Saudi Journal of Gastroenterology
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LETTER TO EDITOR Table of Contents   
Year : 2007  |  Volume : 13  |  Issue : 2  |  Page : 101
Hepatitis B genotyping and its clinical implications


1 Department of Pathology, Riyadh Military Hospital, P. O. Box 7897, Riyadh 11159, Saudi Arabia
2 Department of Gastroenterology, Riyadh Military Hospital, P. O. Box 7897, Riyadh 11159, Saudi Arabia

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How to cite this article:
Saeed AA, Mohamed AE. Hepatitis B genotyping and its clinical implications. Saudi J Gastroenterol 2007;13:101

How to cite this URL:
Saeed AA, Mohamed AE. Hepatitis B genotyping and its clinical implications. Saudi J Gastroenterol [serial online] 2007 [cited 2020 Oct 30];13:101. Available from: https://www.saudijgastro.com/text.asp?2007/13/2/101/32188


Sir,

Dr. Aljarallah draws timely attention to the tropical hepatitis B virus (HBV) genotypes. [1] We would like to add some relevant information about HBV genotypes in Saudi Arabia.

Among 48 Saudi HBsAg-positive patients whose blood samples are currently being investigated for HBV precore and core promoter mutations (Study I), 41 isolates (85%) are genotype D and seven (15%) are genotype E ( personal communication , Dr. Helen Norder). In an earlier report [2] involving 85 Saudi patients with HBV chronic liver disease and seven apparently healthy HBsAg carriers (Study II), genotypes D, E, A and B were identified with prevalence rates of 83.4, 14.3, 1.5 and 0.8% respectively [Table - 1]. Thus, the distribution of HBV strains in these two studies showed a highly prevalent genotype D (83.4%) which is the predominant strain in the Mediterranean basin and the Middle East. This was followed by genotype E (14.3%), a strain so far restricted to West and Central Africa and relatively recently introduced into humans, probably from an animal reservoir. [3] Genotype E was first described in 1993 [4] and only a few sporadic cases were reported in Africans living in Europe. [3] Therefore, its prevalence in Saudi Arabia represents a new focus for this newly evolved virus that may have been established in this country through settled Moslem pilgrims from West Africa.

In an extension of Study II, the presence of HBV precore mutations was investigated. Seventy-five of the 85 genotyped isolates could be characterized, 80% showing precore mutations while the remaining 20% were of the wild type. The predominance of the precore mutants agreed with the anti-HBe positive/HBe antigen negative status that was confirmed in all these samples and which is the most commonly encountered HBe serology profile in Saudi Arabia. [5]

A retrospective study on these patients was conducted to find out (a) the response of the different genotypes in those who received antiviral therapy and (b) the patients who developed hepatocellular carcinoma. HBV genotype may be a good predictor of these outcomes. In conclusion, at least four of the eight known HBV genotypes appear to be currently circulating in Saudi Arabia with precore mutants prevailing over wild type HBV. The clinical and epidemiological importance of such a diversity of HBV strains within this country warrants further study.

We thank Dr. Helen Norder, Swedish Institute for Infectious Disease Control, Sweden and Dr. Levin Stuyver, Innogenetics NV, Belgium for their valuable assistance with the molecular investigations on the samples from our Saudi patients.

 
   References Top

1.Aljarallah BM. Hepatitis B genotyping and its clinical implications. Saudi J Gastroenterol 2006;12:146-8.  Back to cited text no. 1    
2.Stuyver L, Rossau R, Maertens G. Lin probe assays for the detection of hepatitis B and C virus genotypes. Antivir Ther 1996;1:53-7.  Back to cited text no. 2    
3.Mulders MN, Venard V, Njayou M, Edorh AP, Bola Oyefolu AO, Kehinde MO, et al . Low genetic diversity despite hyperendemicity of hepatitis B virus genotype E throughout West Africa. J Infect Dis 2004;15:400-8.  Back to cited text no. 3    
4.Norder H, Hammas B, Lee SD, Bile K, Gourouce AM, Mushahwar IK, et al . Genetic relatedness of hepatitis B viral strains of diverse geographical origin and natural variations in the primary structure of the surface antigen. J Gen Virol 1993;74:1341-8.  Back to cited text no. 4    
5.Ramia S, Abdul-Jabbar F, Bakir TM, Hossain A. Vertical transmission of hepatitis B surface antigen in Saudi Arabia. Annals Trop Paed 1984;4:213-4.  Back to cited text no. 5  [PUBMED]  

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Correspondence Address:
Awad A Saeed
Department of Pathology, Riyadh Military Hospital, P. O. Box 7897, Riyadh 11159
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.32188

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