title: Molecular epidemiology of hepatitis B virus in Amsterdam 1992-1997.
abstract: To gain insight into the spread of hepatitis B among various risk groups in Amsterdam a 6-year (1992-1997) retrospective DNA sequencing study was carried out on isolates from stored sera from reported primary cases of acute hepatitis B infection. Cases were classified according to risk behavior, as determined in interviews. Of the available serum, a selected region of hepatitis B-virus-DNA was amplified and sequenced. The nucleotide alignments were subjected to phylogenetic tree analysis. When nucleotide alignments were subjected to phylogenetic analysis, the strains of 54 isolates, 26% of the 204 reported primary cases, clustered in five genotypes: A, C, D, E, and F. In genotype A, a cluster related to men having sex with men was identified. In genotype D, two subclusters could be identified: one was related to injecting drug use and another was related to the Moroccan population in Amsterdam. The remaining strains showed a high genetic variability within three different genotypes: F, E, and C. Of the 14 identical isolates in the "homosexual men cluster," one was isolated from a female heterosexual. Of the 14 identical strains in the "drug users strain," six were from non-drug using heterosexual active individuals. In the cluster of twelve isolates related to hepatitis B-endemic areas, probable modes of transmission were varied. Sequence analysis provides important insight into the spread of hepatitis B among various high-risk groups. The analysis indicates that the prevention strategy in The Netherlands fails to stop transmission of hepatitis B from persistently infected individuals originating from hepatitis B endemic countries.
authors.affiliation: Municipal Health Service Amsterdam, Division of Public Health, Amsterdam, The Netherlands. JvSteenbergen@gggd.amsterdam.nl
authors.forename: J E
authors.initials: JE
authors.lastname: van Steenbergen
authors.forename: H G M
authors.initials: HG
authors.lastname: Niesters
authors.forename: E L M
authors.initials: EL
authors.lastname: Op de Coul
authors.forename: G J J
authors.initials: GJ
authors.lastname: van Doornum
authors.forename: A D M E
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: A
authors.initials: A
authors.lastname: Leentvaar-Kuijpers
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: J A R
authors.initials: JA
authors.lastname: van den Hoek
mesh_terms: D000208:Acute Disease; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D009426:Netherlands / Q000453:epidemiology; D010802:Phylogeny; D012189:Retrospective Studies; D012309:Risk-Taking; D017422:Sequence Analysis, DNA
chemical_list: D004279:DNA, Viral