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.
Tsatsralt-Od
Bira
B
Division of Virology, Department of Infection and Immunity, Jichi Medical School, Tochigi-Ken, Japan.
Takahashi
Masaharu
M
Endo
Kazunori
K
Buyankhuu
Osorjin
O
Baatarkhuu
Oidov
O
Nishizawa
Tsutomu
T
Okamoto
Hiroaki
H
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