Infection with hepatitis A, B, C, and delta viruses among patients with acute hepatitis in Mongolia.
One hundred ten consecutive patients (60 males and 50 females; age, mean +/- standard deviation [SD], 22.6 +/- 6.4 years; range 16-48 years) who were clinically diagnosed with sporadic acute hepatitis between December 2004 and January 2005 in Ulaanbaatar, Mongolia, were studied. IgM antibodies to hepatitis A virus were detected in 18 patients (16.4%), IgM antibodies to hepatitis B core (anti-HBc IgM) in 38 patients (34.5%) including two patients with concurrent hepatitis delta virus (HDV) infection, and hepatitis C virus RNA in nine patients (8.2%). There were 30 hepatitis B virus (HBV) carriers who had detectable hepatitis B surface antigen and antibodies to HDV but were negative for anti-HBc IgM, suggesting that they acquired type D acute hepatitis due to superinfection of HDV on a background of chronic HBV infection. None had IgM antibodies to hepatitis E virus (HEV). Consequently, 16.4, 32.7, 6.4, 1.8, and 27.3% of the patients were diagnosed as having acute hepatitis of type A, B, C, type B + D (HBV/HDV coinfection), and type D (superinfection of HDV), respectively. The cause of hepatitis was not known in the remaining 17 patients (15.5%). All 18 HAV isolates were genotyped as IA, all 9 HCV isolates were genotyped as 1b, and all 32 HDV isolates were classified into genotype I. The distribution of HBV genotypes among the 67 HBV isolates was A (1.5%, n = 1) and D (98.5%, n = 66). The present study indicates that de novo infections of HAV, HBV, HCV, and HDV are prevalent among young adults in Mongolia.
Division of Virology, Department of Infection and Immunity, Jichi Medical School, Tochigi-Ken, Japan.
Bira
B
Tsatsralt-Od
Masaharu
M
Takahashi
Kazunori
K
Endo
Osorjin
O
Buyankhuu
Oidov
O
Baatarkhuu
Tsutomu
T
Nishizawa
Hiroaki
H
Okamoto
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006506:Hepatitis A / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D030041:Hepatitis A virus / Q000235:genetics / Q000276:immunology; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D003699:Hepatitis D / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D008986:Mongolia / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D013045:Species Specificity; D015163:Superinfection
D006508:Hepatitis Antibodies; D007075:Immunoglobulin M