Characterization of hepatitis B virus genome variability in Iranian patients with chronic infection, a nationwide study

Authors

  • Seyed Reza Mohebbi,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    2. Virology Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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  • Samad Amini-Bavil-Olyaee,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    2. Virology Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
    3. Biotechnology Department, Pasture Institute of Iran, Tehran, Iran
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  • Narges Zali,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Behzad Damavand,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Pedram Azimzadeh,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Faramarz Derakhshan,

    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Farzaneh Sabahi PhD,

    Corresponding author
    1. Virology Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
    • Virology Department, Faculty of Medical Sciences, Tarbiat Modares University, PO Box 14115-331, Tehran, Iran.
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  • Mohammad Reza Zali MD, FACG, AGAF

    Corresponding author
    1. Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    • Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, 7th floor of Taleghani Hospital, Yaman Ave., Velenjak, PO Box 19835-187, Tehran, Iran.
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  • The authors declare that they have no conflict of interest.

Abstract

Hepatitis B virus (HBV) isolates from Iranian patients around the country were characterized. Eighty-one complete genomes from HBV isolates were sequenced and analyzed. The studied population was grouped into three categories including inactive carriers, patients with chronic hepatitis, and patients with liver cirrhosis. Molecular and phylogenetic analyses revealed that Iranian patients were infected with HBV genotype D and subgenotype D1. The most common subtype was ayw2, followed by ayw3 and ayw4. Several deletions and insertions that had no correlation with disease outcome were observed in the HBV genomes. The most frequent mutation in the major hydrophilic region (MHR) of HBV surface antigen (HBsAg) was sP120S. Almost half of the patients studied carried precore (PC) mutant variants and one-third of the studied population was infected with variants carrying basal core promoter (BCP) mutations. PC and BCP mutations were observed in older patients, especially in those with chronic liver disease. Sixty-seven patients (82.7%) were HBeAg negative, and the prevalence of precore mutant isolates (G1896A) was higher in this group than in HBeAg-positive patients. Lamivudine drug resistance mutations were detected after 1 year of treatment in about 30% of lamivudine-treated patients. In conclusion, these results demonstrate that HBV subgenotype D1 is the only subgenotype circulating in Iran, and there is no evidence of any exotic genotype in the region. The HBV PC (G1896A) mutation may play an important role in the clinical outcome of the disease by increasing the risk of progressive liver disease among Iranian patients infected with HBV. J. Med. Virol. 84:414–423, 2012. © 2011 Wiley Periodicals, Inc.

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