RT Journal Article
SR Electronic
T1 Hepatitis B virus strains of subgenotype A2 with an identical sequence spreading rapidly from the capital region to all over Japan in patients with acute hepatitis B
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2011-300832
DO 10.1136/gutjnl-2011-300832
A1 Yoko Tamada
A1 Hiroshi Yatsuhashi
A1 Naohiko Masaki
A1 Makoto Nakamuta
A1 Eiji Mita
A1 Tatsuji Komatsu
A1 Yukio Watanabe
A1 Toyokichi Muro
A1 Masaaki Shimada
A1 Taizo Hijioka
A1 Takeaki Satoh
A1 Yutaka Mano
A1 Toshiki Komeda
A1 Masahiko Takahashi
A1 Hiroshi Kohno
A1 Hajime Ota
A1 Shigeki Hayashi
A1 Yuzo Miyakawa
A1 Seigo Abiru
A1 Hiromi Ishibashi
YR 2011
UL http://gut.bmj.com/content/early/2011/11/07/gutjnl-2011-300832.abstract
AB Objective To examine recent trends of acute infection with hepatitis B virus (HBV) in Japan by nationwide surveillance and phylogenetic analyses.Methods During 1991 through 2009, a sentinel surveillance was conducted in 28 national hospitals in a prospective cohort study. Genotypes of HBV were determined in 547 patients with acute hepatitis B. Nucleotide sequences in the preS1/S2/S gene of genotype A and B isolates were determined for phylogenetic analyses.Results HBV genotype A was detected in 137 (25% (accompanied by genotype G in one)) patients, B in 48 (9%), C in 359 (66%), and other genotypes in the remaining three (0.5%). HBV persisted in five with genotype A including the one accompanied by genotype G; another was co-infected with HIV type 1. The genotype was A in 4.8% of patients during 1991–1996, 29.3% during 1997–2002, and 50.0% during 2003–2008 in the capital region, as against 6.5%, 8.5% and 33.1%, respectively, in other regions. Of the 114 genotype A isolates, 13 (11.4%) were subgenotype A1, and 101 (88.6%) were A2, whereas of the 43 genotype B isolates, 10 (23.3%) were subgenotype B1, 28 (65.1%) were B2, two (4.7%) were B3, and three (7.0%) were B4. Sequences of 65 (64%) isolates of A2 were identical, as were three (23%) of A1, and five (18%) of B2, but none of the B1, B3 and B4 isolates shared a sequence.Conclusions Acute infection with HBV of genotype A, subgenotype A2 in particular, appear to be increasing, mainly through sexual contact, and spreading from the capital region to other regions in Japan nationwide. Infection persisted in 4% of the patients with genotype A, and HBV strains with an identical sequence prevailed in subgenotype A2 infections. This study indicates the need for universal vaccination of young people to prevent increases in HBV infection in Japan.