title: Phylogenetic Analysis of Hepatitis B Virus Genotypes Circulating in Different Risk Groups of Panama, Evidence of the Introduction of Genotype A2 in the Country.
abstract: The Hepatitis B Virus (HBV) can cause acute or chronic infection it is also associated with the development of liver cancer, thousands of new infections occur on a yearly basis, and many of these cases are located in certain areas of the Caribbean and Latin America. In these areas, the HBV prevalence is still high which makes this virus a serious public health concern to the entire region. Studies performed in Panama suggest a complex pattern in the distribution of HBV among the country's different risk groups. We use phylogenetic analysis in order to determine which HBV genotypes were circulating in these specific groups; for this we used a fragment of the PreS2/2 region of the HBV genome. Subsequently whole HBV genome sequences were used for Bayesian analysis of phylodynamics and phylogeography. Two main genotypes were found: genotype A (54.5%) and genotype F (45.5%). There was a difference in the distribution of genotypes according to risk groups: 72.9% of high risk groups were associated to genotype A, and 55.0% of samples of genotype F were associated to the low risk group (p<0.002). The Bayesian analysis of phylogeny-traits association revealed a statistically significant geographical association (p<0.0001) with both genotypes and different regions of the country. The Bayesian time of most recent common ancestor analysis (tMRCA) revealed a recent tMRCA for genotype A2 circulating in Panama (1997, 95% HPD: 1986-2005), when it is compared with Panamanian genotype F1c sequences (1930, 95% HPD: 1810 - 2005). These results suggest a possible change in the distribution of HBV genotypes in Panama and Latin America as a whole. They also serve to encourage the implementation of vaccination programs in high-risk groups, in order to prevent an increase in the number of new HBV cases in Latin America and worldwide.
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama; Department of Biotechnology, Acharya Nagarjuna University, Guntur City, Andhra Pradesh, India; INDICASAT-AIP, Clayton, City of Knowledge, Panama.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Martínez
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama.
authors.forename: Yamitzel
authors.initials: Y
authors.lastname: Zaldívar
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama; Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama, Panama.
authors.forename: Griselda
authors.initials: G
authors.lastname: Arteaga
authors.affiliation: Nucleic Acid Test Unit, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama.
authors.forename: Zoila
authors.initials: Z
authors.lastname: de Castillo
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama.
authors.forename: Alma
authors.initials: A
authors.lastname: Ortiz
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama; Department of Biotechnology, Acharya Nagarjuna University, Guntur City, Andhra Pradesh, India; INDICASAT-AIP, Clayton, City of Knowledge, Panama.
authors.forename: Yaxelis
authors.initials: Y
authors.lastname: Mendoza
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama.
authors.forename: Omar
authors.initials: O
authors.lastname: Castillero
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Castillo
authors.affiliation: Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Igua, Montevideo, Uruguay.
authors.forename: Juan
authors.initials: J
authors.lastname: Cristina
authors.affiliation: Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama; Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama, Panama.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Pascale
mesh_terms: D005838:Genotype; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics; D010176:Panama; D010802:Phylogeny