Original Paper
Hepatitis B and C Virus Variants in Long-Term Immunosuppressed Renal Transplant Patients in Latvia
Irina Sominskayaa, Marija Mihailovaa, Juris Jansonsa, Viktorija Emelyanovaa, Inese Folkmaneb, Eriks Smagrisb, Uga Dumpisb, Rafails Rozentalsb, Paul Pumpensa
aBiomedical Research and Study Centre, University of Latvia, and bStradins University Hospital, Riga, Latvia
Address of Corresponding Author
Intervirology 2005;48:192-200 (DOI: 10.1159/000081748)
Key Words
- Hepatitis B virus
- Hepatitis C virus
- Genotype
- Subtypes
- Variant
- Mutation
Abstract
The incidence of genome variants of hepatitis B and hepatitis C viruses among 38 long-term (2-15 years) immunosuppressed patients after renal transplantation and 10 patients undergoing dialysis was investigated. Twelve patients had only HBV infection, 9 had only HCV infection and 14 were co-infected. Regions corresponding to the HBV X/EnII/BCP, preC/C, preS/S and to the HCV core were sequenced for molecular characterization of the HBV and HCV genomes. Fifty-seven percent of HBV DNA isolates belonged to genotype D and 42% to genotype A, whereas 77% of HCV RNA isolates belonged to genotype 1b and only 17% to genotype 3a. One sample (6%) was of genotype 2c. Detailed analysis of the above-mentioned HBV genome regions revealed the presence of nucleotide point mutations, which, in some cases, resulted in amino acid substitutions. The clinical significance of such mutations is discussed. Copyright © 2005 S. Karger AG, Basel
References
- 1.
- Pereira BJ: Renal transplantation in patients positive for hepatitis B or C (con). Transplant Proc 1998;30:2070-2072.

- 2.
- Fabrizi F, Lunghi G, Martin P: Hepatitis B virus infection in hemodialysis: Recent discoveries. J Nephrol 2002;15:463-468.

- 3.
- Natov SN: Transmission of viral hepatitis by kidney transplantation: Donor evaluation and transplant policies. 1. Hepatitis B virus). Transpl Infect Dis 2002;4:124-131.

- 4.
- Flores PA, Vierling JM: Modifications of immunosuppression in hepatitis B virus infection. Curr Opin Organ Transplant 2001;6:331-337.

- 5.
- Hunt CM, McGill JM, Allen MI, Condreay LD: Clinical relevance of hepatitis B viral mutations. Hepatology 2000;31:1037-1044.

- 6.
- Pumpens P, Grens E, Nassal M: Molecular epidemiology and immunology of hepatitis B virus infection - an update. Intervirology 2002;45:218-232.

- 7.
- Gunther S, Paulij W, Meisel H, Will H: Analysis of hepatitis B virus populations in an interferon-alpha-treated patient reveals predominant mutations in the C-gene and changing e-antigenicity. Virology 1998;244:146-160.

- 8.
- Ogura Y, Kurosaki M, Asahina Y, Enomoto N, Marumo F, Sato C: Prevalence and significance of naturally occurring mutations in the surface and polymerase genes of hepatitis B virus. J Infect Dis 1999;180:1444-1451.

- 9.
- Preikschat P, Gunther S, Reinhold S, Will H, Budde K, Neumayer HH, Kruger DH, Meisel H: Complex HBV populations with mutations in core promoter, C gene, and pre-S region are associated with development of cirrhosis in long-term renal transplant recipients. Hepatology 2002;35:466-477.

- 10.
- Fabrizi F, Martin P, Ponticelli C: Hepatitis C virus infection and renal transplantation. Am J Kidney Dis 2001;38:919-934.

- 11.
- Meyers CM, Seeff LB, Stehman-Breen CO, Hoofnagle JH: Hepatitis C and renal disease: An update. Am J Kidney Dis 2003;42:631-657.

- 12.
- Gunther S, Li BC, Miska S, Kruger DH, Meisel H, Will H: A novel method for efficient amplification of whole hepatitis B virus genomes permits rapid functional analysis and reveals deletion mutants in immunosuppressed patients. J Virol 1995;69:5437-5444.

- 13.
- Karayiannis P, Alexopoulou A, Hadziyannis S, Thursz M, Watts R, Seito S, Thomas HC: Fulminant hepatitis associated with hepatitis B virus e antigen-negative infection: Importance of host factors. Hepatology 1995;22:1628-1634.

- 14.
- Preikschat P, Meisel H, Will H, Gunther S: Hepatitis B virus genomes from long-term immunosuppressed virus carriers are modified by specific mutations in several regions. J Gen Virol 1999;80(pt 10):2685-2691.

