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Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region

2021; Multidisciplinary Digital Publishing Institute; Volume: 13; Issue: 7 Linguagem: Inglês

10.3390/v13071380

1999-4915

Ronylson José S. Silva, Raquel Silva do Nascimento, José Augusto de Jesus de Oliveira Neto, Fabricio Quaresma Silva, Juliana Nádia Figueiredo Piauiense, Camila M.S. Gomes, Luiz Marcelo de Lima Pinheiro, Rafael Lima Resque, João Renato Rebello Pinho, Emil Kupek, Benedikt Fischer, Luiz Fernando Almeida Machado, Luisa Carício Martins, José Alexandre Rodrigues de Lemos, Aldemir Branco de Oliveira Filho,

HIV, Drug Use, Sexual Risk

Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.