Cargando…

Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014

BACKGROUND: Hepatitis A virus (HAV) infection is endemic in Eastern European and Balkan region countries. In 2012, Bulgaria showed the highest rate (67.13 cases per 100,000) in Europe. Nevertheless, HAV genotypes and strains circulating in this country have never been described. The present study re...

Descripción completa

Detalles Bibliográficos
Autores principales: Bruni, Roberto, Taffon, Stefania, Equestre, Michele, Cella, Eleonora, Lo Presti, Alessandra, Costantino, Angela, Chionne, Paola, Madonna, Elisabetta, Golkocheva-Markova, Elitsa, Bankova, Diljana, Ciccozzi, Massimo, Teoharov, Pavel, Ciccaglione, Anna Rita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513050/
https://www.ncbi.nlm.nih.gov/pubmed/28705178
http://dx.doi.org/10.1186/s12879-017-2596-1
_version_ 1783250584904663040
author Bruni, Roberto
Taffon, Stefania
Equestre, Michele
Cella, Eleonora
Lo Presti, Alessandra
Costantino, Angela
Chionne, Paola
Madonna, Elisabetta
Golkocheva-Markova, Elitsa
Bankova, Diljana
Ciccozzi, Massimo
Teoharov, Pavel
Ciccaglione, Anna Rita
author_facet Bruni, Roberto
Taffon, Stefania
Equestre, Michele
Cella, Eleonora
Lo Presti, Alessandra
Costantino, Angela
Chionne, Paola
Madonna, Elisabetta
Golkocheva-Markova, Elitsa
Bankova, Diljana
Ciccozzi, Massimo
Teoharov, Pavel
Ciccaglione, Anna Rita
author_sort Bruni, Roberto
collection PubMed
description BACKGROUND: Hepatitis A virus (HAV) infection is endemic in Eastern European and Balkan region countries. In 2012, Bulgaria showed the highest rate (67.13 cases per 100,000) in Europe. Nevertheless, HAV genotypes and strains circulating in this country have never been described. The present study reports the molecular characterization of HAV from 105 patients from Bulgaria. METHODS: Anti-HAV IgM positive serum samples collected in 2012–2014 from different towns and villages in Bulgaria were analysed by nested RT-PCR, sequencing of the VP1/2A region and phylogenetic analysis; the results were analysed together with patient and geographical data. RESULTS: Phylogenetic analysis revealed two main sequence groups corresponding to the IA (78/105, 74%) and IB (27/105, 26%) sub-genotypes. In the IA group, a major and a minor cluster were observed (62 and 16 sequences, respectively). Most sequences from the major cluster (44/62, 71%) belonged to either of two strains, termed "strain 1" and "strain 2", differing only for a single specific nucleotide; the remaining sequences (18/62, 29%) showed few (1 to 4) nucleotide variations respect to strain 1 and 2. Strain 2 is identical to the strain previously responsible for an outbreak in the Czech Republic in 2008 and a large multi-country European outbreak caused by contaminated mixed frozen berries in 2013. Most sequences of the IA minor cluster and the IB group were detected in large/medium centers (LMCs). Overall, sequences from the IA major cluster were more frequent in small centers (SCs), but strain 1 and strain 2 showed an opposite relative frequency in SCs and LMCs (strain 1 more frequent in SCs, strain 2 in LMCs). CONCLUSIONS: Genotype IA predominated in Bulgaria in 2012–2014 and phylogenetic analysis identified a major cluster of highly related or identical IA sequences, representing 59% of the analysed cases; these isolates were mostly detected in SCs, in which HAV shows higher endemicity than in LMCs. The distribution of viral sequences suggests the existence of some differences between the transmission routes in SCs and LMCs. Molecular characterization of an increased number of isolates from Bulgaria, regularly collected over time, will be useful to explore specific transmission routes and plan appropriate preventing measures.
format Online
Article
Text
id pubmed-5513050
