Serological and Molecular Detection of Hepatitis B virus among patients referred to Kurdistan Center for Hepatology and Gastroenterology in Sulaimani City/Kurdistan Region of Iraq
Keywords:Hepatitis B Virus, Hepatitis B Surface Antigen, Enzyme-linked Immunosorbent Assay, Gold In-tube, Realtime Polymerase Chain Reaction
Hepatitis B virus infection is caused by the hepatitis B virus, a major global health problem. This infection can lead to chronic conditions, followed by cirrhosis and hepatocellular carcinoma (HCC). The current study was aimed to detect HBV using serological and molecular techniques. During 2019, 300 blood samples were collected from Kurdistan Center for Hepatology and Gastroenterology in Sulaimani city. Enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (RT-PCR) techniques were used for the detection of HBsAg and HBV DNA, respectively. Obtained results were revealed that 92 out of 300 tested patients (30.66%) seropositive for HBsAg. Among 92 seropositive patients, 53 were shown positive results for HBV DNA by RT-PCR. Dental clinic visiting and dialysis were among the important risk factors for HBV transmission. The vast majority of positive results were among males. Smokers showed relatively high rates of positive results. One-third of the referred patients who had liver complaints were positive for HBsAg. More than half of the seropositive patients showed RT-PCR positive results. It was concluded that the molecular method (RT-PCR) is more sensitive and gives a more accurate result than serology (ELISA). Therefore, it can be used as a diagnostic tool for HBV detection.
 World Health Organization. “Hepatitis B: Fact Sheet”, World Health Organization, Geneva, 2020.
 S. Lanini, V. Puro, F. N. Lauria, F. M. Fusco, C. Nisii and G. Ippolito. “Patient to patient transmission of hepatitis B virus: A systematic review of reports on outbreaks between 1992 and 2007”. BMC Medicine, vol. 7, p. 15, 2009.
 G. Fattovich. “Natural history of hepatitis B”. The Journal of Hepatology, vol. 39, no. Suppl 1, pp. S50-S58, 2003.
 G. Raimondo, T. Pollicino and G. Squadrito. “Clinical virology of hepatitis B virus infection”. The Journal of Hepatology, vol. 39, no. Suppl 1, pp. S26-S30, 2003.
 M. G. Peters. “Hepatitis B virus infection: What is current and new”. Topics in Antiviral Medicine, vol. 26, no. 4, pp. 112-116, 2019.
 S. K. K. Mani and O. Andrisani. “Hepatitis B virus-associated hepatocellular carcinoma and hepatic cancer stem cells”. Genes (Basel), vol. 9, no. 3, p. 137, 2018.
 X. Liu, A. Baecker, M. Wu, J. Y. Zhou, J. Yang, R. Q. Han, P. H. Wang, Z. Y. Jin, A. M. Liu, X. Gu, X. F. Zhang, X. S. Wang, M. Su, X. Hu, Z. Sun, G. Li, L. Mu, N. He, L. Li, J. K. Zhao and Z. F. Zhang. “Interaction between tobacco smoking and hepatitis B virus infection on the risk of liver cancer in a Chinese population”. International Journal of Cancer, vol. 142, no. 8, pp. 1560-1567, 2018.
 C. Seeger and W. S. Mason. “Molecular biology of hepatitis B virus infection”. Virology, vol. 479-480, pp. 672-686, 2015.
 J. E. Song and D. Y. Kim. “Diagnosis of hepatitis B”. The Annals of Translational Medicines, vol. 4, no. 18, p. 338, 2016.
 World Health Organization. “Hepatitis B”. World Health Organization, Geneva, 2017.
 M. Asad, F. Ahmed, H. Zafar, S. Farman. “Frequency and determinants of Hepatitis B and C virus in general population of Farash Town, Islamabad”. Pakistan Journal of Medical Sciences, vol. 31, no. 6, pp. 1394-1398, 2015.
 S. A. Hama and M. I. Sawa. “Prevalence of hepatitis B, C, and D among thalassemia patients in sulaimani governorate”. Kurdistan Journal of Applied Research, vol. 2, no. 2. pp. 137-142, 2017.
 S. A. Hama. “Hepatitis C seropositivity and RNA detection among Type2 diabetic patients in sulaimani governorate-Iraqi Kurdistan Region”. Journal of Zankoy Sulaimani A, vol. 18, no. 4, pp. 1-8, 2016.
 Z. Nokhodian, M. R. Yazdani, M. Yaran, P. Shoaei, M. Mirian, B. Ataei, A. Babak, M. Ataie. “Prevalence and risk factors of HIV, syphilis, hepatitis B and C among female prisoners in Isfahan, Iran”. Hepatitis Monthly, vol. 12, pp. 442-447, 2012.
