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
Ronylson José S. Silva,
Raquel Silva do Nascimento,
José Augusto J. Oliveira-Neto,
Fabricio Quaresma Silva,
Juliana Nádia F. Piauiense,
Camila Moraes Gomes,
Luiz Marcelo L. Pinheiro,
Rafael Lima Resque,
João Renato R. Pinho,
Emil Kupek,
Benedikt Fischer,
Luiz Fernando A. Machado,
Luísa Caricio Martins,
José Alexandre R. Lemos,
Aldemir B. Oliveira-Filho
Affiliations
Ronylson José S. Silva
Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
Raquel Silva do Nascimento
Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
José Augusto J. Oliveira-Neto
Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
Fabricio Quaresma Silva
Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
Juliana Nádia F. Piauiense
Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil
Camila Moraes Gomes
Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
Luiz Marcelo L. Pinheiro
Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, PA, Brazil
Rafael Lima Resque
Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, AP, Brazil
João Renato R. Pinho
Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
Emil Kupek
Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, SC, Brazil
Benedikt Fischer
Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
Luiz Fernando A. Machado
Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil
Luísa Caricio Martins
Programa de Pós-Graduação em Saúde na Amazônia, Universidade Federal do Pará, Belém 66055-240, PA, Brazil
José Alexandre R. Lemos
Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil
Aldemir B. Oliveira-Filho
Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, PA, Brazil
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.
