Genotypes of Hepatitis B Virus in Sera of patients positive for HbsAg at Jinja Regional Referral Hospital between January-April, 2019

Abstract

Hepatitis B virus infection is a serious disease that manifests clinically either as an acute hepatitis or in various chronic conditions causing approximately 650,000 deaths worldwide every year. About 10% of the Uganda’s population is chronically infected and are at risk of developing severe HBV liver related diseases. The HBV exists in different genotypes and each genotype has been shown to influence its clinical out and treatment differently. There is limited data about the circulating genotypes in different regions of Uganda where HBV is highly prevalent. In this study, the circulating genotypes of HBV in patients that reported to Jinja regional referral hospital between January to April 2019 were determined. In total, 102 stored HBsAg positive serum samples obtained from patients who reported to the hospital for HBV screening and testing between January to April, 2019 were included in the study. The DNA from the serum samples was extracted and tested them with PCR using primers targeting highly conserved pre-core/core region of all HBV genotypes. Of the 102 samples, 54 were successfully amplified as HBV which were then amplified by genotype-specific primers in order to determine the genotypes in the samples. Thirty five samples were successfully amplified by the different primer sets and the HBV genotypes identified as follows: D (n=12; 37.5%); A (n=8; 25.0%); E (n=2; 5.71%); C (n=1; 2.86%); B (n=1; 2.86%) and mixed genotype infections (n=11;31.43%). Representative amplicons of the different genotypes were sequenced and phylogenetic analysis carried out. All sequences of the amplicons were in agreement with the results of genotype-specific primers with the exception of genotype C which instead clustered with genotype A. In conclusion, genotype A and D were the most dominant genotypes in patients reporting to Jinja regional referral hospital. Proper management of HBsAg positive patients is recommended since Genotype D, the most dominant genotype in the region is associated with severe clinic outcomes.