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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2015; 21(38): 10714-10720
Published online Oct 14, 2015. doi: 10.3748/wjg.v21.i38.10714
Hepatitis B virus infection in Indonesia
Yoshihiko Yano, Takako Utsumi, Maria Inge Lusida, Yoshitake Hayashi
Yoshihiko Yano, Takako Utsumi, Yoshitake Hayashi, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Takako Utsumi, Maria Inge Lusida, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya 60115, Indonesia
Author contributions: All the authors made a substantial contribution to the conception and design of the study, data acquisition, and to drafting and critically revising the manuscript; the authors approved the final version.
Supported by Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) program from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takako Utsumi, PhD, Center for Infectious Diseases, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. tutsumi@people.kobe-u.ac.jp
Telephone: +81-78-3825700 Fax: +81-78-3825719
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: June 23, 2015
Revised: July 14, 2015
Accepted: September 15, 2015
Article in press: September 15, 2015
Published online: October 14, 2015
Abstract

Approximately 240 million people are chronically infected with hepatitis B virus (HBV), 75% of whom reside in Asia. Approximately 600000 of infected patients die each year due to HBV-related diseases or hepatocellular carcinoma (HCC). The endemicity of hepatitis surface antigen in Indonesia is intermediate to high with a geographical difference. The risk of HBV infection is high in hemodialysis (HD) patients, men having sex with men, and health care workers. Occult HBV infection has been detected in various groups such as blood donors, HD patients, and HIV-infected individuals and children. The most common HBV subgenotype in Indonesia is B3 followed by C1. Various novel subgenotypes of HBV have been identified throughout Indonesia, with the novel HBV subgenotypes C6-C16 and D6 being successfully isolated. Although a number of HBV subgenotypes have been discovered in Indonesia, genotype-related pathogenicity has not yet been elucidated in detail. Therefore, genotype-related differences in the prognosis of liver disease and their effects on treatments need to be determined. A previous study conducted in Indonesia revealed that hepatic steatosis was associated with disease progression. Pre-S2 mutations and mutations at C1638T and T1753V in HBV/B3 have been associated with advanced liver diseases including HCC. However, drug resistance to lamivudine, which is prominent in Indonesia, remains obscure. Although the number of studies on HBV in Indonesia has been increasing, adequate databases on HBV infection are limited. We herein provided an overview of the epidemiology and clinical characteristics of HBV infection in Indonesia.

Keywords: Hepatitis B virus, Epidemiology, Prevention, Clinical characteristics, Indonesia

Core tip: Hepatitis B virus (HBV) infection is an important public concern and its prevalence varies greatly in different parts of the world. The high prevalence of HBV in Indonesia highlights the need to improve prevention and control measures because few evidence-based prevention strategies are currently available. Although studies on HBV in Indonesia are increasing, it is still not fully understood. We herein reviewed epidemiologically important aspects of HBV infection in Indonesia.