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Erschienen in: Infection 4/2015

01.08.2015 | Original Paper

Clinical, epidemiological and virological features of acute hepatitis B in Italy

verfasst von: Ornella Zuccaro, Luisa Romanò, Alfonso Mele, Andrea Mariano, Massimo Clementi, Maria Elena Tosti, Gloria Taliani, Claudio Galli, Alessandro Remo Zanetti, Enea Spada, Study Group

Erschienen in: Infection | Ausgabe 4/2015

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Abstract

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 clarification.
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Metadaten
Titel
Clinical, epidemiological and virological features of acute hepatitis B in Italy
verfasst von
Ornella Zuccaro
Luisa Romanò
Alfonso Mele
Andrea Mariano
Massimo Clementi
Maria Elena Tosti
Gloria Taliani
Claudio Galli
Alessandro Remo Zanetti
Enea Spada
Study Group
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 4/2015
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-015-0747-0

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