PREVALENCE AND GENETIC VARIANTS OF VIRUS HEPATITIS B IN PREGNANT WOMEN

Objective: to analyze the prevalence of hepatitis B in Europe, Russia and St. Petersburg, to assess the current epidemic trends of chronic hepatitis B in pregnant women in St. Petersburg and to determine the genetic variants of HBV circulating among them. Materials and methods. In this paper, we analyzed the rates of detection of HBsAg in Europe, Russia and St. Petersburg. Additionally, the HBsAg detection frequency in pregnant women in St. Petersburg was analyzed. Moreover, to study the heterogeneity of HBV in pregnant women with chronic hepatitis B in SPb, plasma samples from 13 patients were examined. HBV DNA was isolated from the blood plasma using the commercial kit AmpliPrime Ribo-Prep following the manufacturer’s protocol. Results and discussion. The incidence of HBsAg detection in pregnant women in St. Petersburg was higher than the morbidity rate in the 18–39 age group in the general population. The study revealed the circulation of 4 subgenotypes: A2, D1, D2, D3 and one recombinant form of A/D. Conclusion. Despite some positive trends, the epidemic situation with hepatitis B in pregnant women in St. Petersburg remains serious. Since there are significant differences between HBV genotypes with respect to clinical features, to the response to antiviral therapy, as well as regarding the risk of a vertical transmission, it is advisable to determine the HBV genotype in broader groups of patients. 

1. World Health Organization. Hepatitis B. World Health Organization Fact Sheet 204 (Revised August 2004). URL: http://www.who.int/mediacentre/factsheets/fs204/en/.

2. Borgia G., Carleo M.A., Gaeta G.B., Gentile I. Hepatitis B in pregnancy. World J. Gastroenterol., 2012, No. 18 (34), pp. 4677–4683. URL: https://www.wjgnet.com/1007-9327/full/v18/i34/4677.htm.

3. Jonas M.M. Hepatitis B and pregnancy: an underestimated issue. Liver Int., 2009, No. 29, Suppl. 1, pp. 133–139. URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2008.01933.x/full.

4. EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection. J. Hepatol., 2012, No. 57, pp. 167–185. URL: http://www.easl.eu/medias/cpg/issue8/English-Report.pdf.

5. Ивашкин В.Т., Ющук Н.Д., Маевская М.В., Знойко О.О., Дудина К.Р., Кареткина Г.Н. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации и Российского общества по изучению печени по диагностике и лечению взрослых больных гепатитом // Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2014. Т. 24, № 3. С. 58–88. URL: http://www.gastro-j.ru/files/_2014_ 3_s8_1406993670.pdf. [Ivashkin V.T., Yushchuk N.D., Mayevskaya M.V., Znoiko O.O., Dudina K.R., Karetkina G.N. et al. Clinical guidelines of the Russian gastroenterological Association and the Russian society on studying of liver diseases on diagnostics and treatment of adult patients with hepatitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology, 2014, Vol. 24, No. 3, pp. 58–88. URL: http://www.gastroj.ru/files/_2014_3_s8_1406993670.pdf (In Russ.)].

6. Han G.R., Cao M.K., Zhao W. et al. A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. J Hepatol., 2011, No. 55 (6), pp. 1215–1221. URL: https://www.ncbi.nlm.nih.gov/pubmed/21703206.

7. Белопольская М.А., Мельникова Г.Ю., Яковлев А.А. Противовирусная терапия у женщин детородного возраста с хроническим вирусным гепатитом В // Лечение и профилактика. 2016. Т. 4, № 20. С. 58–63. URL: https://elibrary.ru/download/elibrary_27524346_97665078.pdf. [Belopol’skaya M.A., Mel’nikova G.Yu., Yakovlev A.A. Antiviral therapy in women of childbearing age with chronic viral hepatitis B. Treatment and Prevention, 2016, Vol. 4, No. 20, pp. 58–63. URL: https://elibrary.ru/download/elibrary_27524346_97665078.pdf (In Russ.)].

8. Резолюция Генеральной Ассамблеи Организации Объединенных Наций A/RES/70/1 — Преобразование нашего мира: Повестка дня в области устойчивого развития на период до 2030 г. URL: http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E (по состоянию на 30 октября 2015 г.). [The resolution of the General Assembly United Nations A/RES/70/1 — Transformation of our world: an Agenda for sustainable development for the period up to 2030. URL: http://www.un.org/ga/search/view_doc.asp?sym bol= A/RES/70/1&Lang=E (as of October 30, 2015) (In Russ.)].

9. WHO-UNICEF. 2016. URL: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragedtp3.html.

10. Locarnini S., Littlejohn M., Aziz M.N., Yuen L. Possible origins and evolution of the hepatitis B virus (HBV). Seminars in Cancer Biology, 2013, Vol. 23, No. 6, pp. 561–575. URL: http://www.sciencedirect.com/science/article/pii/S1044579X13000825.