- 15.
- Hall TA: BioEdit: a user-friendly biological sequence alignment editor and analysis program for Windows 95/98/NT. Nucl Acids Symp Ser 1999;41:95-98.

- 16.
- Felsenstein J: PHYLIP-phylogenetic interference package (version 3.2). Cladistics 1989;5:164-166.
- 17.
- Fabrizi F, Martin P, Ponticelli C: Hepatitis B virus and renal transplantation. Nephron 2002;90:241-251.

- 18.
- Arauz-Ruiz P, Norder H, Robertson BH, Magnius LO: Genotype H: A new Amerindian genotype of hepatitis B virus revealed in Central America. J Gen Virol 2002;83:2059-2073.

- 19.
- Norder H, Courouce AM, Magnius LO: Complete genomes, phylogenetic relatedness, and structural proteins of six strains of the hepatitis B virus, four of which represent two new genotypes. Virology 1994;198:489-503.

- 20.
- Stuyver L, De Gendt S, Van Geyt C, Zoulim F, Fried M, Schinazi RF, Rossau R: A new genotype of hepatitis B virus: Complete genome and phylogenetic relatedness. J Gen Virol 2000;81:67-74.

- 21.
- Magnius LO, Norder H: Subtypes, genotypes and molecular epidemiology of the hepatitis B virus as reflected by sequence variability of the S-gene. Intervirology 1995;38:24-34.

- 22.
- Pumpen PP, Kozlovskaia TM, Dishler AV, Bychko VV, Kalis I: The comparative mapping of virion and cloned DNA of the hepatitis B virus. Mol Biol (Mosk) 1982;16:1314-1321.

- 23.
- Lindh M, Hannoun C, Dhillon AP, Norkrans G, Horal P: Core promoter mutations and genotypes in relation to viral replication and liver damage in East Asian hepatitis B virus carriers. J Infect Dis 1999;179:775-782.

- 24.
- Nagasaka A, Hige S, Marutani M, Tsunematsu I, Saito M, Yamamoto Y, Konishi S, Asaka M: Prevalence of mutations in core promoter/precore region in Japanese patients with chronic hepatitis B virus infection. Dig Dis Sci 1998;43:2473-2478.

- 25.
- Kramvis A, Kew MC: Structure and function of the encapsidation signal of hepadnaviridae. J Viral Hepat 1998;5:357-367.

- 26.
- Venard V, Corsaro D, Kajzer C, Bronowicki JP, Le Faou A: Hepatitis B virus X gene variability in French-born patients with chronic hepatitis and hepatocellular carcinoma. J Med Virol 2000;62:177-184.

- 27.
- Bertoletti A, Costanzo A, Chisari FV, Levrero M, Artini M, Sette A, Penna A, Giuberti T, Fiaccadori F, Ferrari C: Cytotoxic T lymphocyte response to a wild type hepatitis B virus epitope in patients chronically infected by variant viruses carrying substitutions within the epitope. J Exp Med 1994;180:933-943.

- 28.
- Carman WF, Boner W, Fattovich G, Colman K, Dornan ES, Thursz M, Hadziyannis S: Hepatitis B virus core protein mutations are concentrated in B cell epitopes in progressive disease and in T helper cell epitopes during clinical remission. J Infect Dis 1997;175:1093-1100.

- 29.
- Chuang WL, Omata M, Ehata T, Yokosuka O, Ito Y, Imazeki F, Lu SN, Chang WY, Ohto M: Precore mutations and core clustering mutations in chronic hepatitis B virus infection. Gastroenterology 1993;104:263-271.

- 30.
- Okumura A, Ishikawa T, Yoshioka K, Yuasa R, Fukuzawa Y, Kakumu S: Mutation at codon 130 in hepatitis B virus (HBV) core region increases markedly during acute exacerbation of hepatitis in chronic HBV carriers. J Gastroenterol 2001;36:103-110.

- 31.
- Parvez MK, Thakur V, Kazim SN, Guptan RC, Hasnain SE, Sarin SK: Base-pair alterations in the epsilon-lower stem due to a novel double substitution in the precore gene of HBV-e negative variant were recovered by secondary mutations. Virus Genes 2001;23:315-320.

- 32.
- Bozdayi AM, Bozkaya H, Turkyilmaz A, Aslan N, Verdi H, Kence A, Uzunalimoglu O: Polymorphism of precore region of hepatitis B virus DNA among patients with chronic HBV infection in Turkey. Infection 1999;27:357-360.

- 33.
- Luo K: Hot spot mutations of hepatitis B virus pre-C/C gene and its promotor in Chinese patients and the clinical implications. Chin Med J (Engl ) 1999;112:182-184.
- 34.
- Li JS, Tong SP, Wen YM, Vitvitski L, Zhang Q, Trepo C: Hepatitis B virus genotype A rarely circulates as an HBe-minus mutant: Possible contribution of a single nucleotide in the precore region. J Virol 1993;67:5402-5410.

