title: Molecular epidemiology and phylogenetic analysis of Hepatitis B virus in a group of migrants in Italy.
abstract: BACKGROUND
  Hepatitis B virus infection (HBV) is widespread and it is considered a major health problem worldwide. The global distribution of HBV varies significantly between countries and between regions of the world. Among the many factors contributing to the changing epidemiology of viral hepatitis, the movement of people within and between countries is a potentially important one. In Italy, the number of migrant individuals has been increasing during the past 25 years. HBV genotype D has been found throughout the world, although its highest prevalence is in the Mediterranean area, the Middle East and southern Asia. We describe the molecular epidemiology of HBV in a chronically infected population of migrants (living in Italy), by using the phylogenetic analysis.
  
  
  METHODS
  HBV-DNA was amplified and sequenced from 43 HBV chronically infected patients. Phylogenetic and evolutionary analysis were performed using both maximum Likelihood and Bayesian methods.
  
  
  CONCLUSIONS
  Of the 43 HBV S gene isolates from migrants, 25 (58.1 %) were classified as D genotype. Maximum Likelihood analysis showed an intermixing between Moldavian and foreigners sequences mostly respect to Italian ones. Italian sequences clustered mostly together in a main clade separately from all others. The estimation of the time of the tree's root gave a mean value of 17 years ago, suggesting the origin of the tree back to 1992 year. The skyline plot showed that the number of infections softly increased until the early 2005s, after which reached a plateau. Comparing phylogenetic data to the migrants date of arrival in Italy, it should be possible that migrants arrived in Italy yet infected from their country of origin. In conclusion, this is the first paper where phylogenetic analysis and genetic evolution has been used to characterize HBV sub genotypes D1 circulation in a selected and homogenous group of migrants coming from a restricted area of Balkans and to approximately define the period of infection besides the migration date.
authors.affiliation: Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. umbertina.villano@iss.it.
authors.forename: Umbertina
authors.initials: U
authors.lastname: Villano
authors.affiliation: Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. alessandra.lopresti@guest.iss.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lo Presti
authors.affiliation: Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy. michele.equestre@iss.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Equestre
authors.affiliation: Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. eleonora.cella@yahoo.it.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Cella
authors.affiliation: Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy. giulio.pisani@iss.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Pisani
authors.affiliation: Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. giovanetti.marta@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Giovanetti
authors.affiliation: Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. roberto.bruni@iss.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bruni
authors.affiliation: Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. Elena.tritarelli@iss.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Tritarelli
authors.affiliation: Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy. amicosan@uniroma2.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Amicosante
authors.affiliation: Department of Biology, University of Rome "Tor Vergata", Rome, Italy. Alba.Grifoni@uniroma2.it.
authors.forename: Alba
authors.initials: A
authors.lastname: Grifoni
authors.affiliation: Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy. carmelo.scarcella@aslbrescia.it.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Scarcella
authors.affiliation: Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy. issa1957@libero.it.|Brescia Local Health Authority, Brescia, Italy. issa1957@libero.it.
authors.forename: Issa
authors.initials: I
authors.lastname: El-Hamad
authors.affiliation: Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy. chiarapezzoli@yahoo.com.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Pezzoli
authors.forename: Silvia
authors.initials: S
authors.lastname: Angeletti
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University hospital Campus Biomedico, Rome, Italy. s.angeletti@unicampus.it.
authors.forename: Angeletti
authors.initials: A
authors.lastname: Silvia
authors.affiliation: Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. annarita.ciccaglione@iss.it.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Ciccaglione
authors.affiliation: Epidemiology Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. massimo.ciccozzi@iss.it.|Clinical Pathology and Microbiology Laboratory, University hospital Campus Biomedico, Rome, Italy. massimo.ciccozzi@iss.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Ciccozzi
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D017720:Molecular Epidemiology; D010802:Phylogeny; D015995:Prevalence; D014171:Transients and Migrants