Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management

Background. Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regio...

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Main Authors: Hussein Mukasa Kafeero, Dorothy Ndagire, Ponsiano Ocama, Charles Drago Kato, Eddie Wampande, Henry Kajumbula, David Kateete, Abdul Walusansa, Ali Kudamba, Kigozi Edgar, Fred Ashaba Katabazi, Maria Magdalene Namaganda, Jamilu E. Ssenku, Hakim Sendagire
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2022/3688547
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author Hussein Mukasa Kafeero
Dorothy Ndagire
Ponsiano Ocama
Charles Drago Kato
Eddie Wampande
Henry Kajumbula
David Kateete
Abdul Walusansa
Ali Kudamba
Kigozi Edgar
Fred Ashaba Katabazi
Maria Magdalene Namaganda
Jamilu E. Ssenku
Hakim Sendagire
author_facet Hussein Mukasa Kafeero
Dorothy Ndagire
Ponsiano Ocama
Charles Drago Kato
Eddie Wampande
Henry Kajumbula
David Kateete
Abdul Walusansa
Ali Kudamba
Kigozi Edgar
Fred Ashaba Katabazi
Maria Magdalene Namaganda
Jamilu E. Ssenku
Hakim Sendagire
author_sort Hussein Mukasa Kafeero
collection DOAJ
description Background. Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease. Methods. A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson’s chi-square, multinomial logistic regression, and Mann–Whitney U tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A p<0.05 was considered statistically significant. Results. Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (p<0.05). Genotype D was significantly associated with elevated viral load and direct bilirubin (p<0.05). The recombinant genotype D/E was significantly associated with elevated viral load (p<0.05). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (p<0.05). Conclusion. There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.
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spelling doaj-art-d8c3567f54f047839e8206cbcb133b342025-02-03T01:04:31ZengWileyInternational Journal of Hepatology2090-34562022-01-01202210.1155/2022/3688547Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV ManagementHussein Mukasa Kafeero0Dorothy Ndagire1Ponsiano Ocama2Charles Drago Kato3Eddie Wampande4Henry Kajumbula5David Kateete6Abdul Walusansa7Ali Kudamba8Kigozi Edgar9Fred Ashaba Katabazi10Maria Magdalene Namaganda11Jamilu E. Ssenku12Hakim Sendagire13Department of MicrobiologyDepartment of Plant SciencesDepartment of MedicineDepartment of Biomolecular Resources & Biolab Sciences (BBS) College of Veterinary MedicineDepartment of Biomolecular Resources & Biolab Sciences (BBS) College of Veterinary MedicineDepartment of MicrobiologyDepartment of Molecular Biology and ImmunologyDepartment of Medical MicrobiologyDepartment of PhysiologyDepartment of Molecular Biology and ImmunologyDepartment of Molecular Biology and ImmunologyDepartment of Molecular Biology and ImmunologyDepartment of Plant SciencesDepartment of MicrobiologyBackground. Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease. Methods. A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson’s chi-square, multinomial logistic regression, and Mann–Whitney U tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A p<0.05 was considered statistically significant. Results. Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (p<0.05). Genotype D was significantly associated with elevated viral load and direct bilirubin (p<0.05). The recombinant genotype D/E was significantly associated with elevated viral load (p<0.05). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (p<0.05). Conclusion. There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.http://dx.doi.org/10.1155/2022/3688547
spellingShingle Hussein Mukasa Kafeero
Dorothy Ndagire
Ponsiano Ocama
Charles Drago Kato
Eddie Wampande
Henry Kajumbula
David Kateete
Abdul Walusansa
Ali Kudamba
Kigozi Edgar
Fred Ashaba Katabazi
Maria Magdalene Namaganda
Jamilu E. Ssenku
Hakim Sendagire
Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
International Journal of Hepatology
title Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
title_full Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
title_fullStr Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
title_full_unstemmed Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
title_short Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management
title_sort disproportionate distribution of hbv genotypes a and d and the recombinant genotype d e in the high and low hbv endemic regions of uganda a wake up call for regional specific hbv management
url http://dx.doi.org/10.1155/2022/3688547
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