Serological markers and molecular analysis of hepatitis B infection in a tertiary care hospital at Kathmandu, Nepal

Indian J Gastroenterol. 2020 Aug;39(4):354-361. doi: 10.1007/s12664-020-01051-w. Epub 2020 Oct 10.

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; HBV vaccine; Hepatitis B virus; Hepatocellular cancer; Nepal; Occult hepatitis; Portal hypertension; Viral hepatitis.

MeSH terms

  • Acute Disease
  • Antibodies, Viral / blood
  • Biomarkers / blood
  • Chronic Disease
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Genotype
  • Genotyping Techniques
  • Hepatitis B / diagnosis*
  • Hepatitis B / virology*
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B e Antigens / blood*
  • Hepatitis B virus / genetics*
  • Hepatitis B virus / immunology*
  • Humans
  • Immunoglobulin M / blood*
  • Male
  • Nepal
  • Phylogeny
  • Real-Time Polymerase Chain Reaction
  • Serogroup
  • Tertiary Care Centers

Substances

  • Antibodies, Viral
  • Biomarkers
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens
  • Immunoglobulin M