title: Investigation of hepatitis B virus transmission in a health care setting: application of direct sequence analysis.
abstract: An epidemiologically linked cluster of hepatitis B virus (HBV) infections was investigated using HBV DNA amplification by a nested polymerase chain reaction with primers complementary to the region around the immunodominant a determinant of the surface gene, part of the X and core genes, and precore region and direct nucleotide sequence analysis. The cluster, in which 2 persons died of fulminant hepatitis, comprised 1 blood donor, 2 patients, and 2 health care workers. The Kimura two-parameter method was used to compare variance among the cluster with that in the control samples, which were collected from 7 patients infected with the same HBV subtype. Significantly less variation occurred within the cluster than in the control group (unpaired t test, P < .05). In an unrooted phylogenetic tree analysis, the 5 study samples formed a cluster distinct from the controls. This direct molecular approach of analyzing conserved regions of the HBV genome differentiated between viruses involved in HBV transmission events.
authors.affiliation: Department of Medical Microbiology, University College London Medical School, United Kingdom.
authors.forename: M A
authors.initials: MA
authors.lastname: Zuckerman
authors.forename: A E
authors.initials: AE
authors.lastname: Hawkins
authors.forename: M
authors.initials: M
authors.lastname: Briggs
authors.forename: J
authors.initials: J
authors.lastname: Waite
authors.forename: P
authors.initials: P
authors.lastname: Balfe
authors.forename: B
authors.initials: B
authors.lastname: Thom
authors.forename: R J
authors.initials: RJ
authors.lastname: Gilson
authors.forename: R S
authors.initials: RS
authors.lastname: Tedder
mesh_terms: D000368:Aged; D004279:DNA, Viral / Q000235:genetics; D004196:Disease Outbreaks; D005260:Female; D005814:Genes, Viral; D006282:Health Personnel; D006509:Hepatitis B / Q000145:classification* / Q000235:genetics / Q000635:transmission*; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D015534:Trans-Activators / Q000235:genetics; D054334:Viral Regulatory and Accessory Proteins
chemical_list: D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins; C057628:hepatitis B virus X protein