- 35.
- Rodriguez-Frias F, Buti M, Jardi R, Cotrina M, Viladomiu L, Esteban R, Guardia J: Hepatitis B virus infection: Precore mutants and its relation to viral genotypes and core mutations. Hepatology 1995;22:1641-1647.

- 36.
- Funk ML, Rosenberg DM, Lok AS: World-wide epidemiology of HBeAg-negative chronic hepatitis B and associated precore and core promoter variants. J Viral Hepat 2002;9:52-61.

- 37.
- Ehata T, Omata M, Chuang WL, Yokosuka O, Ito Y, Hosoda K, Ohto M: Mutations in core nucleotide sequence of hepatitis B virus correlate with fulminant and severe hepatitis. J Clin Invest 1993;91:1206-1213.

- 38.
- Karasawa T, Shirasawa T, Okawa Y, Kuramoto A, Shimada N, Aizawa Y, Zeniya M, Toda G: Association between frequency of amino acid changes in core region of hepatitis B virus (HBV) and the presence of precore mutation in Japanese HBV carriers. J Gastroenterol 1997;32:611-622.

- 39.
- Takahashi K, Akahane Y, Hino K, Ohta Y, Mishiro S: Hepatitis B virus genomic sequence in the circulation of hepatocellular carcinoma patients: comparative analysis of 40 full-length isolates. Arch Virol 1998;143:2313-2326.

- 40.
- Hawkins AE, Gilson RJ, Gilbert N, Wreghitt TG, Gray JJ, Ahlers-de Boer I, Tedder RS, Alexander GJ: Hepatitis B virus surface mutations associated with infection after liver transplantation. J Hepatol 1996;24:8-14.

- 41.
- Weinberger KM, Bauer T, Bohm S, Jilg W: High genetic variability of the group-specific a-determinant of hepatitis B virus surface antigen (HBsAg) and the corresponding fragment of the viral polymerase in chronic virus carriers lacking detectable HBsAg in serum. J Gen Virol 2000;81:1165-1174.

- 42.
- Kfoury Baz EM, Zheng J, Mazuruk K, Van Le A, Peterson DL: Characterization of a novel hepatitis B virus mutant: Demonstration of mutation-induced hepatitis B virus surface antigen group specific 'a' determinant conformation change and its application in diagnostic assays. Transfus Med 2001;11:355-362.

- 43.
- Chong-Jin O, Wei NC, Shiuan K, Gek KL: Identification of hepatitis B surface antigen variants with alterations outside the 'a' determinant in immunized Singapore infants. J Infect Dis 1999;179:259-263.

- 44.
- Chen WN, Oon CJ: Mutation 'hot spot' in HLA class I-restricted T cell epitope on hepatitis B surface antigen in chronic carriers and hepatocellular carcinoma. Biochem Biophys Res Commun 1999;262:757-761.

- 45.
- Tai PC, Banik D, Lin GI, Pai S, Pai K, Lin MH, Yuoh G, Che S, Hsu SH, Chen TC, Kuo TT, Lee CS, Yang CS, Shih C: Novel and frequent mutations of hepatitis B virus coincide with a major histocompatibility complex class I-restricted T-cell epitope of the surface antigen. J Virol 1997;71:4852-4856.

- 46.
- Gerken G, Kremsdorf D, Capel F, Petit MA, Dauguet C, Manns MP, Meyer zum Buschenfelde KH, Brechot C: Hepatitis B defective virus with rearrangements in the preS gene during chronic HBV infection. Virology 1991;183:555-565.

- 47.
- Uy A, Wunderlich G, Olsen DB, Heermann KH, Gerlich WH, Thomssen R: Genomic variability in the preS1 region and determination of routes of transmission of hepatitis B virus. J Gen Virol 1992;73(pt 11):3005-3009.

- 48.
- Gane E, Pilmore H: Management of chronic viral hepatitis before and after renal transplantation. Transplantation 2002;74:427-437.

Author Contacts
Irina Sominskaya Biomedical Research and Study Centre, University of Latvia Ratsupites 1 LV-1067 Riga (Latvia) Tel. +371 7808212, Fax +371 7442407, E-Mail irina@biomed.lu.lv
Article Information
Received: February 2, 2004
Accepted after revision: September 10, 2004
Number of Print Pages : 9
Number of Figures : 3, Number of Tables : 2, Number of References : 48
Publication Details
Intervirology (International Journal of Basic and Medical Virology)
Vol. 48, No. 2-3, Year 2005 (Cover Date: March-June 2005)
Journal Editor: U.G. Liebert, Leipzig
ISSN: 0300-5526 (print), 1423-0100 (Online) For additional information: http://www.karger.com/int
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