International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Seminar Infection Diseases in Arctic

Greenland is considered a high- to intermediate-risk area of hepatitis B infection. Most transmission of hepatitis B virus (HBV) in Greenland takes place before the age of 20 years. We investigated a cohort exposed to HBV 3-5 decades ago. Aims: 1) To determine the prevalence of HBV infection present and past in relation to participant demographics; 2) To determine the prevalence of HBV genotypes and pre-core mutations and HBV-DNA levels.

Materials and methods: Participants were Inuit men (n=229) and women (n=205) aged 50-69 years, living in the Capital Nuuk in Westgreenland, Tasiilaq, the major town, and four settlements in Eastgreenland, representing three different levels of westernization. A physical examination was done and a blood sample taken. Heatitis serologi was done on an Abbott AxsymTM System and quantitative HBV-DNA, pre-core mutation and HBV genotypes were analysed using in-house real-time PCR methods. Results: The participation rate was 96%. Median age was 58 years with no gender difference. None had signs of liver disease. HBsAg was positive in 88 (20.4%) and negative in 343 (79.6%) with fewer positive in the city in Westgreenland than in rural Eastgreenland (6 vs. 82; 4% vs. 28.9%; pO.OOl) without difference between Eastgreenland town and settlements (40 vs. 42; 28.6% vs. 29.4%; p=0.88). More men than women were HBsAg positive (60 vs. 28; 26,4% vs. 13.7%; p=0.001). Among the 88 HBsAg positive, 85 were anti-HBe positive. Among the 343 HBsAg negative, 242 (56.1%) were anti-HBc and/or anti-HBs positive, 30 of these were anti-HBs positive only. Hence, only 101 (23.4%) had no serological sign of HBV exposure. HBV-DNA was negative in 27 and positive in 61 of the HBsAg positive. Median HBV-DNA was 40,000 copies/mL (10; 90 percentiles: 1,000; 404,000 copies/mL). Pre-core mutation analysis was feasible in 56 Inuit, of which 55 had pre-core mutation, G1896A, while 1 had wild type. Genotype could be determined in 52 Inuit, of which 47 had HBV genotype B, 4 genotype D, and 1 both genotype B and D.

Conclusion: The validity of the study was strengthened by the high participation rate. More than 75% had or had had hepatitis B. HBV genotype B with pre-core mutation was predominating and HBV viral load was generally low. Being HBsAg positive did not associate with westernization. Interestingly, hepatitis B infection, genotype B, with pre-core mutation, appears to be an indolent disease in Inuit in Greenland,

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)