An outbreak of hepatitis B with high mortality in India: association with precore, basal core promoter mutants and improperly sterilized syringes.

摘要: In 2009, an outbreak of hepatitis B with high mortality was observed in Sabarkantha district, Gujarat state, India 456 cases and 89 deaths. Hospitalized patients self-limiting disease (152, AVH)) fulminant hepatic failure (39, FHF including 27 fatal 12 survivals) were investigated. These screened for diagnostic markers viruses, virus (HBV) genotyping mutant analysis. Complete HBV genomes from 22 17 AVH sequenced. Serosurveys carried out the most least affected blocks prevalence identification mutants. History injection a physician associated cases. Co-infection other viruses or higher DNA load not responsible mortality. Four contributed to 85.7% (391/456) 95.5% (85/89) while two adjacent had negligible Sequence analysis showed presence pre-core basal core promoter mutants 4 amino acid substitutions exclusively among None exhibited these dual mutations. Genotype D predominant, D1 being present all D2 prevalent Probably due violation accepted infection control procedures by qualified medical practitioners, before outbreak. Gross continued use contaminated (mutant wild viruses) devices led explosive striking association pre-C/BCP genotype.