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Journal of Clinical Microbiology, September 2000, p. 3311-3316, Vol. 38, No. 9
Department of Infectious Diseases, Lund
University Hospital,1 and Division of
Molecular Neurobiology, Wallenberg Neuroscience Center, Lund
University,2 Lund, and Department of
Virology, University of Umeå, Umeå,4
Sweden, and Department of Infectious Diseases, Samara State
Medical University,3 and Laboratory
of Immunology, Samara Medical Institute
"Reaviz",5 Samara, Russia
Received 28 March 2000/Returned for modification 30 May
2000/Accepted 5 July 2000
Until 1991, the Russian city of Samara was largely isolated from
other parts of Russia and the rest of the world. Very recently, Samara
has seen an alarming increase in the incidence of hepatitis. The
proportion of fulminant cases is unusually high. We wanted to assess
the roles of hepatitis B virus (HBV) and hepatitis D virus (HDV) in
acute viral hepatitis in this region by analyzing the prevailing
strains of both and by determining their genotypes and possible origin.
Serum samples were screened for different serological markers and by
PCR followed by direct sequencing. Of the 94 HBV-positive samples (80%
of which were acute infections), 37 (39%) were also HDV positive.
Sixty-seven percent of the patients had anti-HCV antibodies.
Twenty-five percent of all patients in the study had fulminant
hepatitis. Statistically significant sex differences were found among
fulminant cases. For HBV, the core promoter sequences of 62 strains
were determined and all but one were found to be of genotype D. None of
these had any deletions. Only one strain, from a patient with fulminant
fatal hepatitis, showed multiple mutations. The pre-S2 region sequences
of 31 HBV strains were also compared. Phylogenetically, these fell into two distinct groups within genotype D, suggesting different origins. For HDV, part of the region encoding the
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Recent High Incidence of Fulminant Hepatitis in Samara, Russia:
Molecular Analysis of Prevailing Hepatitis B and D Virus
Strains
-antigen was sequenced from
four strains. All proved to be of genotype I and were similar to Far
Eastern and Eastern European strains. The contribution of intravenous
drug use to the sharp increase in viral hepatitis in this unique
setting is discussed.
*
Corresponding author. Mailing address: Department of
Infectious Diseases, Lund University, SE-221 85 Lund, Sweden. Phone: 46-46-171858. Fax: 46-46-137414. E-mail:
Karin.Kidd{at}infek.lu.se.
Journal of Clinical Microbiology, September 2000, p. 3311-3316, Vol. 38, No. 9
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
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