Dr. Isidoro G.

Iriarte’, Quilmes, Argentina, M. Segura66Centro Nacional de Referencia para el

SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires, Argentina,

M. C. Bobillo77Servicio de Huellas Digitales Genéticas y Cátedra de Genética

Molecular, Fac. de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina, D.

Corach2,72Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina7Servicio de Huellas Digitales Genéticas y Cátedra de

Genética Molecular, Fac. de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina,

P. D. Ghiringhelli2,82Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina8Laboratorio de Ingeniería Genética y Biología

Celular Molecular, Universidad Nacional de Quilmes, Bernal, Argentina, D. O.

Sánchez2,92Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina9Universidad Nacional de San Martín, San Martín,

Argentina, M. M. Ávila2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, L. A. M. Peralta2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, F. Kurbanov33Department of Clinical Molecular Informative Medicine,

Nagoya City University Graduate School of Medical Sciences, Kawasumi, Nagoya,

Japan, M. C. Weissenbacher2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, P. Simmonds1010Virus Evolution Group, Laboratory for Clinical and

Molecular Virology, University of Edinburgh, Summerhall, Edinburgh, UK, M.

Mizokami33Department of Clinical Molecular Informative Medicine, Nagoya City

University Graduate School of Medical Sciences, Kawasumi, Nagoya, Japan and J.

R. Oubiña1,21Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina1Centro para el Estudio de Hepatitis Virales,

Depto. de Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA),

Buenos Acres, Argentina; 2Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina; 3Department of Clinical Molecular

Informative Medicine, Nagoya City University Graduate School of Medical

Sciences, Kawasumi, Nagoya, Japan; 4Fundación de Ayuda al Inmunodeficiente

(FUNDAI), Buenos Aires, Argentina; 5Hospital Zonal General de Agudos ‘Dr.

Isidoro G. Iriarte’, Quilmes, Argentina; 6Centro Nacional de Referencia para el

SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires, Argentina;

7Servicio de Huellas Digitales Genéticas y Cátedra de Genética Molecular, Fac.

de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina; 8Laboratorio de

Ingeniería Genética y Biología Celular Molecular, Universidad Nacional de

Quilmes, Bernal, Argentina; 9Universidad Nacional de San Martín, San Martín,

Argentina; and 10Virus Evolution Group, Laboratory for Clinical and Molecular

Virology, University of Edinburgh, Summerhall, Edinburgh, UK

Dr José Raúl Oubiña, Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires, Paraguay 2155,

Piso 11, 1121 Buenos Aires, Argentina. E-mail: joubina@...

*These authors contributed equally to this study.

HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCV, hepatitis C

virus; HIV, human immunodeficiency virus; IDU, injecting drug user; MSM, men who

have sex with men; NJ, neighbour-joining; pre-C/C, Precore/core; RFLP,

restriction fragment length polymorphism.

Abstract

Summary. Previous studies have revealed that hepatitis B virus (HBV)/D and HBV/F

predominate among blood donors from Buenos Aires, Argentina. In the present

study, blood samples from two high-risk groups were analysed: 160 corresponding

to street- and hospital-recruited injecting drug users [81.2% showing the

‘anti-hepatitis B core antigen (anti-HBc) only’ serological pattern] and 20 to

hepatitis B surface antigen (HBsAg)+/anti-HBc+ men who have sex with men. HBV

genotypes were assigned by polymerase chain reaction amplification followed by

restriction fragment length polymorphism and confirmed by nucleotide sequencing

of two different coding regions. HBV DNA was detected in 27 injecting drug users

(16.9%, occult infection prevalence: 7.7%), and 14 men who have sex with men

(70%). HBV/A prevailed among injecting drug users (81.8%) while HBV/F was

predominant among men who have sex with men (57.1%). The high predominance of

HBV/A among injecting drug users is in sharp contrast to its low prevalence

among blood donors (P = 0.0006) and men who have sex with men (P = 0.0137).

Interestingly, all HBV/A S gene sequences obtained from street-recruited

injecting drug users encoded the rare serotype ayw1 and failed to cluster within

any of the known A subgenotypes. Moreover, one of the HBV strains from a

hospital-recruited injecting drug user was fully sequenced and found to be the

first completely characterized D/A recombinant genome from the American

continent. Data suggest that two simultaneous and independent HBV epidemics took

place in Buenos Aires: one spreading among injecting drug users and another one

sexually transmitted among the homosexual and heterosexual population.

_________________________________________________________________

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[Guest guest]

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2893.2008.00997.x

Journal of Viral Hepatitis

OnlineEarly Articles

doi:10.1111/j.1365-2893.2008.00997.x

Abstract

Two simultaneous hepatitis B virus epidemics among injecting drug users and men

who have sex with men in Buenos Aires, Argentina: characterization of the first

D/A recombinant from the American continent

J. Trinks1,2,*1Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina*These authors contributed equally to this

study., M. L. Cuestas1,*1Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina*These authors contributed equally to this study., Y.

Tanaka33Department of Clinical Molecular Informative Medicine, Nagoya City

University Graduate School of Medical Sciences, Kawasumi, Nagoya, Japan, V. L.

Mathet1,21Centro para el Estudio de Hepatitis Virales, Depto. de Microbiología,

Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos Acres,

Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina, M. L. Minassian1,21Centro para el Estudio de Hepatitis

Virales, Depto. de Microbiología, Fac. de Medicina, Universidad de Buenos Aires

(UBA), Buenos Acres, Argentina2Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina, C. W. Rivero1,21Centro para el

Estudio de Hepatitis Virales, Depto. de Microbiología, Fac. de Medicina,

Universidad de Buenos Aires (UBA), Buenos Acres, Argentina2Consejo Nacional de

Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina, J. A.

