Molecular epidemiology and evolution in an outbreak of fulminant hepatitis B virus.
In order to establish the transmission pathway for two outbreak patients affected by fulminant hepatitis B (FHB) following a shared period of hospitalization, we sequenced the complete genomes of the hepatitis B viruses (HBV) isolated from them as well as from the suspected common source and 11 additional controls. Phylogenetic and statistical analyses of these sequences revealed that the two FHB patients were indeed infected by a common source and that the fatal development of the disease did not appear to be associated with any mutation previously reported to be related to FHB. These data have also allowed us to estimate the extent and distribution of genetic variability along the genomes of HBV genotype D samples from the same source population. As a result of these analyses, we provide an improved statistical method to individualize the assignment of each suspected patient and the source of an outbreak and information on which genome region to analyze in the molecular epidemiological assessment of hepatitis B virus transmission cases.
Bracho
Maria Alma
MA
Institut Cavanilles de Biodiversitat i Biologia Evolutiva, Universitat de València, Apartado 22085, 46071 València, Spain.
Gosalbes
María José
MJ
González
Francisco
F
Moya
Andrés
A
González-Candelas
Fernando
F
D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D019143:Evolution, Molecular; D016679:Genome, Viral; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017720:Molecular Epidemiology; D010802:Phylogeny; D017422:Sequence Analysis, DNA
D004279:DNA, Viral