11. Елпаева Е.А., Никитина О.Е., Писарева М.М., Шилова И.В., Грешнякова В.А., Грудинин М.П., Киселев О.И. Генетические варианты вируса гепатита В у пациентов с хроническим гепатитом В // Журнал инфектологии. 2015. Т. 7, № 3. С. 44–50. [Elpaeva E.A., Nikitina O.E., Pisareva M.M., Shilova I.V., Gresnyakova V.A., Grudinin M.P., Kiselev O.I. Genetic variants of hepatitis b virus in patients with chronic hepatitis B. Journal of Infectology, 2015, Vol. 7, No. 3, pp. 44–50 (In Russ)].

12. Lin C.L., Kao J.H. The clinical implications of hepatitis B virus genotype: Recent advances. J. Gastroenterol. Hepatol., 2011, Suppl. 1, pp. 123–130.

13. Croagh C.M., Desmond P.V., Bell S.J. Genotypes and viral variants in chronic hepatitis B: A review of epidemiology and clinical relevance. World Journal of Hepatology, 2015, Vol. 7, No. 3, pp. 289–303. Doi:10.4254/wjh.v7.i3.289.

14. Berger S. Hepatitis B: Global Status. GIDEON Informatics, 2016. URL: https://www.gideononline.com/ebooks/disease/hepatitis-b-global-status/.

15. Wilson ME GIDEON E-Books System Founded by Uri Blackman and Stephen Berger Global Infectious Disease and Epidemiology Network (GIDEON). Clinical Infectious Diseases, 2010, No. 51, pp. 1227–1228. URL: https://academic.oup.com/cid/article/51/10/1227/ 394314/GIDEON-E-Books-System-Founded-by-Uri-Blackman-and.

16. GenBank. URL: https://www.ncbi.nlm.nih.gov/genbank/.

17. Jonsdottir G., Briem H., Blöndal T., Palsson G., Olafsson S., & Gudnason T. Viral hepatitis B and C among immigrants in Iceland. Laeknabladid, 2006, Vol. 92, No. 10, pp. 669–673.

18. Вирусные гепатиты в Российской Федерации: Аналитический обзор / Под ред. В.И.Покровского, А.Б.Жебруна. Выпуск 9. СПб.: ФБУН НИИЭМ им. Пастера, 2013. 160 с. [Viral hepatitis in the Russian Federation: an Analytical review. Ed. V.I.Pokrovsky, A.B.Zhebrun. Issue 9. Saint-Petersburg: Saint-Petersburg Paster Institute, 2013, 160 p. (In Russ.)].

19. Инфекционные болезни-2014: Альманах / Под ред. А.Г.Рахмановой, А.А.Яковлева. CПб.: 2014. 273 с. [Infectious disease 2014: Anthology. Ed. A.G.Rakhmanova, A.A.Yakovlev. Saint-Petersburg: 2014, 273 p. (In Russ.)].

20. Глобальная стратегия сектора здравоохранения по вирусному гепатиту 2016–2021. На пути к ликвидации вирусного гепатита. ВОЗ. Июнь 2016. URL: http://apps.who.int/iris/bitstream/10665/250042/1/WHO-HIV-2016.06-rus.pdf?ua=1. [Global health sector strategy on viral hepatitis 2016–2021. On the way to the elimination of viral hepatitis. Who. June 2016. URL: http://apps.who.int/iris/bitstream/ 10665/250042/1/WHO-HIV-2016.06-rus.pdf?ua=1 (In Russ.)].

21. Яковлев А.А., Комарова А.Я., Мусатов В.Б., Цинзерлинг В.А., Карнаухов Е.В. Хронические вирусные гепатиты и их исходы: что нас ждет в ближайшее десятилетие // Клинические перспективы гастроэнтерологии, гепатологии. 2015. № 2. С. 13–21. [Yakovlev A.A., Komarova A.Ya., Musatov V.B., Zinserling V.A., Karnaukhov E.V. Chronic viral hepatitis and their outcomes: what can we expect in the next decade. Clinical Prospects of Gastroenterology, Hepatology, 2015, No. 2, pp. 13–21 (In Russ.)].

22. Papatheodoridis G.V., Manolakopoulos S., Liaw Y.-F., Lok A. Follow-up and indications for liver biopsy in HBeAg-negative chronic hepatitis B virus infection with persistently normal ALT: a systematic review. J. Hepatol., 2012, Vol. 57, No. 1, pp. 196–202. URL: http://www.journal-ofhepatology.eu/article/S0168-8278(12)00234-6/fulltext.

23. Программа элиминации острого гепатита В на территории Северо-Западного округа Российской Федерации. СПб.: ФБУН НИИЭМ им. Пастера, 2016. 20 с. [The program of elimination of acute hepatitis B in the North-West district of the Russian Federation. Saint-Petersburg: Saint-Petersburg Paster Institute, 2016, 20 p. (In Russ.)].

24. Санитарно-эпидемиологические правила СП 3.1.1.2341-08 «Профилактика вирусного гепатита В». М., 2008. С. 20. URL: http://meganorm.ru/Index2/1/4293831/4293831337.htm. [Sanitary and epidemiological regulations SP 3.1.1.2341-08 «Prevention of viral hepatitis B». Moscow, 2008, 20 p. URL: http://meganorm.ru/Index2/1/4293831/4293831337.htm (In Russ.)].