title: The hepatitis delta genotype 8 in Northeast Brazil: The North Atlantic slave trade as the potential route for infection.
abstract: Hepatitis Delta virus (HDV) is not well known, even though HDV and Hepatitis B virus (HBV) co-infection leads to severe forms of acute and chronic liver diseases. HDV is endemic in the Western Amazon region. Recently, the HDV genotype 8 was found in chronic patients followed at the center for liver studies in the Northeast Brazil, Maranhão. Previous studies suggested that this genotype was introduced in Maranhão during the slave trade. The presence of HDV in that study, which was done outside the Amazon region, led us to investigate whether the virus is found infecting individuals in other regions of Maranhão as well. Thus, we screened ninety-two HBsAg positive individuals from five Municipalities of Maranhão for anti-HD antibody and eight were found positive (8.7%). These eight positive individuals were submitted to polymerase chain reaction (PCR) to investigate active HDV infection. Half of them were positive for a fragment sequence of the delta antigen; their sequence samples were submitted to genotype characterization by phylogenetic analysis. All sequences clustered in a unique branch of the tree separated from the other branch described in Africa. Our study confirmed the presence of HDV-8 in Maranhão. These infected individuals had no evidence of contact with African people. Furthermore, we found individuals infected with HDV-8 in two more different municipalities. More studies like ours are urgent because the co-infection HBV/HDV is more difficult to treat. Identification of the endemic regions and implementation of healthy policies for preventing this infection are urgent in this region.
authors: Laboratory of Tropical Gastroenterologyand Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", LIM-07, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil. Electronic address: maxdiegocs@usp.br.
authors: Max Diego Cruz
authors: MD
authors: Santos
authors: Laboratory of Tropical Gastroenterologyand Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", LIM-07, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors: Michele Soares
authors: MS
authors: Gomes-Gouvêa
authors: Center of Clinical Research, University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors: Jomar Diogo Costa
authors: JD
authors: Nunes
authors: Center of Clinical Research, University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors: Lena Maria Fonseca
authors: LM
authors: Barros
authors: Laboratory of Tropical Gastroenterologyand Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", LIM-07, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors: Flair José
authors: FJ
authors: Carrilho
authors: Center of Clinical Research, University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors: Adalgisa de Sousa Paiva
authors: Ade S
authors: Ferreira
authors: Laboratory of Tropical Gastroenterologyand Hepatology "João Alves de Queiroz and Castorina Bittencourt Alves", LIM-07, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: João Renato Rebello
authors: JR
authors: Pinho
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000914:Antibodies, Viral / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection / Q000821:virology; D019353:Endemic Diseases; D063948:Enslaved Persons / Q000266:history; D005260:Female; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000821:virology; D019701:Hepatitis D, Chronic / Q000453:epidemiology* / Q000821:virology*; D003698:Hepatitis Delta Virus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D035923:Hepatitis delta Antigens / Q000097:blood / Q000235:genetics*; D049669:History, 16th Century; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D035923:Hepatitis delta Antigens
keywords: Brazil; HDV-8; Maranhão; Slave trade