Benetucci44Fundación de Ayuda al Inmunodeficiente (FUNDAI), Buenos Aires,

Argentina, E. D. Gímenez55Hospital Zonal General de Agudos ‘Dr. Isidoro G.

Iriarte’, Quilmes, Argentina, M. Segura66Centro Nacional de Referencia para el

SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires, Argentina,

M. C. Bobillo77Servicio de Huellas Digitales Genéticas y Cátedra de Genética

Molecular, Fac. de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina, D.

Corach2,72Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina7Servicio de Huellas Digitales Genéticas y Cátedra de

Genética Molecular, Fac. de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina,

P. D. Ghiringhelli2,82Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina8Laboratorio de Ingeniería Genética y Biología

Celular Molecular, Universidad Nacional de Quilmes, Bernal, Argentina, D. O.

Sánchez2,92Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET),

Buenos Aires, Argentina9Universidad Nacional de San Martín, San Martín,

Argentina, M. M. Ávila2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, L. A. M. Peralta2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, F. Kurbanov33Department of Clinical Molecular Informative Medicine,

Nagoya City University Graduate School of Medical Sciences, Kawasumi, Nagoya,

Japan, M. C. Weissenbacher2,62Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina6Centro Nacional de Referencia para

el SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires,

Argentina, P. Simmonds1010Virus Evolution Group, Laboratory for Clinical and

Molecular Virology, University of Edinburgh, Summerhall, Edinburgh, UK, M.

Mizokami33Department of Clinical Molecular Informative Medicine, Nagoya City

University Graduate School of Medical Sciences, Kawasumi, Nagoya, Japan and J.

R. Oubiña1,21Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA), Buenos

Acres, Argentina2Consejo Nacional de Investigaciones Científicas y Técnicas

(CONICET), Buenos Aires, Argentina1Centro para el Estudio de Hepatitis Virales,

Depto. de Microbiología, Fac. de Medicina, Universidad de Buenos Aires (UBA),

Buenos Acres, Argentina; 2Consejo Nacional de Investigaciones Científicas y

Técnicas (CONICET), Buenos Aires, Argentina; 3Department of Clinical Molecular

Informative Medicine, Nagoya City University Graduate School of Medical

Sciences, Kawasumi, Nagoya, Japan; 4Fundación de Ayuda al Inmunodeficiente

(FUNDAI), Buenos Aires, Argentina; 5Hospital Zonal General de Agudos ‘Dr.

Isidoro G. Iriarte’, Quilmes, Argentina; 6Centro Nacional de Referencia para el

SIDA, Depto. de Microbiología, Fac. de Medicina, UBA, Buenos Aires, Argentina;

7Servicio de Huellas Digitales Genéticas y Cátedra de Genética Molecular, Fac.

de Farmacia y Bioquímica, UBA, Buenos Aires, Argentina; 8Laboratorio de

Ingeniería Genética y Biología Celular Molecular, Universidad Nacional de

Quilmes, Bernal, Argentina; 9Universidad Nacional de San Martín, San Martín,

Argentina; and 10Virus Evolution Group, Laboratory for Clinical and Molecular

Virology, University of Edinburgh, Summerhall, Edinburgh, UK

Dr José Raúl Oubiña, Centro para el Estudio de Hepatitis Virales, Depto. de

Microbiología, Fac. de Medicina, Universidad de Buenos Aires, Paraguay 2155,

Piso 11, 1121 Buenos Aires, Argentina. E-mail: joubina@...

*These authors contributed equally to this study.

HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCV, hepatitis C

virus; HIV, human immunodeficiency virus; IDU, injecting drug user; MSM, men who

have sex with men; NJ, neighbour-joining; pre-C/C, Precore/core; RFLP,

restriction fragment length polymorphism.

Abstract

Summary. Previous studies have revealed that hepatitis B virus (HBV)/D and HBV/F

predominate among blood donors from Buenos Aires, Argentina. In the present

study, blood samples from two high-risk groups were analysed: 160 corresponding

to street- and hospital-recruited injecting drug users [81.2% showing the

‘anti-hepatitis B core antigen (anti-HBc) only’ serological pattern] and 20 to

hepatitis B surface antigen (HBsAg)+/anti-HBc+ men who have sex with men. HBV

genotypes were assigned by polymerase chain reaction amplification followed by

restriction fragment length polymorphism and confirmed by nucleotide sequencing

of two different coding regions. HBV DNA was detected in 27 injecting drug users

(16.9%, occult infection prevalence: 7.7%), and 14 men who have sex with men

(70%). HBV/A prevailed among injecting drug users (81.8%) while HBV/F was

predominant among men who have sex with men (57.1%). The high predominance of

HBV/A among injecting drug users is in sharp contrast to its low prevalence

among blood donors (P = 0.0006) and men who have sex with men (P = 0.0137).

Interestingly, all HBV/A S gene sequences obtained from street-recruited

injecting drug users encoded the rare serotype ayw1 and failed to cluster within

any of the known A subgenotypes. Moreover, one of the HBV strains from a

hospital-recruited injecting drug user was fully sequenced and found to be the

first completely characterized D/A recombinant genome from the American

continent. Data suggest that two simultaneous and independent HBV epidemics took

place in Buenos Aires: one spreading among injecting drug users and another one

sexually transmitted among the homosexual and heterosexual population.

_________________________________________________________________

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