title: High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo.
abstract: The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 105IU/ml for HBV (range, 769 to 9.82 × 109IU/ml) and 1.4 × 106IU/ml for HDV (range, 3.1 × 102to 2.9 × 108IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC.
authors.affiliation: Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon shemakiala@yahoo.fr pierre.becquart@ird.fr.|Département de Microbiologie, Cliniques Universitaires de Kinshasa (CUK), Kinshasa, Democratic Republic of the Congo.
authors.forename: Sheila
authors.initials: S
authors.lastname: Makiala-Mandanda
authors.affiliation: Hôpital Avicenne, Laboratoire de Virologie, Centre National de Référence associé Hépatite Delta, Bobigny, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Le Gal
authors.affiliation: Département de Microbiologie, Cliniques Universitaires de Kinshasa (CUK), Kinshasa, Democratic Republic of the Congo.
authors.forename: Nadine
authors.initials: N
authors.lastname: Ngwaka-Matsung
authors.affiliation: Département de Microbiologie, Cliniques Universitaires de Kinshasa (CUK), Kinshasa, Democratic Republic of the Congo.|Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the Congo.
authors.forename: Steve
authors.initials: S
authors.lastname: Ahuka-Mundeke
authors.affiliation: Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
authors.forename: Richard
authors.initials: R
authors.lastname: Onanga
authors.affiliation: Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
authors.forename: Berthold
authors.identifier: 0000-0003-0662-6752
authors.initials: B
authors.lastname: Bivigou-Mboumba
authors.affiliation: Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the Congo.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pukuta-Simbu
authors.affiliation: Hôpital Avicenne, Laboratoire de Virologie, Centre National de Référence associé Hépatite Delta, Bobigny, France.
authors.forename: Athenaïs
authors.initials: A
authors.lastname: Gerber
authors.affiliation: Institut de recherche pour le développement (IRD), Montpellier, France.|UMR UMMISCO (UMI 209 IRD-UPMC), Bondy, France.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Abbate
authors.affiliation: Direction de lutte contre les maladies (DLM), Kinshasa, Democratic Republic of the Congo.
authors.forename: Dieudonné
authors.initials: D
authors.lastname: Mwamba
authors.affiliation: Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.|Centre National de Recherche Scientifique (CNRS) UMR 3569, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Berthet
authors.affiliation: Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.|Institut de recherche pour le développement (IRD), Montpellier, France.
authors.forename: Eric Maurice
authors.initials: EM
authors.lastname: Leroy
authors.affiliation: Département de Microbiologie, Cliniques Universitaires de Kinshasa (CUK), Kinshasa, Democratic Republic of the Congo.|Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the Congo.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Muyembe-Tamfum
authors.affiliation: Institut de recherche pour le développement (IRD), Montpellier, France shemakiala@yahoo.fr pierre.becquart@ird.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Becquart
mesh_terms: D000914:Antibodies, Viral / Q000276:immunology*; D015023:Democratic Republic of the Congo; D004797:Enzyme-Linked Immunosorbent Assay; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D030041:Hepatitis A virus / Q000276:immunology / Q000302:isolation & purification*; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology / Q000302:isolation & purification*; D003698:Hepatitis Delta Virus / Q000276:immunology / Q000302:isolation & purification*; D016752:Hepatitis E virus / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007565:Jaundice / Q000175:diagnosis / Q000821:virology; D016036:Seroepidemiologic Studies; D019562:Viral Load; D015004:Yellow Fever / Q000150:complications / Q000821:virology*; D015005:Yellow fever virus / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D000914:Antibodies, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens
keywords: DRC; hepatitis virus; yellow fever surveillance