 L. Gétaz, A. Casillas, C. A. Siegrist, F. Chappuis, G. Togni, N. T. Tran, S. Baggio, F. Negro, J. M. Gaspoz and H. Wolff. “Hepatitis B prevalence, risk factors, infection awareness and disease knowledge among inmates: A cross-sectionalstudy in Switzerland’s largest pre-trial prison”. Journal of Global Health, vol. 8, no. 2, pp. 020407, 2018.
 J. J. Ott, G. A. Stevens, S. T. Wiersma. “The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions. BMC Infectious Diseases, vol. 12, p. 131, 2012.
 P. S. Hoya, A. Marco, J. García-Guerrero, A. Rivera. “Hepatitis C and B prevalence in Spanish prisons”. European Journal of Clinical Microbiology and Infectious Diseases, vol. 30, pp. pp. 857-862, 2011.
 S. Babudieri, B. Longo, L. Sarmati, et al. “Correlates of HIV, HBV, and HCV Infections in a prison inmate population: results from a multicentre study in Italy”. Journal of Medical Virology, vol. 76, pp. 311-317, 2005.
 J. M. Reekie, M. H. Levy, A. H. Richards, et al. “Trends in prevalence of HIV infection, hepatitis B and hepatitis C among Australian prisoners 2004, 2007, 2010”. MJA, vol. 200, pp. 277- 280, 2014.
 A. C. Stief, R. M. Martins, S. M. Andrade, M. A. Pompilio, S. M. Fernandes, P. G. Murat, G. J. Mousquer, S. A. Teles, G. R. Camolez, R. B. L. Francisco and A. R. C. Motta-Castro. “Seroprevalence of hepatitis B virus infection and associated factors among prison inmates in state of Mato Grosso do Sul. Brazil”. Revista da Sociedade Brasileira de Medicina Tropical, vol. 43, no. 5, pp. 512-515.
 F. J. Souto. “Distribution of hepatitis B infection in Brazil: The epidemiological situation at the beginning of the 21st century”. Revista da Sociedade Brasileira de Medicina Tropical, vol. 49, pp. 11-23, 2016.
 J. Paoli, A. C. Wortmann, M. G. Klein, V. R. Z. Pereira, A. M. Cirolini, B. A. de Godoy, N. J. R. Fagundes, J. M. Wolf, V. R. Lunge and D. Simon. “HBV epidemiology and genetic diversity in an area of high prevalence of hepatitis B in Southern Brazil”. The Brazilian Journal of Infectious Diseases, vol. 22, no. 4, pp. 294-304, 2018.
 P. F. Belaunzaran-Zamudio, J. L. Mosqueda-Gomez, A. Macias- Hernandez, S. Rodríguez-Ramírez, J. Sierra-Madero and C. Beyrer. Burden of HIV, syphilis, and hepatitis B and C among inmates in a prison state system in Mexico. AIDS Research and Human Retroviruses, vol. 33, no. 6, pp. 524-533, 2017.
 M. A. A. Al Kasem, M. Al-Kebsi Abbas, M. M. Ebtihal and A. A. S. Hassan. “Hepatitis B virus among dental clinic workers and the risk factors contributing for its infection”. Journal of Dentistry and Oral Health, vol. 1, no. 2, ???, 2018.
 F. Mathai, M. O. Ngayo, S. M. Karanja, A. Kalebi and R. Lihana. “Correlation of quantitative assay of HBsAg and hepatitis B virus DNA levels among chronic HBV patients attending pathologist lancet laboratory in Nairobi, Kenya”. Archives of Clinical Infectious Diseases, vol. 12, no. 4, pp. e13306, 2017.
 M. Gencay, A. Seffner, S. Pabinger, J. Gautier, P. Gohl, M. Weizenegger, D. Neofytos, R. Batrla, A. Woeste, H. S. Kim, G. Westergaard, C. Reinsch, E. Brill, P. T. T. Thuy, B. H. Hoang, M. Sonderup, C. W. Spearman, G. Brancaccio, M. Fasano, G. B. Gaeta, T. Santantonio and W. E. Kaminski. “Detection of in vivo hepatitis B virus surface antigen mutations a comparison of four routine screening assays”. Journal of Viral Hepatitis, vol. 25, no. 10, pp. 1132-1138, 2018.
 H. J. Lee, S. Y. Kim, S. M. Lee, J. Heo, H. H. Kim and C. L. Chang. “Elecsys hepatitis B surface antigen quantitative assay: Performance evaluation and correlation with hepatitis B virus DNA during 96 weeks of follow-up in chronic hepatitis B patients”. Annals of Laboratory Medicine, vol. 32, no. 6, pp. 420-425, 2012.