title: 15year fulminant hepatitis B follow-up in Belgium: Viral evolution and signature of demographic change.
abstract: Fulminant hepatitis among different clinical outcomes of hepatitis B virus infection is very rare and manifests high mortality rate, however it has not been investigated in Belgian inhabitants yet. In the frame of a retrospective study between 1995 and 2010, 80 serum samples (in some cases serial samples) archived in Biobank, were collected from 24 patients who had clinically developed fulminant infection of hepatitis B virus. In total, 33 hepatitis B virus (HBV) strains (31 full-length genome and 2 partial viral genes) of different HBV genotypes and subgenotypes including A2, B2, D1, D2, D3 and E, were amplified, sequenced and phylogenetically analyzed. HBV isolated strains from native and exotic patients were characterized by genome variations associated with viral invasiveness. Although several mutations at nucleotide and protein levels were detected, evolutionary analyses revealed a negative selective pressure over the viral genomes. This study revealed influence of immigration through a steady change in the viral epidemiological profile of the Belgian population.
authors.affiliation: KU Leuven, Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, 3000 Leuven, Belgium; Nonis Mina Clinical Laboratory, 5 Gregori Afxentiou, Iocasti Court Block A, Flat 22 Mesa Yitonia, 4003 Lemesos, Cyprus.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mina
authors.affiliation: Biosafety Development Group, Cellular Sciences Department, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA.
authors.forename: Samad
authors.initials: S
authors.lastname: Amini-Bavil-Olyaee
authors.affiliation: Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
authors.forename: Elham
authors.initials: E
authors.lastname: Shirvani-Dastgerdi
authors.affiliation: KU Lreuven, Department of Microbiology and Immunology, Laboratory Evolutionary and Computational Virology, 3000 Leuven, Belgium.
authors.forename: Nídia Sequeira
authors.initials: NS
authors.lastname: Trovão
authors.affiliation: KU Leuven, Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, 3000 Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van Ranst
authors.affiliation: KU Leuven, Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology, 3000 Leuven, Belgium; Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, 14665-1157 Tehran, Iran. Electronic address: mahmoudreza.pourkarim@kuleuven.be.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Pourkarim
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D005075:Biological Evolution; D004279:DNA, Viral / Q000235:genetics*; D003710:Demography / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000635:transmission; D006515:Hepatitis B virus / Q000145:classification / Q000472:pathogenicity* / Q000502:physiology; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D009154:Mutation; D010802:Phylogeny; D012189:Retrospective Studies; D012641:Selection, Genetic; D012720:Severity of Illness Index; D016019:Survival Analysis; D014774:Virulence
chemical_list: D004279:DNA, Viral
keywords: Belgium; Fulminant hepatitis B infection; Immigrant; Viral evolution