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Журнал микробиологии, эпидемиологии и иммунобиологии. 2021; 98: 440-449

Значимость лабораторной диагностики парентеральных вирусных гепатитов в Гвинейской Республике

Бумбали С. , Серикова Е. Н., Семенов А. В., Останкова Ю. В., Валутите Д. Э., Щемелев А. Н., Зуева Е. Б., Балде Т. А., Баимова Р. Р., Тотолян А. А.

https://doi.org/10.36233/0372-9311-116

Аннотация

Актуальность. Cтраны Африки, особенно к югу от Сахары, являются регионом с высокими показателями заболеваемости хроническими вирусными гепатитами В (ВГВ) и С (ВГС). Методы выявления ВГВ и ВГС в странах с низким и средним уровнем дохода отличаются от тех, которые применяют в странах, имеющих доступ к дорогостоящим технологиям. Гвинейская Республика — регион с высокой встречаемостью гепатотропных вирусов, однако данных о распространённости ВГВ и ВГС на территории крайне мало, что определило актуальность данного исследования.

Цель работы — оценить необходимость совершенствования лабораторной диагностики парентеральных ВГВ и ВГС в Гвинейской Республике.

Материалы и методы. Исследовали 2616 образцов сыворотки крови, полученных от практически здоровых жителей Гвинейской Республики в рамках плановой диспансеризации. Исследование включало качественное определение HBsAg, антител анти-HBs IgG, анти-HBcore IgG, анти-HCV IgG, а также ДНК ВГВ и РНК ВГС.

Результаты. Выявляемость серологических маркеров ВГВ и ВГС составила 80,77 и 18% соответственно. Однако HBsAg+ обнаружен только у 16,01% лиц. ДНК ВГВ выявляли среди как серопозитивных, так и серонегативных по другим маркёрам ВГВ пациентов, ДНК ВГВ обнаружили в 22,36% случаев, в том числе в 6,07% случаев HBsAg–-ВГВ. РНК ВГС выявили в 2,2% случаев. Одновременно РНК ВГС и ДНК ВГВ определили у 27 человек, включая 19 HBsAg–-случаев, что составило 1,03% обследованной группы.

Выводы. Применяемые в настоящее время в Гвинейской Республике маркёры лабораторного выявления ВГВ и ВГС не позволяют достоверно диагностировать все случаи. Очевидна необходимость совершенствования лабораторной диагностики для своевременного обнаружения парентеральных вирусных гепатитов. Целесообразно внедрение в рутинную работу лабораторий анализа на дополнительные серологические и молекулярные маркёры ВГС и ВГВ.

Список литературы

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2. Мукомолов С.Л., Левакова И.А. Эпидемиологическая характеристика хронических вирусных гепатитов в Российской Федерации в 1999–2009 гг. Инфекция и иммунитет. 2011, 1(3): 255–62. https://doi.org/10.15789/2220-7619-2011-3-255-262

3. Zabala V., Tong M., Yu R., Ramirez T., Yalcin E.B., Balbo S., et al. Potential contributions of the tobacco nicotine-derived nitrosamine ketone (NNK) in the pathogenesis of steatohepatitis in a chronic plus binge rat model of alcoholic liver disease. Alcohol Alcohol. 2015, 50(2): 118–31. https://doi.org/10.1093/alcalc/agu083

4. Yim H.J., Lok A.S. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005. Hepatology. 2006, 43(2 Suppl. 1): S173–81. https://doi.org/10.1002/hep.20956

5. Ющук Н.Д., Климова Е.А., Знойко О.О., Кареткина Г.Н., Максимов С.Л., Маев И.В. Вирусные гепатиты: клиника, диагностика, лечение. М.: ГЭОТАР-Медиа, 2012.

