title: Epidemiological and molecular features of hepatitis B and hepatitis delta virus transmission in a remote rural community in central Africa.
abstract: Hepatitis B virus (HBV) and hepatitis delta virus (HDV) occur worldwide and are prevalent in both urban and remote rural communities. In a remote village in Gabon, central Africa, we observed a high prevalence of HBsAg carriage and HDV infection, particularly in children and adolescents. The prevalence of HBsAg differed significantly by gender and age, females being more likely than males to carry the HBsAg during the first 10 years of life, while the prevalence was higher among males than females aged 11-20 years. We also characterised HBV and HDV strains circulating in the village. The principal HBV strains belonged to genotype HBV-E and subgenotype QS-A3. Complete genome analysis revealed for the first time the presence of the HBV-D genotype in Gabon, in the form of an HBV-D/E recombinant. Molecular analysis of HDV strains and their complete genomic characterisation revealed two distinct groups within the dominant HDV clade 8. Molecular analysis of HBV and HDV strains did not reveal vertical transmission within the families studied but rather horizontal, intrafamilial transmission among children aged 0-10 years. Our findings indicate that HBV is transmitted in early childhood by body fluids rather than by sexual contact. Health education adapted to the different age groups might therefore help to reduce HBV transmission. Young children should be vaccinated to control HBV infection in areas of extremely high prevalence.
authors.affiliation: Laboratoire de Virologie, Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon.
authors.forename: Sandrine
authors.initials: S
authors.lastname: François-Souquière
authors.affiliation: Laboratoire de Virologie, Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon.
authors.forename: Maria
authors.initials: M
authors.lastname: Makuwa
authors.affiliation: Laboratoire de Virologie, Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bisvigou
authors.affiliation: Laboratoire de Virologie, Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon; Réseau International des Instituts Pasteur, Institut Pasteur de la Guyane, French Guiana, France. Electronic address: mirdad.kazanji@pasteur.fr.
authors.forename: Mirdad
authors.initials: M
authors.lastname: Kazanji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000821:virology; D005260:Female; D005681:Gabon / Q000453:epidemiology; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000378:metabolism; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics* / Q000276:immunology; D003699:Hepatitis D / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens
keywords: Genome characterization; Hepatitis B virus; Hepatitis delta virus; Intrafamilial transmission; Molecular epidemiology; Serology