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Molecular analysis of the interspousal transmission of hepatitis B virus in two Japanese patients who acquired fulminant hepatitis B after 50 and 49 years of marriage
Author(s) -
Okamoto Daisuke,
Nakayama Haruo,
Ikeda Tomoyuki,
Ikeya Shinichi,
Nagashima Shigeo,
Takahashi Masaharu,
Sugai Yoshiki,
Okamoto Hiroaki
Publication year - 2014
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24040
Subject(s) - fulminant hepatitis , virology , fulminant , hepatitis b virus , genotype , sexual transmission , transmission (telecommunications) , medicine , hepatitis b , biology , virus , immunology , gene , genetics , microbicide , human immunodeficiency virus (hiv) , electrical engineering , engineering
A 71‐year‐old (C1I) and 69‐year‐old (C2I) Japanese female contracted fulminant hepatitis B after 50 and 49 years of marriage, respectively. Both index cases exhibited high levels of anti‐HBc IgM antibodies (24.2 and 31.5 S/CO, respectively), suggestive of acute hepatitis B virus (HBV) infection, although they had no discernible risk factors for HBV infection, except for chronically HBV‐infected spouses with detectable HBV DNA (3.3 log copies/ml [C1S: 72‐year‐old] and 7.2 log copies/ml [C2S: 71‐year‐old]). The HBV genotype/subgenotype was identical in each couple (B/B1 or C/C2). The HBV isolates from the index cases and spouses shared a nucleotide sequence identity of 99.5% and 99.7%, respectively, over the entire genome, and these four isolates had the highest nucleotide sequence identity of only 97% to HBV isolates deposited in DNA databases. Phylogenetic trees confirmed a close relationship of the HBV isolates between C1I and C1S and between C2I and C2S, supported by a high bootstrap value of 100% within each couple, indicating the transfer of HBV infection between spouses. These four isolates shared a precore mutation of G1896A known to be associated with fulminant hepatitis B. Although the history of sexual contact within a reasonable incubation period was obscure for one stable, monogamous couple (C1I and C1S), the other couple had a monogamous sexual relationship within six months prior to disease onset. This study indicates that two elderly Japanese patients with fulminant hepatitis B acquired HBV infection via interspousal (most likely sexual) transmission during long‐lasting marriages. J. Med. Virol. 86:1851–1860, 2014 . © 2014 Wiley Periodicals, Inc.