6. Allain J.P., Opare-Sem O. Screening and diagnosis of HBV in low-income and middle-income countries. Nat. Rev. Gastroenterol. Hepatol. 2016, 13(11): 643–53. https://doi.org/10.1038/nrgastro.2016.138

7. Останкова Ю.В., Семенов А.В., Тотолян А.А. Выявление вируса гепатита B в плазме крови при низкой вирусной нагрузке. Клиническая лабораторная диагностика. 2019, 64(10): 635–40. https://doi.org/10.18821/0869-2084-2019-64-10-635-640

8. Семенов А.В., Останкова Ю.В. Оккультный (скрытый) гепатит В: проблемы лабораторной диагностики. Инфекционные болезни: новости, мнения, обучение. 2019, 8(3): 60–9. https://doi.org/10.24411/2305-3496-2019-13010

9. Morales-Romero J., Vargas G., García-Román R. Occult HBV infection: a faceless enemy in liver cancer development. Viruses. 2014, 6(4): 1590–611. https://doi.org/10.3390/v6041590

10. Raimondo G., Locarnini S., Pollicino T., Levrero M., Zoulim F., Lok A.S., et al. Taormina workshop on occult HBV infection faculty members. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J. Hepatol. 2019, 71(2): 397–408. https://doi.org/10.1016/j.jhep.2019.03.034

11. Shi Y.H., Shi C.H. Molecular characteristics and stages of chronic hepatitis B virus infection. World J. Gastroenterol. 2009, 15(25): 3099–105. https://doi.org/10.3748/wjg.15.30991

12. Sylla A., Diallo M.S., Castegnaro J., Wild C.P. Interactions between hepatitis B virus infection and exposure to aflatoxins in the development of hepatocellular carcinoma: a molecular epidemiological approach. Mutat. Res. 1999, 428(1): 187–96. https://doi.org/10.1016/s1383-5742(99)00046-0

13. Komas N.P., Vickos U., Hübschen J.M., Béré A., Manirakiza A., Muller C.P., et al. Cross-sectional study of hepatitis B virus infection in rural communities, Central African Republic. BMC Infect. Dis. 2013, 13: 286. https://doi.org/10.1186/1471-2334-13-286

14. Peto T.J., Mendy M.E., Lowe Y., Webb E.L., Whittle H.C., HallA.J. Efficacy and effectiveness of infant vaccination against chronic hepatitis B in the Gambia Hepatitis Intervention Study (1986-90) and in the nationwide immunisation program. BMC Infect. Dis. 2014, 14: 7. https://doi.org/10.1186/1471-2334-14-7

15. Nkrumah B., Owusu M., Averu P. Hepatitis B and C viral infections among blood donors. A retrospective study from a rural community of Ghana. BMC Res. Notes. 2011, 4: 529–32. https://doi.org/10.1186/1756-0500-4-529

16. Suesstrunk J., Djongali F.B. Hepatitis B virus prevalence in rural areas in south-west Chad. Trop. Doctor. 2017, 47(4): 374–7. https://doi.org/10.1177/0049475517699718

17. Bernier R.H., Sampliner R., Gerety R., Tabor E., Hamilton F., Nathanson N. Hepatitis B infection in households of chronic carriers of hepatitis B surface antigen: factors associated with prevalence of infection. Am. J. Epidemiol. 1982, 116(2): 199–211. https://doi.org/10.1093/oxfordjournals.aje.a113406

18. Shimakawa Y., Bottomley C., Njie R., Mendy M. The association between maternal hepatitis B e antigen status, as a proxy for perinatal transmission, and the risk of hepatitis B antigenaemia in Gambian children. BMC Public Health. 2014, 14: 532. https://doi.org/10.1186/1471-2458-14-532

19. Zampino R., Boemio A., Sagnelli C., Alessio L., Adinolfi L.E., Sagnelli E., et al. Hepatitis B virus burden in developing countries. World J. Gastroenterol. 2015, 21(42): 11941–53. https://doi.org/10.3748/wjg.v21.i42.11941

20. Sadoh A.E., Sadoh W.E. Serological markers of hepatitis B e infection in infants presenting for their first immunization. Niger J. Paediatr. 2013, 40(3): 248–53. https://doi.org/10.4314/njp.v40i3,9

21. Bigna J.J., Amougou M.A., Asangbeh S.L., Kenne A.M., Noumegni S.R.N., Ngo-Malabo E.T., et al. Seroprevalence of hepatitis B virus infection in Cameroon: a systematic review and meta-analysis. BMJ Open. 2017, 7(6): e015298. https://doi.org/10.1136/bmjopen-2016-015298