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-55130502017-07-19 Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014 Bruni, Roberto Taffon, Stefania Equestre, Michele Cella, Eleonora Lo Presti, Alessandra Costantino, Angela Chionne, Paola Madonna, Elisabetta Golkocheva-Markova, Elitsa Bankova, Diljana Ciccozzi, Massimo Teoharov, Pavel Ciccaglione, Anna Rita BMC Infect Dis Research Article BACKGROUND: Hepatitis A virus (HAV) infection is endemic in Eastern European and Balkan region countries. In 2012, Bulgaria showed the highest rate (67.13 cases per 100,000) in Europe. Nevertheless, HAV genotypes and strains circulating in this country have never been described. The present study reports the molecular characterization of HAV from 105 patients from Bulgaria. METHODS: Anti-HAV IgM positive serum samples collected in 2012–2014 from different towns and villages in Bulgaria were analysed by nested RT-PCR, sequencing of the VP1/2A region and phylogenetic analysis; the results were analysed together with patient and geographical data. RESULTS: Phylogenetic analysis revealed two main sequence groups corresponding to the IA (78/105, 74%) and IB (27/105, 26%) sub-genotypes. In the IA group, a major and a minor cluster were observed (62 and 16 sequences, respectively). Most sequences from the major cluster (44/62, 71%) belonged to either of two strains, termed "strain 1" and "strain 2", differing only for a single specific nucleotide; the remaining sequences (18/62, 29%) showed few (1 to 4) nucleotide variations respect to strain 1 and 2. Strain 2 is identical to the strain previously responsible for an outbreak in the Czech Republic in 2008 and a large multi-country European outbreak caused by contaminated mixed frozen berries in 2013. Most sequences of the IA minor cluster and the IB group were detected in large/medium centers (LMCs). Overall, sequences from the IA major cluster were more frequent in small centers (SCs), but strain 1 and strain 2 showed an opposite relative frequency in SCs and LMCs (strain 1 more frequent in SCs, strain 2 in LMCs). CONCLUSIONS: Genotype IA predominated in Bulgaria in 2012–2014 and phylogenetic analysis identified a major cluster of highly related or identical IA sequences, representing 59% of the analysed cases; these isolates were mostly detected in SCs, in which HAV shows higher endemicity than in LMCs. The distribution of viral sequences suggests the existence of some differences between the transmission routes in SCs and LMCs. Molecular characterization of an increased number of isolates from Bulgaria, regularly collected over time, will be useful to explore specific transmission routes and plan appropriate preventing measures. BioMed Central 2017-07-14 /pmc/articles/PMC5513050/ /pubmed/28705178 http://dx.doi.org/10.1186/s12879-017-2596-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Bruni, Roberto
Taffon, Stefania
Equestre, Michele
Cella, Eleonora
Lo Presti, Alessandra
Costantino, Angela
Chionne, Paola
Madonna, Elisabetta
Golkocheva-Markova, Elitsa
Bankova, Diljana
Ciccozzi, Massimo
Teoharov, Pavel
Ciccaglione, Anna Rita
Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title_full Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title_fullStr Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title_full_unstemmed Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title_short Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014
title_sort hepatitis a virus genotypes and strains from an endemic area of europe, bulgaria 2012–2014
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513050/
https://www.ncbi.nlm.nih.gov/pubmed/28705178
http://dx.doi.org/10.1186/s12879-017-2596-1
work_keys_str_mv AT bruniroberto hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT taffonstefania hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT equestremichele hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT cellaeleonora hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT loprestialessandra hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT costantinoangela hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT chionnepaola hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT madonnaelisabetta hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT golkochevamarkovaelitsa hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT bankovadiljana hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT ciccozzimassimo hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT teoharovpavel hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014
AT ciccaglioneannarita hepatitisavirusgenotypesandstrainsfromanendemicareaofeuropebulgaria20122014