High frequency of genotype D and spontaneous hepatitis B virus genomic mutations among Haitians in a multiethnic North American population.
OBJECTIVE
The importance of hepatitis B virus (HBV) genotype and mutations has been increasingly recognized. We aimed to determine HBV genotype, precore (PC), and basal core promoter region (BCP) mutations in a HBV multiethnic South Florida population.


METHODS
Samples from 213 patients were tested for HBV-DNA using Abbott RealTime HBV IUO assay, and for mutations using INNO-LiPA assay.


RESULTS
Patients were predominantly male (67%); 61 (31%) were African American, 60 (28%) Hispanic, 37 (17%) Haitian, 27 (19%) white non-Hispanic, and 14 (6.6%) Asian. Genotype A was found in 101 (69%), D in 25 (17%), F in 9 (6%), G in 7 (5%), C and E in 6 (4%) each, B in 4 (3%), and H in 2 (1%) patients. Mixed genotypes were detected in 11 patients. Genotype A was more prevalent in all ethnicities except for Asian. Among hepatitis B e antigen (HBeAg)-negative patients (59%), BCP, PC, and combined BCP/PC mutations were found in 30 (37.5%), 13 (16.3%), and 14 (17.5%), respectively. Genotype D was associated with higher frequency of HBeAg-negative status [18/24 (75%) vs. 62/121 (51%) P=0.03] and mutations [16/19 (84%) vs. 40/67 (60%) P=0.04] compared with others. Genotype A was negatively associated with mutations [26/31 (84%) vs. 30/55 (55%), P=0.009]. PC mutations were more common in genotype D (14/19, 73%) compared with genotype A (7/54, 13%, P<0.0001). One-hundred percent and 79% of Asians and Haitians had spontaneous mutations, respectively. All Haitians with genotype D had PC mutations and 3 (50%) had BCP/PC.


CONCLUSIONS
The present study shows that HBeAg-negative status and spontaneous mutations were more common with genotype D; the presence of genotype D in Haitians was always associated with spontaneous mutations.
Department of Internal Medicine and Alfa Gastroenterology Institute, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Claudia A
CA
Couto
Cynthia
C
Levy
Carol J
CJ
Morris
Mary
M
Hill
Maria
M
de Medina
Mark R
MR
Sanborn
Gavin A
GA
Cloherty
Eugene R
ER
Schiff
Paul
P
Martin
D001741:Black or African American / Q000706:statistics & numerical data; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005431:Florida / Q000453:epidemiology; D023281:Genomics; D005838:Genotype; D006205:Haiti / Q000208:ethnology; D006512:Hepatitis B Core Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009154:Mutation; D015995:Prevalence; D011401:Promoter Regions, Genetic; D012494:Sampling Studies; D044465:White People / Q000706:statistics & numerical data
D004279:DNA, Viral; D006512:Hepatitis B Core Antigens