22. EASL recommendations on treatment of hepatitis C: Final update of the series. J. Hepatol. 2020, 73(5): 1170–218. https://doi.org/10.1016/j.jhep.2020.08.018

23. Tognon F., Sevalie S., Gassimu J., Sesay J., Hann K., Sheku M., et al. Seroprevalence of hepatitis B and hepatitis C among blood donors in Sierra Leone: A multi-year retrospective study. Int. J. Infect. Dis. 2020, 99: 102–7. https://doi.org/10.1016/j.ijid.2020.07.030

24. Hønge B.L., Olesen J.S., Jensen M.M., Jespersen S., da Silva Z.J., Rodrigues A., et al. Hepatitis B and C in the adult population of Bissau, Guinea-Bissau: a cross-sectional survey. Trop. Med. Int. Health. 2020, 25(2): 255–63. https://doi.org/10.1111/tmi.13335

25. Ladep N.G., Lesi O.A., Mark P., Lemoine M., Onyekwere C., Afihene M., et al. Problem of hepatocellular carcinoma in West Africa. World J. Hepatol. 2014, 6(11): 783–92. https://doi.org/10.4254/wjh.v6.i11.783

26. Flores A., Marrero J.A. Emerging trends in hepatocellular carcinoma: focus on diagnosis and therapeutics. Clin. Med. Insights. Oncol. 2014, 8: 71–6. https://doi.org/10.4137/cmo.s9926

27. Umoh N.J., Lesi O.A., Mendy M., Bah E., Akano A., Whittle H., et al. Aetiological differences in demographical, clinical and pathological characteristics of hepatocellular carcinoma in the Gambia. Liver. Int. 2011, 31(2): 215–21. https://doi.org/10.1111/j.1478-3231.2010.02418.x

28. Kew M.C., Welschinger R., Viana R. Occult hepatitis B virus infection in Southern African blacks with hepatocellular carcinoma. J. Gastroenterol. Hepatol. 2008, 23(9): 1426–30. https://doi.org/10.1111/j.1440-1746.2008.05481.x

Journal of microbiology, epidemiology and immunobiology. 2021; 98: 440-449

Significance of parenteral viral hepatitis laboratory diagnostics in the Republic of Guinea

Boumbaly S. , Serikova E. N., Semenov A. V., Ostankova Yu. V., Valutite D. E., Schemelev A. N., Zueva E. B., Balde T. A.L., Baimova R. R., Totolian A. A.

https://doi.org/10.36233/0372-9311-116

Abstract

Rationale. Countries of Africa, especially countries in sub-Saharan Africa, represent a region characterized by high incidence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Methods for detection of HBV and HCV in low and middle-income countries differ from those that are used in countries having access to high-cost technologies. The Republic of Guinea is a region with high prevalence of hepatotropic viruses, however, the information on HBV and HCV prevalence in the area is extremely limited, thus emphasizing the significance of this study.

The purpose of the study is to evaluate the need for improving laboratory diagnostics of parenteral HBV and HCV infections in the Republic of Guinea.

Materials and methods. A total of 2,616 samples of blood serum were tested, the samples were collected from apparently healthy residents of the Republic of Guinea during the routine medical checkup. The testing included qualitative detection of HBsAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV IgG antibodies as well as HBV DNA and HCV RNA.

Results. The detection frequency of serological markers of HBV and HCV infections was 80.77% and 18%, respectively. However, HBsAg was detected only in 16.01% of individuals. Tests for detection of HBV DNA were performed among seropositive patients and patients seronegative by other HBV markers, HBV DNA was detected in 22.36% of cases, including 6.07% of HBsAg-negative cases. HCV RNA was detected in 2.2% of cases. Both HCV RNA and HBV DNA were detected in 27 people, including 19 HBsAg-negative cases, thus accounting for 1.03% of the examined group.

