Skip to main content
×
Home
    • Aa
    • Aa

Genetic analysis of precore/core and partial pol genes in an unprecedented outbreak of fulminant hepatitis B in India

  • S. KHARE (a1), S. S. NEGI (a2), S. SINGH (a1) (a2), M. SINGHAL (a2), S. KUMAR (a2), C. PRAKASH (a1), R. VENUGOPAL (a2), D. S. RAWAT (a2), L. S. CHAUHAN (a1) (a2) and A. RAI (a2)...
Abstract
SUMMARY

We investigated an unprecedented outbreak of fulminant hepatitis B virus (HBV) that occurred in Modasa, Gujarat (India) in 2009. Genomic analysis of all fulminant hepatic failure cases confirmed exclusive predominance of subgenotype D1. A1762T, G1764A basal core promoter (BCP) mutations, insertion of isoleucine after nt 1843, stop codon mutation G1896A, G1862T transversion plus seven other mutations in the core gene caused inhibition of HBeAg expression implicating them as circulating precore/BCP mutant virus. Two rare mutations at amino acids 89 (Ile→Ala) and 119 (Leu→Ser) in addition to other mutations in the polymerase (pol) gene may have caused some alteration in either of four pol gene domains to affect encapsidation of pregenomic RNA to enhance pathogenicity. Sequence similarity among patients' sequences suggested an involvement of a single hepatitis B mutant strain/source to corroborate the finding of gross and continued usage of HBV mutant-contaminated syringes/needles by a physician which resulted in this unprecedented outbreak of fulminant hepatitis B. The fulminant exacerbation of the disease might be attributed to mutations in the BCP/precore/core and pol genes that may have occurred due to selection pressure during rapid spread/mutation of the virus.

Copyright
Corresponding author
*Author for correspondence: Dr A. Rai, Ph.D., Joint Director & Head, Division of Biochemistry & Biotechnology, National Centre for Disease Control (NCDC), 22-Sham Nath Marg, Delhi-110054, India. (Email: arvindrai_16@hotmail.com)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

4. VA Arankalle , An outbreak of hepatitis B with high mortality in India: association with precore, basal core promoter mutants and improperly sterilized syringes. Journal of Viral Hepatitis 2011; 18: e20e28.

7. K Tamura , MEGA 4: Molecular Evolutionary Genetic Analysis (MEGA) software version 4.0. Molecular Biology and Evolution 2007; 24: 15961599.

8. M Mondelli , AL Eddleston . Mechanism of liver cell injury in acute and chronic hepatitis B. Seminars in Liver Disease 1984; 4: 4758.

12. T Valliammai , Precore and core mutations in HBV from individuals in India with chronic infection. Journal of Medical Virology 1995; 45: 321325.

14. P Garmiri , Deletions and recombinations in the core region of hepatitis B virus genotype E strains from asymptomatic blood donors in Guinea, West Africa. Journal of General Virology 2009; 90: 24422451.

17. MR Brunetto , A new hepatitis B virus strain in patient with severe anti-HBe positive chronic hepatitis B. Journal of Hepatology 1990; 10: 258–61.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 6 *
Loading metrics...

Abstract views

Total abstract views: 52 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th May 2017. This data will be updated every 24 hours.