Infection with hepatitis A, B, C, and delta viruses among patients with acute hepatitis in Mongolia

• Published in: Journal of medical virology 2006-05, Vol.78 (5), p.542-550
• Main Authors: Tsatsralt-Od, Bira, Takahashi, Masaharu, Endo, Kazunori, Buyankhuu, Osorjin, Baatarkhuu, Oidov, Nishizawa, Tsutomu, Okamoto, Hiroaki
• Format: Article
• Language: English
• Subjects: Acute Disease; acute hepatitis; Adolescent; Adult; Biological and medical sciences; Comorbidity; Female; Fundamental and applied biological sciences. Psychology; genotype; Hepacivirus - genetics; Hepacivirus - immunology; Hepatitis A - blood; Hepatitis A - epidemiology; Hepatitis A - virology; Hepatitis A virus; Hepatitis A virus - genetics; Hepatitis A virus - immunology; Hepatitis Antibodies - blood; Hepatitis B - blood; Hepatitis B - epidemiology; Hepatitis B - virology; Hepatitis B virus; Hepatitis B virus - genetics; Hepatitis B virus - immunology; Hepatitis C - blood; Hepatitis C - epidemiology; Hepatitis C - virology; Hepatitis C virus; Hepatitis D - blood; Hepatitis D - epidemiology; Hepatitis D - virology; Hepatitis D virus; Hepatitis Delta Virus - genetics; Hepatitis Delta Virus - immunology; Hepatitis E virus; hepatitis viruses; Human viral diseases; Humans; Immunoglobulin M - blood; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Molecular Sequence Data; Mongolia; Mongolia - epidemiology; phylogenetic tree; Seroepidemiologic Studies; Species Specificity; Superinfection; Viral diseases; Viral hepatitis; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.20574

One hundred ten consecutive patients (60 males and 50 females; age, mean ± standard deviation [SD], 22.6 ± 6.4 years; range 16–48 years) who were clinically diagnosed with sporadic acute hepatitis between December 2004 and January 2005 in Ulaanbaatar, Mongolia, were studied. IgM antibodies to hepatitis A virus were detected in 18 patients (16.4%), IgM antibodies to hepatitis B core (anti‐HBc IgM) in 38 patients (34.5%) including two patients with concurrent hepatitis delta virus (HDV) infection, and hepatitis C virus RNA in nine patients (8.2%). There were 30 hepatitis B virus (HBV) carriers who had detectable hepatitis B surface antigen and antibodies to HDV but were negative for anti‐HBc IgM, suggesting that they acquired type D acute hepatitis due to superinfection of HDV on a background of chronic HBV infection. None had IgM antibodies to hepatitis E virus (HEV). Consequently, 16.4, 32.7, 6.4, 1.8, and 27.3% of the patients were diagnosed as having acute hepatitis of type A, B, C, type B + D (HBV/HDV coinfection), and type D (superinfection of HDV), respectively. The cause of hepatitis was not known in the remaining 17 patients (15.5%). All 18 HAV isolates were genotyped as IA, all 9 HCV isolates were genotyped as 1b, and all 32 HDV isolates were classified into genotype I. The distribution of HBV genotypes among the 67 HBV isolates was A (1.5%, n = 1) and D (98.5%, n = 66). The present study indicates that de novo infections of HAV, HBV, HCV, and HDV are prevalent among young adults in Mongolia. J. Med. Virol. 78:542–550, 2006. © 2006 Wiley‐Liss, Inc.