Studies of nosocomial outbreaks of hepatitis B in nursing homes in Germany suggest a major role of hepatitis B e antigen expression in disease severity and progression

International Journal of Medical Microbiology : IJMM
Pia L SeizChristian G Schüttler

Abstract

Hepatitis B virus (HBV) causes acute or chronic hepatitis B. Local outbreaks of HBV infections in skilled nursing facilities is a matter of growing concern in developed countries. Here, we investigated two outbreaks of hepatitis B that recently occurred in nursing homes in Germany. The outbreak at location A was associated with acute fulminant hepatitis with fatal outcome in several cases, while individuals infected at location B developed asymptomatic or mild hepatitis B. Sequence analysis of viruses involved in these outbreaks revealed different, but unique HBV strains for each location. Each of the strains produced high viremia of more than 10(9) virions/mL serum. We found that the mild course of hepatitis B at location B was caused by a circulating wild-type HBV genotype A2 strain, which is commonly found in Central Europe. Complete genome sequences of isolates obtained from infected patients revealed nearly 100% sequence identity at the nucleotide level as well as expression of HBV e protein (HBeAg), a known T cell tolerogen in the incubation or chronic phases of HBV infection. By contrast, the outbreak at location A was associated with an HBV genotype D2 variant that lacked HBeAg expression, suggesting that immunopatholog...Continue Reading

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Citations

Sep 14, 2015·International Journal of Medical Microbiology : IJMM·Ulrich VogelMary Slack
Aug 3, 2019·Proceedings of the National Academy of Sciences of the United States of America·Andrea RascheJan Felix Drexler
Jun 19, 2019·Future Microbiology·Lara TavoschiPier L Lopalco
Jun 18, 2017·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Hilary L P OrlowskiChristine O Menias
Nov 14, 2021·Infectious Diseases and Therapy·Mallavalli SurendranathPavitra Dewda

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