Conclusions. The markers that are currently used for laboratory detection of HBV and HCV in the Republic of Guinea are not efficient enough to diagnose reliably all cases. Undoubtedly, there is an urgent need to improve laboratory diagnostics for timely detection of parenteral viral hepatitis. Routine laboratory operations need assays for additional serological and molecular markers of HCV and HBV infections.

References

1. WHO. Prevention and control of viral hepatitis infection: frame work for global action 2012. Geneva, 2012.

2. Mukomolov S.L., Levakova I.A. Epidemiologicheskaya kharakteristika khronicheskikh virusnykh gepatitov v Rossiiskoi Federatsii v 1999–2009 gg. Infektsiya i immunitet. 2011, 1(3): 255–62. https://doi.org/10.15789/2220-7619-2011-3-255-262

3. Zabala V., Tong M., Yu R., Ramirez T., Yalcin E.B., Balbo S., et al. Potential contributions of the tobacco nicotine-derived nitrosamine ketone (NNK) in the pathogenesis of steatohepatitis in a chronic plus binge rat model of alcoholic liver disease. Alcohol Alcohol. 2015, 50(2): 118–31. https://doi.org/10.1093/alcalc/agu083

4. Yim H.J., Lok A.S. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005. Hepatology. 2006, 43(2 Suppl. 1): S173–81. https://doi.org/10.1002/hep.20956

5. Yushchuk N.D., Klimova E.A., Znoiko O.O., Karetkina G.N., Maksimov S.L., Maev I.V. Virusnye gepatity: klinika, diagnostika, lechenie. M.: GEOTAR-Media, 2012.

6. Allain J.P., Opare-Sem O. Screening and diagnosis of HBV in low-income and middle-income countries. Nat. Rev. Gastroenterol. Hepatol. 2016, 13(11): 643–53. https://doi.org/10.1038/nrgastro.2016.138

7. Ostankova Yu.V., Semenov A.V., Totolyan A.A. Vyyavlenie virusa gepatita B v plazme krovi pri nizkoi virusnoi nagruzke. Klinicheskaya laboratornaya diagnostika. 2019, 64(10): 635–40. https://doi.org/10.18821/0869-2084-2019-64-10-635-640

8. Semenov A.V., Ostankova Yu.V. Okkul'tnyi (skrytyi) gepatit V: problemy laboratornoi diagnostiki. Infektsionnye bolezni: novosti, mneniya, obuchenie. 2019, 8(3): 60–9. https://doi.org/10.24411/2305-3496-2019-13010

9. Morales-Romero J., Vargas G., García-Román R. Occult HBV infection: a faceless enemy in liver cancer development. Viruses. 2014, 6(4): 1590–611. https://doi.org/10.3390/v6041590

10. Raimondo G., Locarnini S., Pollicino T., Levrero M., Zoulim F., Lok A.S., et al. Taormina workshop on occult HBV infection faculty members. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J. Hepatol. 2019, 71(2): 397–408. https://doi.org/10.1016/j.jhep.2019.03.034

11. Shi Y.H., Shi C.H. Molecular characteristics and stages of chronic hepatitis B virus infection. World J. Gastroenterol. 2009, 15(25): 3099–105. https://doi.org/10.3748/wjg.15.30991

12. Sylla A., Diallo M.S., Castegnaro J., Wild C.P. Interactions between hepatitis B virus infection and exposure to aflatoxins in the development of hepatocellular carcinoma: a molecular epidemiological approach. Mutat. Res. 1999, 428(1): 187–96. https://doi.org/10.1016/s1383-5742(99)00046-0

13. Komas N.P., Vickos U., Hübschen J.M., Béré A., Manirakiza A., Muller C.P., et al. Cross-sectional study of hepatitis B virus infection in rural communities, Central African Republic. BMC Infect. Dis. 2013, 13: 286. https://doi.org/10.1186/1471-2334-13-286

14. Peto T.J., Mendy M.E., Lowe Y., Webb E.L., Whittle H.C., HallA.J. Efficacy and effectiveness of infant vaccination against chronic hepatitis B in the Gambia Hepatitis Intervention Study (1986-90) and in the nationwide immunisation program. BMC Infect. Dis. 2014, 14: 7. https://doi.org/10.1186/1471-2334-14-7

15. Nkrumah B., Owusu M., Averu P. Hepatitis B and C viral infections among blood donors. A retrospective study from a rural community of Ghana. BMC Res. Notes. 2011, 4: 529–32. https://doi.org/10.1186/1756-0500-4-529

16. Suesstrunk J., Djongali F.B. Hepatitis B virus prevalence in rural areas in south-west Chad. Trop. Doctor. 2017, 47(4): 374–7. https://doi.org/10.1177/0049475517699718

17. Bernier R.H., Sampliner R., Gerety R., Tabor E., Hamilton F., Nathanson N. Hepatitis B infection in households of chronic carriers of hepatitis B surface antigen: factors associated with prevalence of infection. Am. J. Epidemiol. 1982, 116(2): 199–211. https://doi.org/10.1093/oxfordjournals.aje.a113406

18. Shimakawa Y., Bottomley C., Njie R., Mendy M. The association between maternal hepatitis B e antigen status, as a proxy for perinatal transmission, and the risk of hepatitis B antigenaemia in Gambian children. BMC Public Health. 2014, 14: 532. https://doi.org/10.1186/1471-2458-14-532

19. Zampino R., Boemio A., Sagnelli C., Alessio L., Adinolfi L.E., Sagnelli E., et al. Hepatitis B virus burden in developing countries. World J. Gastroenterol. 2015, 21(42): 11941–53. https://doi.org/10.3748/wjg.v21.i42.11941

20. Sadoh A.E., Sadoh W.E. Serological markers of hepatitis B e infection in infants presenting for their first immunization. Niger J. Paediatr. 2013, 40(3): 248–53. https://doi.org/10.4314/njp.v40i3,9

21. Bigna J.J., Amougou M.A., Asangbeh S.L., Kenne A.M., Noumegni S.R.N., Ngo-Malabo E.T., et al. Seroprevalence of hepatitis B virus infection in Cameroon: a systematic review and meta-analysis. BMJ Open. 2017, 7(6): e015298. https://doi.org/10.1136/bmjopen-2016-015298

22. EASL recommendations on treatment of hepatitis C: Final update of the series. J. Hepatol. 2020, 73(5): 1170–218. https://doi.org/10.1016/j.jhep.2020.08.018

23. Tognon F., Sevalie S., Gassimu J., Sesay J., Hann K., Sheku M., et al. Seroprevalence of hepatitis B and hepatitis C among blood donors in Sierra Leone: A multi-year retrospective study. Int. J. Infect. Dis. 2020, 99: 102–7. https://doi.org/10.1016/j.ijid.2020.07.030

24. Hønge B.L., Olesen J.S., Jensen M.M., Jespersen S., da Silva Z.J., Rodrigues A., et al. Hepatitis B and C in the adult population of Bissau, Guinea-Bissau: a cross-sectional survey. Trop. Med. Int. Health. 2020, 25(2): 255–63. https://doi.org/10.1111/tmi.13335

25. Ladep N.G., Lesi O.A., Mark P., Lemoine M., Onyekwere C., Afihene M., et al. Problem of hepatocellular carcinoma in West Africa. World J. Hepatol. 2014, 6(11): 783–92. https://doi.org/10.4254/wjh.v6.i11.783

26. Flores A., Marrero J.A. Emerging trends in hepatocellular carcinoma: focus on diagnosis and therapeutics. Clin. Med. Insights. Oncol. 2014, 8: 71–6. https://doi.org/10.4137/cmo.s9926

27. Umoh N.J., Lesi O.A., Mendy M., Bah E., Akano A., Whittle H., et al. Aetiological differences in demographical, clinical and pathological characteristics of hepatocellular carcinoma in the Gambia. Liver. Int. 2011, 31(2): 215–21. https://doi.org/10.1111/j.1478-3231.2010.02418.x

28. Kew M.C., Welschinger R., Viana R. Occult hepatitis B virus infection in Southern African blacks with hepatocellular carcinoma. J. Gastroenterol. Hepatol. 2008, 23(9): 1426–30. https://doi.org/10.1111/j.1440-1746.2008.05481.x