title: Transmission of hepatitis B virus infection in Gambian families revealed by phylogenetic analysis.
abstract: OBJECTIVE
  Transmission of hepatitis B virus (HBV) in Africa occurs horizontally, with most people becoming infected between the ages of 1 and 5 years. The index cases in such events have been assumed to come from within the family unit or from sources outside the immediate family, such as other families or inhabitants of the same compound or village. Here, we define these routes of transmission by phylogenetic tree analysis of sequences from the entire pre-core/core region of the virus, in Gambian chronic carriers.
  
  
  METHODS
  Amplification by polymerase chain reaction of serum extracted HBV-DNA was followed by direct sequencing of the target region. Following editing and alignment of these sequences, phylogenetic tree analysis was performed using the neighbour-joining and maximum-likelihood methods.
  
  
  RESULTS
  Despite the overall conserved nature of the sequences of the pre-core/core region from 142 chronic carriers, distinct clusters were easily defined at the family and village level, but not on a wider geographical separation.
  
  
  CONCLUSIONS
  Phylogenetic tree analysis of sequences obtained from family members provided strong evidence of intrafamilial transmission of HBV in at least two-thirds of the families studied from Gambia.
authors.affiliation: Department of Medicine A, Imperial College School of Medicine, London, UK.
authors.forename: U
authors.initials: U
authors.lastname: Dumpis
authors.forename: E C
authors.initials: EC
authors.lastname: Holmes
authors.forename: M
authors.initials: M
authors.lastname: Mendy
authors.forename: A
authors.initials: A
authors.lastname: Hill
authors.forename: M
authors.initials: M
authors.lastname: Thursz
authors.forename: A
authors.initials: A
authors.lastname: Hall
authors.forename: H
authors.initials: H
authors.lastname: Whittle
authors.forename: P
authors.initials: P
authors.lastname: Karayiannis
mesh_terms: D016000:Cluster Analysis; D018562:Disease Transmission, Infectious; D005192:Family Health; D005714:Gambia; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission*; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D005810:Multigene Family / Q000235:genetics; D010802:Phylogeny; D012423:Rural Health; D013997:Time Factors; D014758:Viral Core Proteins / Q000235:genetics*
chemical_list: D006513:Hepatitis B e Antigens; D014758:Viral Core Proteins