title: Genotypic distribution of hepatitis B virus (HBV) among acute cases of HBV infection, selected United States counties, 1999-2005.
abstract: BACKGROUND
  Knowledge of the genotypic distribution of hepatitis B virus (HBV) facilitates epidemiologic tracking and surveillance of HBV infection as well as prediction of its disease burden. In the United States, HBV genotyping studies have been conducted for chronic but not acute hepatitis B.
  
  
  METHODS
  Serum samples were collected from patients with acute hepatitis B cases reported from the 6 counties that participated in the Sentinel Counties Study of Acute Viral Hepatitis from 1999 through 2005. Polymerase chain reaction followed by nucleotide sequencing of a 435-base pair segment of the HBV S gene was performed, and the sequences were phylogenetically analyzed.
  
  
  RESULTS
  Of 614 patients identified with available serum samples, 75% were infected with genotype A HBV and 18% were infected with genotype D HBV. Thirty-two percent of genotype A sequences constituted a single subgenotype A2 cluster. The odds of infection with genotype A (vs with genotype D) were 5 times greater among black individuals than among Hispanic individuals (odds ratio [OR], 5; 95% confidence interval [CI], 2.3-10.7). The odds of infection with genotype A were 49, 8, and 4 times greater among patients from Jefferson County (Alabama), Pinellas County (Florida), and San Francisco (California), respectively, than among those living in Denver County (Colorado). Genotype A was less common among recent injection drug users than it was among non-injection drug users (OR, 0.2; 95% CI, 0.1-0.4).
  
  
  CONCLUSIONS
  HBV genotype distribution was significantly associated with ethnicity, place of residence, and risk behavior.
authors.affiliation: Division of Viral Hepatitis, National Center for HIV, Hepatitis, TB and STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. eht4@cdc.gov
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.forename: Sumathi
authors.initials: S
authors.lastname: Ramachandran
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Xia
authors.forename: Henry
authors.initials: H
authors.lastname: Roberts
authors.forename: Justina
authors.initials: J
authors.lastname: Groeger
authors.forename: Vaughn
authors.initials: V
authors.lastname: Barry
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
authors.forename: Scott D
authors.initials: SD
authors.lastname: Holmberg
authors.forename: Deborah
authors.initials: D
authors.lastname: Holtzman
authors.forename: John W
authors.initials: JW
authors.lastname: Ward
authors.forename: Chong-Gee
authors.initials: CG
authors.lastname: Teo
authors.forename: Yuri
authors.initials: Y
authors.lastname: Khudyakov
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D003710:Demography; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D012307:Risk Factors; D018571:Sentinel Surveillance; D017422:Sequence Analysis, DNA; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral