Hepatology research : the official journal of the Japan Society of Hepatology · 2025
Population-Based Molecular Surveillance of Hepatitis B Virus Genotypes in the Goto Islands, Japan: A Three Decade Study (1977-2008) of 916 Carriers.
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Ko Ko, Ataa Golda Akuffo, Yamasaki Kazumi, Hirase Kazuhiro, Yasaka Takahiro, Shirahama Satoshi, Akita Tomoyuki, Sugiyama Aya, Fukuma Shingo, Takahashi Kazuaki, Tanaka Junko
Аннотация
AIMS: Understanding the molecular characteristics and genotype distribution of hepatitis B virus (HBV) is essential to elucidate intra and inter community transmission routes, identify cluster cases, and assess clinical implications based on genotype-specific virulence. This study aimed to investigate HBV genotype distribution in a geographically isolated Japanese islands with high HBV endemicity.
METHODS: From 1977 to 2008, all 34,136 residents of the Kamigoto area in the Goto Islands were screened for HBsAg, identifying 1474 positive cases (4.3%). Among them, 916 stocked serum samples with sufficient volume were randomly selected. HBV DNA levels were quantified using real-time PCR. Genotyping was carried out through nested PCR targeting the overlapping surface-polymerase or surface gene, followed by phylogenetic analysis. Full genome sequencing was conducted on 23 randomly selected samples to identify sub-genotypes.
RESULTS: HBV DNA was detected in 82.9% of participants. Genotyping was successful in 81.8%, revealing predominant genotype C (96.5%), followed by genotypes B (3.1%) and A (0.4%). Phylogenetic analysis identified multiple genotype C clusters, suggesting intra-community transmission. Full genome sequencing confirmed sub-genotypes C2 and B1, closely related to Japanese reference strains. HBV DNA levels were significantly higher in younger age groups (p < 0.0001), with no sex difference.
CONCLUSION: This study presents rare population-based molecular evidence of sustained HBV genotype C2 endemicity and intra-community transmission within a defined setting. The findings underscore clinical significance of implementing targeted area- and population-specific strategies including early detection through screening, linkage to care, vaccination, and long-term surveillance, as an effective model for HBV micro-elimination in high-burden communities.
METHODS: From 1977 to 2008, all 34,136 residents of the Kamigoto area in the Goto Islands were screened for HBsAg, identifying 1474 positive cases (4.3%). Among them, 916 stocked serum samples with sufficient volume were randomly selected. HBV DNA levels were quantified using real-time PCR. Genotyping was carried out through nested PCR targeting the overlapping surface-polymerase or surface gene, followed by phylogenetic analysis. Full genome sequencing was conducted on 23 randomly selected samples to identify sub-genotypes.
RESULTS: HBV DNA was detected in 82.9% of participants. Genotyping was successful in 81.8%, revealing predominant genotype C (96.5%), followed by genotypes B (3.1%) and A (0.4%). Phylogenetic analysis identified multiple genotype C clusters, suggesting intra-community transmission. Full genome sequencing confirmed sub-genotypes C2 and B1, closely related to Japanese reference strains. HBV DNA levels were significantly higher in younger age groups (p < 0.0001), with no sex difference.
CONCLUSION: This study presents rare population-based molecular evidence of sustained HBV genotype C2 endemicity and intra-community transmission within a defined setting. The findings underscore clinical significance of implementing targeted area- and population-specific strategies including early detection through screening, linkage to care, vaccination, and long-term surveillance, as an effective model for HBV micro-elimination in high-burden communities.