Genotype determination in Moroccan hepatitis B chronic carriers.
BACKGROUND
In Morocco, chronic liver disease related to hepatitis B virus (HBV) is a public health burden. Treatment of chronic hepatitis B is often complicated by the appearance of escape mutants after treatment with nucleoside analogs, especially with genotypes responsible for the more severe form of the disease.


OBJECTIVE
In the present study we investigate the prevalence of the different HBV genotypes in Morocco since no previous careful study has been attempted.


METHODS
Epidemiological data from 91 chronically infected patients (45 women and 46 men) were collected prospectively. Sera were tested for anti-HBc IgG, HBeAg, anti-HBe antibody and liver enzymes. Restriction Fragment Length Polymorphism (RFLP) analysis was confirmed by subsequent sequencing of the pre-S and S region of the viral genome in order to determine which HBV genotypes were prevalent among Moroccan patients.


RESULTS
The mean age was 41+/-12.4 years. Ten patients (11%) were positive for hepatitis B e antigen (HBeAg) and 81 (89%) were positive for anti-HBe antibodies. By the RLFP method, genotype D, pattern D2, was found in the 77 cases where HBV was successfully amplified. Phylogenetic analysis based on pre-S/S sequences revealed that genotype D in Morocco differed from others D strains subgenotypes (D1, D2, D3 and D4). In addition, the pre-core mutant defined as HBeAg-negative/anti-HBe-positive and HBV DNA positive was detected in 86% of cases.


CONCLUSIONS
Our results clearly show that genotype D and pre-core mutant are highly prevalent in Morocco.
Ezzikouri
Sayeh
S
Institut Pasteur du Maroc 1, Place Louis Pasteur, 20100 Casablanca, Maroc, Morocco.
Chemin
Isabelle
I
Chafik
Abdelaziz
A
Wakrim
Lahsen
L
Nourlil
Jalal
J
Malki
Abdelouhad El
AE
Marchio
Agnès
A
Dejean
Anne
A
Hassar
Mohammed
M
Trepo
Christian
C
Pineau
Pascal
P
Benjelloun
Soumaya
S
D004279:DNA, Viral / Q000032:analysis; D005814:Genes, Viral; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000235:genetics / Q000821:virology*; D006579:Heterozygote; D006801:Humans; D009018:Morocco; D010802:Phylogeny
D004279:DNA, Viral