1 research outputs found
Clinical, epidemiological and virological features of acute hepatitis B in Italy
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 clarificatio