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Journal of Clinical Microbiology, April 2006, p. 1288-1294, Vol. 44, No. 4
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.4.1288-1294.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology and Evolution in an Outbreak of Fulminant Hepatitis B Virus

Maria Alma Bracho,1 María José Gosalbes,1 Francisco González,2 Andrés Moya,1 and Fernando González-Candelas1*

Institut Cavanilles de Biodiversitat i Biología Evolutiva and Departament de Genètica, Universitat de València, 46071 València, Spain,1 Dirección General de Salud Pública, Conselleria de Sanitat i Consum, Micer Mascó 26, 46010 València, Spain2

Received 27 July 2005/ Returned for modification 14 October 2005/ Accepted 31 January 2006

In order to establish the transmission pathway for two outbreak patients affected by fulminant hepatitis B (FHB) following a shared period of hospitalization, we sequenced the complete genomes of the hepatitis B viruses (HBV) isolated from them as well as from the suspected common source and 11 additional controls. Phylogenetic and statistical analyses of these sequences revealed that the two FHB patients were indeed infected by a common source and that the fatal development of the disease did not appear to be associated with any mutation previously reported to be related to FHB. These data have also allowed us to estimate the extent and distribution of genetic variability along the genomes of HBV genotype D samples from the same source population. As a result of these analyses, we provide an improved statistical method to individualize the assignment of each suspected patient and the source of an outbreak and information on which genome region to analyze in the molecular epidemiological assessment of hepatitis B virus transmission cases.

* Corresponding author. Mailing address: Institut Cavanilles de Biodiversitat i Biologia Evolutiva, Universitat de València, Apartado 22085, 46071 València, Spain. Phone: (34) 96 3543653. Fax: (34) 96 3543670. E-mail: fernando.gonzalez{at}uv.es.

Journal of Clinical Microbiology, April 2006, p. 1288-1294, Vol. 44, No. 4
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.4.1288-1294.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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